Govt says to upscale oxygen supply to lower health centres

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The health ministry has announced plans to make medical oxygen systems mandatory at lower-level health facilities, particularly Health Centre IIIs and IIs, where the majority of deliveries take place, as part of efforts to close persistent gaps in oxygen access across the country.

The commitment was made during a high-level strategic workshop on oxygen technology and alignment with the national oxygen programme on February 19, 2026, in Kampala by the FREO2 Foundation in partnership with the ministry.

Clinical services commissioner Dr Rony Bahatungire acknowledged that Uganda still does not have enough oxygen to fully cover the entire health system.

“We may not have enough oxygen for the whole country and the entire network of hospitals and healthcare facilities, but it is a work in progress. Once we complete the pilot and prescribe the appropriate system for each level of care, it will become a principle that any Health Centre III, IV or general hospital must have piped oxygen as part of its infrastructure,” Dr Bahatungire said.

Bahatungire added that about 80 per cent of births occur at Health Centre IIIs and IIs, facilities that historically have had limited oxygen coverage.

“That is where the bulk of our mothers deliver from. Yet these are the facilities that have had the least oxygen coverage. We pledged to partner with FREO2 to improve access to oxygen across Uganda,” he said.

System expansion

The country’s oxygen ecosystem has expanded significantly since the COVID-19 crisis exposed critical shortages. According to figures shared at the workshop, 79 health facilities are currently enrolled under the FREO2-supported programme, with 98 oxygen systems installed nationwide.

Of these, 35 facilities are connected to remote monitoring systems that allow real-time tracking of oxygen purity and system performance, while 22 facilities have solarised infrastructure to ensure supply during power outages.

Ensuring access

Health Services director general Dr Charles Olaro said the focus is now shifting from concentrating oxygen plants at regional referral hospitals to ensuring access at lower-level facilities.

“More than 50 per cent of deliveries in this country happen at lower health facilities. If oxygen is only available at the referral hospital, then children arrive already damaged from hypoxaemia. Oxygen has no substitute,” Olaro said.

Under the current system, many lower facilities depend on transporting cylinders to and from regional referral hospitals that host oxygen plants. This process is costly, slow and often unreliable. Even when cylinders are available, delivery equipment may be missing or non-functional, according to the health ministry.

The pilot model being implemented with FREO2 produces oxygen on-site and pipes it directly into neonatal care units. This allows health workers to immediately administer oxygen to babies born with breathing complications, without waiting for referrals.

“What we have piloted so far has demonstrated very good results in neonatal units. We are seeing better survival of children who could easily have been lost due to hypoxaemia," Bahatungire said.

Olaro recalled Uganda’s struggles during COVID-19 when oxygen demand surged dramatically, with some patients requiring up to 20 litres per minute.

“At that time, we were not even measuring properly. You only gave oxygen when someone was gasping. Now we understand that the entry point to oxygen management is measurement in pulse oximetry,” he said.

Under the National Oxygen Scale-Up Plan launched in 2024, the Government has prioritised strengthening hypoxaemia diagnosis and oxygen utilisation.

According to Dr Miriam Ajambo, the head of the Oxygen subcommittee Secretariat at the health ministry, most Health Centre IVs now have handheld pulse oximeters, and the ministry aims to extend coverage to Health Centre IIIs as lower units are upgraded.

She noted that Uganda is also recruiting biomedical engineers to support plant maintenance and working to integrate oxygen indicators into national health data systems to track coverage and performance.

FREO2 Foundation CEO Máire Ruane said Uganda has treated about 20,000 children under the programme, making it a centre of excellence for innovation globally.

Globally, an estimated 1.6 million child deaths are linked to a lack of oxygen access, with 80 per cent occurring in low-resource and peripheral settings like Uganda.

“If we can get oxygen into children’s lungs at the right time without waiting for referral, we can save at least 30 per cent of those lives,” Ruane said.

Olaro said the next step is to finalise an investment case and secure dedicated budget lines to ensure sustainability at facilities where most mothers and newborns first seek care.