Access to Medical Oxygen

Scaling a sustainable social business enterprise to deliver reliable, affordable, life-saving medical oxygen to rural health facilities in Sub-Saharan Africa.

Every year, over 300,000 children under 5 with Pneumonia die from lack of consistent supply to medical oxygen. Unfortunately, this is not just an issue for children with pneumonia. Most vulnerable patients in rural health facilities in Sub-Saharan Africa including many premature infants, neonates with respiratory distress, mothers with obstetric emergencies, trauma victims, and surgical patients requiring oxygen to recover or even survive die because of lack of medical oxygen.

Medical oxygen saves lives.  It prevents adverse anesthesia events like death in surgery and reduces infection risk.  It keeps trauma patients alive during shock.  But patients in East Africa aren’t getting oxygen.

In the US, doctors simply walk to patient beds and open an oxygen valve.  In East Africa, hospitals truck oxygen hundreds of miles in cylinders to deliver only a fraction of the life-saving gas needed. Long transportation distances and few production facilities make oxygen costly and scarce.  When oxygen does arrive, many health workers don’t understand the drug’s impact.

Our goal is to save lives in poor and last mile communities by addressing the problem of medical oxygen scarcity with a fully sustainable social enterprise.  Our innovation thrives on public-private partnerships where health facilities are the customer and a local entrepreneur is the private supplier for affordable oxygen.  We work with Ministries of Health to develop a clinical training program and partner with a local front line health worker organizations to provide training in oxygen best practices.  Addressing the lack of access to consistent medical oxygen directly impact SDG3 of good health and well-being for all.

With the revenue generating component, our model is sustainable and reproducible.  Using a hub and spoke model, hospitals receive oxygen directly, which drastically cuts costs and increases the total volume of oxygen available to them.  Profits generated will pay for staff salaries and maintenance, and fund more oxygen plants as the business grows.  This means communities can count on their oxygen supply for years to come. 

If we can grow our solution beyond the current list of countries (Kenya & Rwanda), we can start to build a self-sustaining network of front line oxygen providers across rural sub-Saharan Africa.  This allows health facilities to receive 100% of their required medical oxygen, hospitals to give oxygen to twice the number of patients who need it, decrease the number of pneumonia fatalities, (Oxygen studies show a 35% reduction in pneumonia mortality), decrease the number of neonatal deaths and decrease the number of children under 5 who die from lack of a consistent supply of oxygen.

With support from Solve, we can leverage the resources and the platform to grow our business model and build a network of front line oxygen providers across East Africa. More surgeries will happen, babies with respiratory infections will recover without brain damage, and mothers will survive hemorrhage giving birth and live to nurture their new child.

Local oxygen plants are set up as hub and spoke businesses in rural settings, allowing facilities to significantly reduce transportation cost and inventory delays. Each implementation supports a private entity to provide sustainable livelihood for its employees. Reinvesting the profits into the plant, ensures sustainability for 15-20 years.

Other solutions such as oxygen concentrators are possible but not reliable due to consistent power outages and its inability to supply oxygen to the entire facility.  

While many initiatives focus on one health problem, a partnership with Solve will allow us to grow this out-of-the-box intervention to impact multiple healthcare areas.

An integral component of the business model includes managing inventory, training and measuring impact.  From supply chain management to impact evaluation, digital technology suitable within the local context is leveraged to measure success for a sustainable business plan.

Oxygen production relies on a Pressure Swing Absorption oxygen generator to separate oxygen from ambient air under pressure through a sieve of absorbent material that has an affinity to trap (absorb) nitrogen molecules, permitting oxygen to pass, producing a (near) pure oxygen.

This technology is scaled for individual concentrators, piped systems or augmented by high pressure compressors to fill high volume cylinders.

After successful pilots in Kenya and Rwanda, we are growing the model to two additional plants in Ethiopia.  This will enable us to test the viability of the business model.  Over the next year, we hope to showcase sustainable pilots across three countries in East Africa with local variations to the core innovation.

In addition to implementation, our goal over the next twelve months is to grow the business model to position it for scale.  This requires small scale investment and expertise to capture the learnings from our pilot models to develop a business innovation toolkit to scale the solution.

Our vision is for everyone, everywhere to have access to consistent medical oxygen. This means more babies, mothers, surgical patients, and trauma victims survive and thrive because of ample supply of Oxygen. 

