Thread by @GrahamHamish

I'm so pleased to share the 5-year results of the Nigeria Oxygen 🫁 program! We found #oxygen systems improvements were sustained and were highly cost-effective (US$82–125 per DALY-averted). Why is this important? (1/10)
gh.bmj.com/content/7/8/e0…

We know that #oxygen is an essential medicine for many, many medical conditions. Yet, around the world, the majority of severely ill patients who need oxygen do not receive it. So we wondered how we could change this. (2/10)

We worked with 12 hospitals in Southwest Nigeria to make pulse oximetry routine practice, improve oxygen supplies, and support healthcare workers and biomedical technicans. And we saw encouraging change. (3/10) academic.oup.com/inthealth/arti…
gh.bmj.com/content/3/3/e0…

Short-term results showed that improving hospital oxygen systems increased pulse oximetry and oxygen coverage (from <20% to >80%) and reduced the risk of in-hospital death from child pneumonia by 50%. But... would it last?? (4/10)
journals.plos.org/plosmedicine/a…

After 5 years we found that pulse oximetry and oxygen practices WERE sustained. Remarkable given that oximetry was barely practiced at baseline and despite all the project oximeters needing to be replaced (by the hospitals themselves). (5/10)

We found that the improvements to hospital oxygen systems were highly cost effective (US$2694–4382 per life saved, US$82–125 per DALY-averted) - comparable to some of our very best child survival interventions. (6/10)

But it wasn't easy and we learnt some important practical lessons for the future. Multidisciplinary teams are essential. Equipment does fail. Reliable power is tricky. Culture and leadership matters. Users need support. (7/10)

We are pleased that #oxygen has been prioritised in #COVID19 response. But big investments in oxygen production and supply will only benefit patients and be sustained if there is equal efforts to support users on the frontline. (8/10)

In 2022 no patient should die because they can't get oxygen - not in Melbourne, Mumbai or Mbale. All hospitals need reliable oxygen. Every nurse needs a pulse oximeter. Medical technicans need tools and spare parts. Health departments need oxygen plans and budget lines. (9/10)

Huge credit to Prof Falade and team and all those who have gone before us. You have shown us that "oxygen for all" is possible. We can do this. We must. (10/10)
gh.bmj.com/content/6/12/e…
ncbi.nlm.nih.gov/pmc/articles/P…

@Stop_Pneumonia @gatesfoundation
@CHAI_health @PATHtweets @Fmohnigeria @nighealthwatch @AfricaCDC @WHOAFRO @UNICEFSupply @MCRI_for_kids @UniMelb @Oxygen4life1