Realist Evaluation and Learning in a Multi-country Medical Oxygen Program to Improve Oxygen Access and Use in Children Under 15

What this Trial Is About

This research aims to understand how oxygen and pulse oximetry are used in healthcare facilities across multiple countries, focusing on children under 15 years old with conditions like hypoxemia, pneumonia, neonatal disease, sepsis, and mortality risks. The study addresses the critical issue of oxygen access disparities exacerbated by the COVID-19 pandemic and seeks to identify barriers and opportunities to improve oxygen systems for better patient care. It involves five mixed-methods sub-studies designed to explore facility readiness, care pathways, patient journeys, healthcare worker practices, and stakeholder perspectives in six countries. The study evaluates different multi-faceted oxygen system strengthening interventions tailored to each country's context. These include efforts to improve policies, governance, healthcare worker and technician training, and data systems for oxygen use and maintenance. The research uses a mixed methods design with sequential and concurrent data collection across sub-studies that involve cross-sectional assessments, direct observations, interviews, and focus groups in selected health facilities representing various performance levels. Participants, primarily children under 15 and healthcare staff, will be observed and interviewed to map care processes, oxygen use, and decision-making in emergency and inpatient settings. Data collection includes patient and equipment flow mapping, patient journey tracking during initial care hours, nursing practices, and stakeholder perceptions. The study will measure mixed methods outcomes over five years, aiming to inform effective policies and strategies to enhance oxygen access and use. The total study duration extends to December 2027, with ongoing monitoring and analysis.

Evaluation of a Multi-country Medical Oxygen Program