Design, implementation and outcomes of a national oxygen distribution network in Lesotho

Despite its essential and life-saving role in the treatment of many medical conditions, access to medical oxygen remains limited in many countries. In 2021, Partners In Health established an oxygen distribution network in Lesotho to increase medical oxygen access.

We conducted an observational study reporting on the design, implementation, and outcomes of a national oxygen distribution network in Lesotho from November 2022 through January 2024. Oxygen delivery data were abstracted from tracking logs and analysed in Stata. Continuous and ordinal variables were summarised by medians and ranges. Categorical variables were described using frequencies and proportions.

Over the 15 month study period, the network expanded from one oxygen production hub serving five recipients to four hubs and 21 recipients located across nine of Lesotho's 10 districts. The network delivered 1565 filled cylinders containing 9619.23 m³ oxygen, enough to treat 601 patients. For the 13 recipients with inpatient beds, the median monthly volume of oxygen delivered per bed was 1.43 m³ (IQR: 0.57 to 2.31).

This study demonstrates the feasibility of an oxygen distribution network in Lesotho, providing proof-of-concept for an intervention to improve oxygen access in low- and middle-income countries. By employing real-time monitoring and redundant sourcing, the network provided a reliable oxygen supply responsive to variations in demand and periods of oxygen plant downtime. This study also provides insights into facility-level oxygen consumption, which may help policymakers improve quantification and prediction of oxygen demand. Future efforts should focus on enhancing data collection, characterising oxygen usage and strengthening infrastructure to promote sustainable oxygen security.