Over the next three to five years, we want to build, install and operate 35 oxygen plants that will serve an estimated 485 health facilities to receive 100% of their oxygen supply in multiple countries across East Africa. 

If successful, this should build a network of public-private partners to address the oxygen supply chain and create a ripple effect to scale the program on its own in Africa.

We partner with local governments and health officials to identify the best location for the oxygen business, usually at a referral hospital in a rural area that lacks access to oxygen.  We then partner with local entrepreneurs and hospital administration to set up the oxygen business.  We train on the technical and business aspects of running an oxygen plant, and an oxygen business.  We also train health care workers in surrounding areas on the proper clinical use of medical oxygen, increasing their confidence to administer this life-saving drug, and also increasing the frequency of use.

Oxygen availability at facilities is measured based on the population it has the potential to serve vs. the utilization. Our oxygen solution, through two plants, is currently capable of providing access to oxygen for a catchment population of 3.1 million people in Rwanda across 13 health facilities, and for  a catchment population of 2.5 million people in Kenya across 20 health facilities, serving a combined catchment population of approximately 5.7 million people annually. 

In Ethiopia, the two plants provide access to oxygen to a catchment area serving a catchment population of 11.4 million people across 14 rural healthcare facilities.  

In 12 months of operations across the four oxygen plants, approximately 17.1 million people will have the potential to access oxygen for their medical needs. Our goal is to scale this to 35 more oxygen plants across East Africa.

In 3 years, approximately 9.4 million Rwandans, 17.8 million Kenyans, and 74.4 million Ethiopians are estimated to have the potential to access medical oxygen for their medical needs.

The effects of availability to oxygen at a rural health facility for essential and emergency services are immediate. Our solution removes any uncertainty for healthcare providers that use this essential drug sparingly today.  

We have been working on the social business enterprise oxygen solution for four plus years and have expertise in program implementation, oxygen production technology and partnerships. We are a collaborative group of innovators that are constantly looking to strengthen our solutions platform.  We believe in the mission and prefer to leverage best practices rather than re-invent the wheel. Our staff has over 20 years of humanitarian experience building and developing programs in developing countries.  

We are shifting our focus to an impact investment solution under a for-profit model based on our learnings from our Ethiopia and Kenya oxygen implementation.

The solution is setup as a public-private partnership where the public facilities (spokes) are the primary customers and a for-profit entity in partnership with a district hospital (hub) is responsible for the distribution and maintenance of the oxygen plant.  The private entity is setup as a total solutions partner that will provide all components – oxygen cylinders, accessories, training, maintenance, monitoring – to ensure maximum benefit to patients. Revenue generated from the sale of oxygen guarantees long term sustainability of the plant and the supply chain of oxygen to the catchment area. Expansion is achieved based on market opportunity either via expanding the hub and spoke model within the current region, warehousing or building new plants across the country.

This model is competitive over the typical scenario of one medical oxygen provider in a country that holds a monopoly on oxygen production and delivery.  By placing oxygen plants in rural areas, we can deliver oxygen at reduced rates and decrease transportation costs. Delivery time is also significantly reduced.  In some areas, we have seen a reduction in typical delivery time from 3 days to 3 hours.  This has huge positive health implications for the hospitals served.

Our solution is at a point of transitioning from pilot to growth.  This requires that we leverage the learning from the pilot implementations to design a scalability road map for market analysis and oxygen delivery to rural health facilities in Sub-Saharan Africa.  Governments are eager to advance oxygen availability in their own countries by engaging in innovative business solutions and developing national roadmaps.

Solve provides the platform to scale this innovative business and to utilize its network for expertise on impact investment models.  We are also looking for partnerships within the medical oxygen ecosystem like pulse oximeter distribution and training. 

Our innovation requires participation from many partners, including Government, local hospitals, and local business partners. For our project to succeed, each partner must execute their commitments per plan.  The oxygen production and distribution businesses could fail to generate revenue adequate to meet the goals. Lack of awareness to access to medical oxygen in rural health facilities in Sub-Saharan Africa is also a key barrier. 

Solve can help us overcome these barriers by providing the platform to strengthen our business plan, bringing the much-needed awareness to the problem and transforming our oxygen business solution into a robust impact investing model.