Exploring the Role of ‘Outsourced Oxygen-to-the-Bedside’ in Expanding Oxygen Access for Patients

Setting: up sustainable oxygen systems within a health facility is complex. In this paper, we propose a conceptualisation of a particular delivery model that takes a broader approach than the traditional oxygen procurement and delivery – ‘Outsourced Oxygen-to-the-Bedside’ (O2B). We explore its potential strengths and limitations using early learnings from five pilot projects in India, Kenya, Tanzania, Nigeria and Uganda. O2B models involve oxygen supply services provided by external entities that provide a minimum set of oxygen supply equipment, alongside bundles of repair, maintenance and training, and are contracted to guarantee continuous medical oxygen supply to the bedside. This market-based approach may be particularly suitable for smaller rural facilities that have limited options and capacity. Envisioned benefits of this model are the reduced mental load on facilities to manage their oxygen and distribution arrangements, whilst building local skills and knowledge to increase equipment functionality, longevity, and oxygen availability. O2B providers currently offer different variations of this service, but in all cases their main value proposition is to make oxygen access easier for facilities. Potential risks include fragmentation of existing oxygen supply solutions, and difficulties in balancing business sustainability with affordable pricing - particularly to small and under-resourced facilities. Relying on financing from individual facilities is unlikely to succeed in most contexts – particularly for poorer hard-to-reach communities. Therefore, future evaluations should focus on long-term funding solutions and cost-effectiveness of different service bundles to determine best value for money in different contexts .