Financial, Supply Limitations Challenge Jimma Hospital’s Services

New oxygen plant hoped to improve treatment capacity and reduce delivery delays

The leading teaching hospital in southwestern Ethiopia, Jimma University Medical Center continues to operate under significant budget constraints. Oxygen supply shortages caused by logistical delays have left the lives of critical patients in the balance, awaiting the completion of a donor-funded oxygen plant not scheduled to come online before 2026.

Speaking with The Reporter, Hunde Ahmed (MD), chief clinical director and pediatric specialist at the hospital, described how financial constraints and infrastructure gaps are threatening essential health services for hundreds of thousands of patients annually.

“Each year, we serve more than 220,000 outpatient visits, admit over 18,000 patients, and conduct over 10,000 surgeries,” he said. “The total number of services we provide reaches nearly 300,000 annually. The majority of our patients are critically ill and require oxygen support—but we currently don’t have a working oxygen plant.”

Instead, the hospital relies on oxygen supplies transported from Addis Ababa. But Hunde noted the delivery process is highly vulnerable to logistical delays, fuel shortages, and restricted night travel, often stretching deliveries to as long as three days.

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“Interruptions in oxygen supply can have significant, even fatal consequences for our patients, especially those in the intensive care unit who rely on mechanical ventilators that consume large amounts of oxygen, meeting this demand is difficult under current budget constraints,” he explained.

To address the recurring oxygen crisis, Jimma University Medical Center is constructing an on-site oxygen plant in collaboration with the Ministry of Health and international donors. The facility’s structural work is nearly complete, with installation expected to be finalized within the next four to five months.

“This project is expensive and heavily donor-funded,” said Hunde. “But once complete, we will produce our own oxygen and fully end our dependency on external suppliers. We expect to transition to internal production in the 2018 Ethiopian fiscal year.”

Until then, the hospital must continue navigating budgetary and logistical obstacles to maintain its oxygen supply chain.

Hunde noted that the hospital serves not only communities in southwestern Ethiopia, but also patients from across the border in Sudan and South Sudan.

“Illness knows no borders,” he said. “We serve all who come to us, and this requires a hospital with both infrastructure and sustainable operational funding.”

Yet the hospital’s financial structure  reflects a deeper institutional mismatch. While Jimma University Hospital reports its health performance to the Ministry of Health, its budget is allocated by the Ministry of Education—as part of the university system. This arrangement, Hunde argues, leaves hospital services critically underfunded.

“Our annual budget requirement exceeds one billion Birr. The funding we receive is not sufficient to cover staff salaries, procurement of essential medicines, or maintenance,” he said. “We’ve only managed to survive this far because of support from development partners.”

Despite the financial hurdles, the hospital recently cleared all of its debts, including long-overdue staff overtime payments and supplier arrears.

According to documents obtained by The Reporter from the Ministry of Finance, Jimma University received a total of 2.1 billion Birr, including 550 million Birr in capital budget, in funding over the just-ended financial year.

For 2025/26, the figure has risen to 3.47 billion Birr, with 800 million Birr earmarked for capital expenditures.

But hospital officials insist the increase still falls short of what is needed to sustain full operations. The facility’s wide-ranging services, from critical care to surgery and training of medical students, require more than routine annual budgetary increments.

“We have the technical expertise, the infrastructure, and the human resource,” Hunde emphasized. “What we lack is consistent financial and equipment support to serve the community at scale. Given our wide range of services, the current budget is not adequate. We need additional financial, technical, and equipment support to continue serving the broad public.”

As Jimma Hospital races to finalize its oxygen plant, hospital leadership says systemic reforms in budgeting and supply chain logistics will be essential—not just to survive, but to deliver quality healthcare to the region and beyond.