A rapid facility-level assessment of oxygen systems in 39 low-income and middle-income countries: a cross-sectional study.

Summary

Among 2,884 facilities in 39 LMICs, reliable oxygen availability was low: 24.5% of primary, 52.4% of secondary, and 66.8% of tertiary facilities. Functional gaps spanned sources, distribution, delivery, monitoring, and QA, with significant disparities across regions.

Key Findings

• Reliable oxygen availability: 24.5% (primary), 52.4% (secondary), 66.8% (tertiary) across 2,884 facilities.
• Functional availability of key components (sources, piping, delivery devices, oximetry, QA) varied widely with significant regional disparities.
• Findings indicate urgent need for targeted investments to close system gaps.

Clinical Implications

Programs should prioritize reliable oxygen sources, bedside pulse oximetry, distribution infrastructure, and QA/maintenance, especially in primary care. Results support oxygen-specific financing and implementation frameworks.

Limitations

• Cross-sectional design with purposive sampling may limit generalizability
• Self-reported elements and no direct patient outcome linkage

Future Directions

Link facility oxygen readiness to patient-level outcomes; evaluate cost-effective packages (source+oximetry+maintenance) and region-tailored implementation strategies.