Oxygen therapy for newborn, child, and maternal health

Increasing access to oxygen through normative policy change

PATH is implementing a comprehensive approach to increase access to oxygen in low- and middle-income countries, including supporting normative policy change by the World Health Organization (WHO), helping strengthen markets for oxygen concentrators and pulse oximeters, raising awareness about the importance of oxygen through its HO2PE: Oxygen Gives Life campaign, partnering with the United for Oxygen alliance, and developing a suite of evidence-based materials to help advocates and policymakers drive change at the national level.

Evidence-based advocacy

PATH, in collaboration with national and international maternal, newborn, and child health partners, has developed Oxygen Is Essential: A Policy and Advocacy Primer—a resource to help advocates and decision-makers understand the need for strengthening oxygen delivery systems and how it can be done, even with limited resources. The primer provides materials intended to help advocates and decision-makers understand the planning, policies, and technologies involved in oxygen delivery scale-up.

Additional listing for oxygen on the WHO EML

In collaboration with partners and expert advisers, PATH petitioned the WHO Model List of Essential Medicines (EML) secretariat to include an additional listing of oxygen as a medical gas, extending its use for the management of hypoxemia. Hypoxemia, or dangerously low levels of oxygen in the blood, can be fatal without oxygen therapy. Without oxygen, it would be next to impossible to treat hypoxemia resulting from conditions such as pneumonia, which is the leading cause of mortality in children under five.

Previously, oxygen was listed only for use as an inhalational medicine in general anesthesia on the EML and EML for Children (EMLc). PATH reviewed the national essential medicines lists of 105 countries and found that approximately a third (31 percent) did not include oxygen and roughly half (48 percent) listed oxygen only by anesthetic indication.

On June 7, 2017, PATH hailed WHO’s landmark decision to include a new indication for oxygen in its EML and EMLc (both lists are available here), identifying oxygen as a medicine essential for the management of hypoxemia. This change clarifies oxygen’s importance as a medical treatment that should be widely available in health facilities everywhere. Ensuring such global endorsement and normative guidance for the broader applications of oxygen may foster a more enabling environment for oxygen delivery at the national level.

Reliable provision of oxygen therapy and accurate identification of hypoxemia is essential in reducing mortality. Identifying barriers to access and ensuring inclusion of oxygen and pulse oximetry in current normative policies, treatment guidelines, health budgeting, and system infrastructure (e.g. maintenance and supply chain management) are key to improving oxygen availability.