Innovating to improve access to and availability of medical O2 in Uganda

Newly published results on the impact of solar-powered O2 on mortality among children and a new study to develop a clinical algorithm (Smart O2) that guides health workers on oxygen titration based on continuous pulse oximetry monitoring .
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​Each year, an estimated 7 million children with hypoxemic pneumonia are admitted to LMIC hospitals needing medical oxygen therapy, yet in many settings only one in five actually receive it. Supplemental oxygen (O2) therapy is a critical intervention, yet access remains inconsistent due to cost and logistical challenges. Traditional O2 delivery methods, such as compressed O2 cylinders and O2 concentrators, face obstacles like high transportation costs and unreliable electricity.

In 2013, Michael Hawkes and his team conceived the idea of solar-powered oxygen systems to help prevent the significant pneumonia deaths in children worldwide, primarily in Africa and Asia. By 2016, in collaboration with Global Health Uganda, they had installed the first solar-powered oxygen systems in two Ugandan hospitals for testing. After confirming their reliability, safety, and effectiveness, the team expanded the project to 20 hospital sites across Uganda.

Recently published in The Lancet, the results of their stepped-wedge, cluster randomized controlled trial highlight the impact of solar-powered O2 on mortality among children under 5 with hypoxaemic illnesses. Conducted from June 2019 to November 2021, the trial spanned 20 health facilities with unreliable traditional O2 supplies. The solar O2 systems, comprising photovoltaic cells, battery banks, and O2 concentrators, were installed sequentially at these sites.

The findings revealed a significant decrease in 48-hour mortality rates from 5.1% to 2.9% post-installation, representing a 48.7% relative risk reduction. Oxygen use increased dramatically from 50.2% to 98.8% following the intervention. The study emphasizes the cost-effectiveness and life-saving potential of solar-powered O2, positioning it as a viable solution for addressing O2 access challenges in low and middle-income countries (LMICs).

In 2024, teams at the Institute for Global Health at BC Children's Hospital and BC Women's Hospital + Health Centre and Holy Innocents Children's Hospital in Uganda began recruitment for a new study - Smart O2. This study aims to develop a clinical algorithm (Smart O2) and decision support system that guides health workers on oxygen titration based on continuous pulse oximetry monitoring to ensure more efficient oxygen use and prevent waste of this precious resource.


 
 
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