Saving children’s lives with oxygen
An investment in 130 oxygen plants worldwide will help 400,000 children every year to breathe and recover from life-threatening conditions.
In Pakistan, one-year-old Muhammad Umar suffers from pneumonia, a condition that kills 700,000 children under five each year. He was admitted to the emergency ward where, for two days, he received oxygen to help him breathe while antibiotics fought the disease.
"My child was admitted to the emergency ward and placed on oxygen for two days. The doctor re-examined him later and said that his breathing has improved. Thank God."
In low- and middle-income countries like Pakistan, less than half of all health facilities have an uninterrupted medical oxygen supply which is crucial for the recovery of young children with life-threatening conditions. These facilities often rely on unstable methods, such as referring patients to distant hospitals that produce oxygen or transporting cylinders from the nearest plant — options that can be costly and located hundreds of kilometers away.
Umar is healthy today, healed from pneumonia, thanks to oxygen provided from a recently installed plant near his home.
An investment in over 130 oxygen plants worldwide
Since 2021, UNICEF has expanded its health programming to bring fully operational Pressure Swing Absorption (PSA) plants, which are systems that extract oxygen from the air, to locations in need. Amid the peak of the COVID-19 pandemic, UNICEF launched the Plant in a Box project which aims to install 130 plants in over 40 countries by 2025.
By early 2024, 57 plants have been set up in 21 countries, including the new plant in Charsada, Pakistan, where Umar lives.
Conquering complexities: The road to oxygen access
Oxygen plants are complex. They are challenging to deliver, to install, and to operate. UNICEF has collaborated with partners and governments to address these hurdles so that that children receive the oxygen they need to survive, with key actions illustrated below.
Close coordination for timely delivery
Transporting the delicate components required for oxygen plants, including generators, cylinders, and humidifiers, across vast distances and varied terrains presents logistical challenges. These components, often exceeding 500 pieces per plant, are not only bulky but also prone to damage and delays. This complexity requires detailed coordination with local authorities and service providers. In Uganda, thorough planning ensured smooth customs clearance and timely delivery of equipment.
Solar installations for uninterrupted power supply
In regions poorly equipped to support large electrical systems, producing oxygen is a major challenge. It is a process that involves compressing and purifying air to isolate oxygen, then storing and distributing it under pressure, all tasks that require a stable power supply. In Pakistan, solar panels are ensuring that newly installed oxygen plants have a continued energy source, in addition to supporting several other health facility needs.
Technical assistance to prepare sites for plant installation
Each country adopts a unique approach to identify the most suitable locations for oxygen plants, typically within or adjacent to large health facilities. However, these sites often face challenges such as limited space or adverse climate conditions, which can disrupt a steady oxygen supply. For instance, in Guinea, inflation caused the construction company to suspend work due to insufficient funds to cover rising expenses. UNICEF negotiated with the construction firm and government authorities, successfully agreeing on a revised cost structure.
Training of engineers and health workers
In many countries, the lack of oxygen plant engineers leads to skill shortages for operating such technology. Health workers also require training to administer the correct oxygen levels. Consequently, each plant installation includes training for biomedical engineers and healthcare workers, along with a comprehensive maintenance plan and spare parts. UNICEF also collaborates with partners to establish regional centers of excellence in biomedical engineering, ensuring technicians are available to maintain oxygen systems and other vital medical equipment.
Delivering through crises
Emergency situations present significant complications. In Sudan, the first-ever UNICEF-procured oxygen plants were set up just months before conflict broke out. Tragically, nearby conflict damaged hospital equipment and disrupted services. In response, UNICEF urgently relocated the oxygen plant equipment to a safe place, waiting for an appropriate time to resume operations and continuing to deliver life-saving supplies despite the crisis.
The impact of investing in oxygen plants
When all 130 plants become fully operational by 2025, they will provide essential oxygen therapy to an estimated 400,000 sick children with hypoxemia each year, and access to oxygen for millions. This includes the facility near Umar’s home in Pakistan, where UNICEF and the government have invested in five plants installed in five district hospitals across the country.
But the equipment alone is not enough. Investing in oxygen requires strengthening entire health systems with sustained funding, skilled biomedical engineering and health workers, robust quality assurance systems, and government planning and investment.
UNICEF’s broader response involves support to over 100 countries with equipment, training, planning and advocacy efforts. This includes more than 60 countries where UNICEF is working closely with governments to plan and implement comprehensive scale-up plans for oxygen access in healthcare, which includes training programmes to tens of thousands of health workers and engineers.
A message to world leaders: Oxygen must be a sustained investment
As the World Health Assembly gathers this year, partners will be discussing the most critical issues in health. This will include how to realize the universal commitment to ensure that medical oxygen is accessible across health services worldwide. Last year, world leaders made a resolution that urges countries to increase access to medical oxygen.
Fifty-seven new oxygen plants now in operation in 21 countries is a clear demonstration that countries have responded to the call to action.
As a member of the secretariat of the the Global Oxygen Alliance (GO2AL), an initiative launched in 2023, UNICEF collaborates with leaders in the medical oxygen field to promote universal access. The recent Road to Oxygen Access Meeting in Senegal, supported by GO2AL and convened by WHO, and the World Health Assembly are central to these collaborative efforts, highlighting the importance of strategic investments and international cooperation to improve global health infrastructure and guarantee equitable access to oxygen.
From UNICEF, the message is clear: sustained access to medical oxygen is essential for child survival. This is about more than installing plants. It is about tackling challenges and building sustainable oxygen delivery systems.
From Umar’s hospital in Pakistan to health facilities across the globe, an investment in oxygen is an investment in children, crucial in the fight against life-threatening illnesses.
To learn more about UNICEF’s work to expand access to medical oxygen:
