The Oxygen Plant-in-a-Box: Innovation drives a key response to COVID-19

The COVID-19 pandemic led to intense global demand for medical-grade oxygen. In response, UNICEF worked with industry to rapidly develop an innovative – and life-saving – emergency solution, the Oxygen Plant-in-a-Box.

In the room there is an oxygen-in-a-box installation and oxygen tanks
03 March 2022

For patients with severe COVID-19, as much as for sick newborns and children with pneumonia, access to oxygen can be the difference between life and death. Globally, around 700,000 children under five die of pneumonia every year.  

Before COVID-19, oxygen was rarely available in low- and middle-income countries outside capital cities or private hospitals. The pandemic turned this gap into a crisis. As health systems became overwhelmed, medical staff were forced to choose which patients would receive limited oxygen supplies and which would not.  

In response, UNICEF set to work with industry partners on an innovative emergency solution: The Oxygen Plant-in-a-Box package. The package includes everything needed to install and operate a fully functional pressure swing adsorption (PSA) oxygen plant within days of arriving at a health facility. The device can produce enough oxygen to treat up to 50 COVID-19 patients, or 100 children with severe pneumonia.   

The innovation transformed rapidly from idea to reality. A long-term agreement was in place in a matter of months, and in mid-December 2021, patients at the Soroti Regional Referral Hospital in Uganda were the first to receive life-saving oxygen from a UNICEF Oxygen Plant-in-a-Box. By the end of the year, over 16 other countries were in the process of ordering this innovative product to respond to COVID-19 and strengthen health systems for the long-term.  

500 pieces of equipment and accessories

The procurement and installation of standard oxygen plants is a highly complex and technical process. Most plants are custom-ordered to suit the needs of each individual facility. This results in long lead times in designing, ordering and installing the equipment. 

To simplify the process, UNICEF worked with suppliers to design a series of standardized small, medium and large plant packages, with competitive long-term agreements to reduce price. The large plant packages comprise more than 500 different pieces of equipment and accessories, including oxygen generators, cylinders, humidifiers and trolleys. 

Critically, the equipment needed to be robust, capable of operating in high heat and altitudes, and able to withstand electrical voltage fluctuations that are common in the challenging environments where UNICEF works.  

By using an innovative approach to standardize the procurement of PSA plants and enable short-term prepositioning, UNICEF has been able to shorten lead times from up to 16 to just two weeks in some cases. If a country faces a sudden surge of COVID-19 cases or another health emergency, a plant can be delivered by air freight and operational within four weeks.  

Key to the success of the project has been the technical support provided by UNICEF Supply Division to guide countries in preparing health facilities for plant installation. 

A COVID-19 patient at the hospital in Uganda
Medical staff attend a COVID-19 patient at the Soroti Regional Referral Hospital, Uganda. A week earlier, the first UNICEF Oxygen Plant-in-a-Box was switched on, providing the hospital with the life-saving medical gas needed to treat patients.

Building stronger health systems

While improving access to therapeutic oxygen remains critical to UNICEF's response to the COVID-19 pandemic, it also serves broader goals of strengthening health systems and improving child survival from pneumonia and other treatable diseases.  

To that end, the UNICEF Oxygen Plant-in-a-Box package has been carefully designed to ensure sustainability. While all plants include cylinder filling stations, which allow for the immediate delivery of oxygen, they also include the necessary equipment to connect to a permanent ward piping system if or when one is available. Spare parts and maintenance kits are part of the package. So are two years of preventative maintenance service visits by the manufacturer’s in-country partner along with 24/7 remote support. 

In this way, the investments made in medical oxygen in response to COVID-19 will continue to save thousands of children’s lives long into the future. 

UNICEF staff inspects a UNICEF Oxygen Plant-in-a-Box in Soroti Regional Referral Hospital, Uganda.
A UNICEF Oxygen Plant-in-a-Box in Soroti Regional Referral Hospital, Uganda.

Finding new solutions to deliver oxygen

UNICEF is driving the development of innovative oxygen products to ensure this life-saving medical gas is available to those who need it most, no matter where they live.