SETTING: Health facilities in The Gambia, West Africa.
OBJECTIVES: Oxygen treatment is vital in pneumonia,
the leading cause of death in children globally. There are
shortages of oxygen in developing countries, but little
information is available on the extent of the problem.
We assessed national oxygen availability and use in The
Gambia, a sub-Saharan African country.
METHODS: A government-led team visited 12 health facilities
in The Gambia. A modifi ed World Health Organization
assessment tool was used to determine oxygen
requirements, current provision and capacity to support
effective oxygen use.
RESULTS: Eleven of the 12 facilities managed severe
pneu monia. Oxygen was reliable in three facilities. Requirement
and supply were often mismatched. Both oxygen
concentrators and oxygen cylinders were used.
Suboptimal electricity and maintenance made using concentrators
diffi cult, while logistical problems and cost
hampered cylinder use. Children were usually triaged by
trained nurses who reported lack of training in oxygen
use. Oxygen was given typically by nasal prongs; pulse
oximetry was available in two facilities.
CONCLUSIONS: National data showed that oxygen
availability did not meet needs in most Gambian health
facilities. Remedial options must be carefully assessed
for real costs, reliability and site-by-site usability. Training
is needed to support oxygen use and equipment
maintenance.