Title : Status of oxygen supply and delivery system in health facilities of Nepal: Mixed method study
Abstract:
Background: Oxygen therapy is a lifesaving intervention, particularly for newborns and children suffering from hypoxemia due to respiratory illnesses. However, access to reliable oxygen supply and appropriate pediatric delivery equipment remains a critical challenge across health facilities in Nepal.
Objective: To assess the availability, functionality, and utilization of oxygen and its supply systems, with a particular focus on newborn and pediatric oxygen delivery equipment across various levels of health facilities in Nepal.
Methods: A cross-sectional mixed-methods study was conducted in 50 health facilities representing primary, secondary, and tertiary levels. Quantitative assessments evaluated infrastructure related to oxygen sources, delivery devices, and maintenance systems. Qualitative data were collected through in-depth interviews and key informant discussions with healthcare providers and facility managers to explore practical challenges and contextual factors influencing oxygen use.
Results: Among 50 health facilities, 86% had oxygen cylinders, but only 52% were functional. Oxygen concentrators were available in 38% of facilities, with only 60% in regular use. While 64% could provide oxygen to newborns, only 42% ensured uninterrupted supply in NICUs. Pulse oximeters were present in 56% of facilities, and only 48% of staff had received oxygen-use training. Qualitative insights highlighted frequent stockouts, delayed refills, lack of trained technicians, and poor monitoring. Weak supply chains, limited accountability, and absence of real-time data further hindered effective oxygen delivery.
Conclusion: Strengthening oxygen systems especially in lower-tier facilities is essential for equitable, timely, and effective pediatric care, and must be integrated into Nepal’s broader MNCH and health system reform strategies.
