Oxygen delivery toolkit: Resources to plan and scale medical oxygen

Reasons for this are many, including limited data, perceptions about costs, poor understanding of the impact on health outcomes, and the complexity of integration and maintenance across the health system all contribute to decreased access. Scaling up access to oxygen is one of the most effective and critical actions decision-makers can take to improve health outcomes and save lives.

This Oxygen Delivery Toolkit: Resources to plan and scale medical oxygen provides materials to help decision-makers, implementers, and advocates plan, manage, and communicate the value of scaling up oxygen delivery systems and access to oxygen and pulse oximetry.

Decision-makers: People with the authority to make improved access to oxygen delivery systems a reality through supportive policymaking and implementation—including funding, regulations, and laws. Examples: Representatives of funding or regulatory bodies, officials from the ministry of health or finance, parliamentarians, regional health leaders, district health committee members, among others.

Implementers: People with the authority to organize action plans and necessary resources, and put them into practice. Examples: Health facility managers, procurement teams, ministry of health or finance officials, among others.

Advocates: Anyone aiming to increase access to oxygen delivery systems by influencing decision-makers to act in support of this goal. Examples: Civil society representatives, technical experts, academia, community members, religious and community leaders, among others.

To help navigate the toolkit, two reports offer guidance:

Oxygen Delivery Toolkit User Guide provides orientation to the toolkit resources and intended users

Optimizing Oxygen Access and Reliability report outlines recommended activities and decision points within key areas of engagement for scaling safe oxygen access, as well as how the toolkit resources could be applied.

Note: The initial set of the toolkit resources is provided below. We are continuing to add other resources (marked as "coming soon") as they become available.

Oxygen is Essential: A Policy and Advocacy Primer: Scaling up access to oxygen is one of the most effective, and critical, actions decision-makers can take to improve health outcomes. The primer provides resources to help advocates and decision-makers understand the planning, policies, and technologies involved in oxygen delivery scale-up. The primer is available in English and French.

Health Facility Standards Guide: Health facility infrastructure and medical device standards documents (i.e., health facility standards) are a set of suggestions or recommended requirements for each health facility level, including guidelines for location, infrastructure, staffing, health services, and/or medical devices. The guide provides recommendations on how to create or improve high-quality, country-specific resources that outline health facility infrastructure and medical device requirements across different levels of the health system.

Baseline Assessment Manual: A complete understanding of the current availability of oxygen can enable precise identification of gaps within or across health facilities and streamline efforts to ensure accurate supply of needed oxygen delivery devices. The manual provides resources to carry out the training of those involved in conducting a baseline assessment of the current status of oxygen delivery systems and barriers to access, as well as tools to collect those data. It includes a ready-made digital survey tool for facility-level data collection of oxygen sources at all levels of the health system and within all wards in a facility at a cross section in time, and a training curriculum for data collectors (inclusive of a training PowerPoint presentation).

Consumption Tracking tool: Health facilities often lack a clear picture of the amount of oxygen that is being used across all patients. The tool is designed to help track daily oxygen use and, ultimately, inform future procurement planning. This tool helps health facilities compare oxygen consumption to the number of patients, by patient group, treated during a given time period.

Procurement Guide: An integrated and efficient procurement process is key to helping ensure that an appropriate, cost-effective, and sustainable oxygen delivery system is selected. The guide describes the key steps that should be followed when procuring and contracting for an oxygen delivery system.

Quantification and Costing Tools: It is important to be able to quantify the unmet need for medical devices before seeking to procure new ones. In addition, the price to procure medical devices is often viewed as only the initial capital expense to purchase it. However, medical devices incur operating costs over time. It is essential to understand the initial and long-term costs associated with different purchasing options in order to make informed procurement choices. The two tools are Excel-based resources that quantify the potential need for oxygen and pulse oximeters; based on these estimates of need, they calculate the anticipated costs over time for meeting this need with different device types.

Reference Pricing Guide (new!): Reference prices are an important safeguard against overcharging by device manufacturers and distributors; however, obtaining a reference price for a device can be challenging. It is often difficult to make like-to-like price comparisons between devices with different specifications, life spans, or order quantities. The guide presents a guiding framework for decision-making based on reference prices.

Electricity Planning Guide: Many essential medical devices require electricity to function; however, access to reliable electricity is still limited in numerous low- and middle-income countries. Besides power interruptions, voltage sags, surges, and other events of low-quality electricity can adversely affect the functionality of devices. The guide outlines recommendations for understanding the state of electricity access as well as methods for improving procurement and deployment of appropriate medical devices in environments where electricity challenges persist.

Asset Management Guide: Medical devices are an important health care investment, supporting effective treatment of a range of medical conditions across the life span. However, in many low- and middle-income countries, they quickly fall into disrepair due to poor management and maintenance over time. The guide offers resources to help track medical device upkeep and, over the long term, improve future procurement decisions.

Global Financing Facility Oxygen Investment Case Guide (new!): Oxygen therapy is essential to treat a broad range of diseases that affect multiple patient populations. However, government officials involved in the Global Financing Facility (GFF) process are often unaware of wide gaps in oxygen access or of its capacity to improve health outcomes, particularly for vulnerable populations such as pregnant women, newborns, and children. This guide provides practical approaches and actions that decision-makers and civil society groups can use throughout the GFF process to advocate for medical oxygen.

For questions or more information: oxygen@path.org.

To learn more about PATH's work in oxygen: Increasing Access to Safe Oxygen