Delivering quality medical oxygen in Nigeria and Uganda – evaluating impact at scale

Oxygen is an essential and life-saving medicine.

The COVID-19 pandemic highlighted and exacerbated an existing global oxygen crisis, with pervasive inequities in the availability of quality oxygen services.

Research into oxygen access was ranked as the highest cross-cutting priority for maternal, neonatal, and child health in recent consensus exercises, and this evidence gaps has been recognised by National Governments in a 2023 draft World Health Assembly Resolution on Oxygen Access.The purpose of our study is to provide evidence on how medical oxygen services can effectively be delivered and maintained at scale, ultimately leading to improved survival.

This will be addressed through five objectives:Determine the impact of medical oxygen systems strengthening interventions on clinical practiceDetermine the impact of medical oxygen systems strengthening interventions on mortalityUnderstand the bottlenecks, challenges, and opportunities of improved medical oxygen services from a range of stakeholder perspectivesExplore how, why, and for whom oxygen systems strengthening efforts work, and whether there are unintended effectsEstablish best-practice recommendations through cross-country learningWe will address these through two studies in Nigeria and Uganda, covering an estimated 50 million people: 1) estimating oxygen impact at scale through quasi-experimental analyses; 2) understanding mechanisms and processes for impact using a realist mixed-methods evaluation.