Authors :
Bruno Houessou
Volume/Issue :
Volume 11 - 2026, Issue 8 - August
Google Scholar :
https://tinyurl.com/57xvx738
DOI :
https://doi.org/10.38124/ijisrt/26aug779
Note : A published paper may take 4-5
working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and
ResearchGate.
Abstract :
Pressure swing adsorption (PSA) oxygen plants have become important health-system assets, particularly where
hospitals seek to strengthen local access to medical oxygen and reduce dependence on external supply chains. Yet installed
production capacity does not necessarily translate into a reliable oxygen service. PSA performance also depends on electricity,
supporting infrastructure, maintenance, technical competence, quality assurance, safety, distribution, and the institutional
capacity to sustain these functions over time. This study examined the lifecycle performance of nine hospital-based PSA oxygen
installations, including six existing plants that had undergone rehabilitation and three newly deployed installations. Data were
obtained through document review, structured interviews, direct inspection, and technical measurements. Assessment domains
included needs–capacity alignment, site and equipment readiness, electrical supply, oxygen production and quality control,
infrastructure, maintenance, spare parts, workforce capacity, safety, distribution, operational records, and sustainability
arrangements. Rehabilitation restored several previously unavailable components and recovered substantial technical
capability. Most installations were technically capable of meeting their intended production requirements, although
vulnerabilities remained outside the PSA generator itself, including electrical instability, infrastructure and ventilation
deficiencies, incomplete safety arrangements, maintenance-contract risks, gaps in operational records, and weak longer-term
sustainability mechanisms. Cross-site analysis suggested a useful distinction between installed capacity, operational capacity,
service-delivery capacity, and sustainable performance. These states are not proposed as a maturity model or new framework,
but as analytical boundaries for understanding where asset value may be preserved or lost between installation and clinical
service. Optimizing PSA assets therefore requires attention not only to whether equipment functions, but to whether safe,
quality-assured oxygen can be produced, delivered, and sustained under actual operating conditions.
Keywords :
Medical Oxygen; Pressure Swing Adsorption; PSA Oxygen Plant; Asset Lifecycle Management; Healthcare Technology Management; Asset Performance; Maintenance; Reliability; Sustainability; ISO 55000.
References :
- World Health Organization. Technical specifications for health facility-based medical oxygen systems. Geneva: World Health Organization; 2024.
- World Health Organization. Technical specifications for pressure swing adsorption (PSA) oxygen plants: interim guidance, 8 June 2020. Geneva: World Health Organization; 2020.
- World Health Organization, United Nations Children's Fund. WHO-UNICEF technical specifications and guidance for oxygen therapy devices. WHO Medical Device Technical Series. Geneva: World Health Organization; 2019.
- World Health Organization. National medical oxygen scale-up plan: development guidance. Geneva: World Health Organization; 2025.
- World Health Organization. WHO technical consultation on oxygen access scale-up for COVID-19. Geneva: World Health Organization; 2021.
- World Health Organization. Statement on access to quality and safe medical oxygen. Geneva: World Health Organization; 2023.
- United Nations Children's Fund. Oxygen System Planning Tool. New York: UNICEF.
- Stein F, Perry M, Banda G, Woolhouse M, Mutapi F. Oxygen provision to fight COVID-19 in sub-Saharan Africa. BMJ Global Health. 2020;5:e002786. doi:10.1136/bmjgh-2020-002786.
- Graham HR, Ayede AI, Bakare AA, Oyewole OB, Gray A, Peel D, et al. Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria. BMJ Global Health. 2021;6:e006069. doi:10.1136/bmjgh-2021-006069.
- Mangipudi S, Leather A, Seedat A, Davies J. Oxygen availability in sub-Saharan African countries: a call for data to inform service delivery. Lancet Global Health. 2020;8(9):e1123–e1124. doi:10.1016/S2214-109X(20)30298-9.
- Graham H, Tosif S, Gray A, Qazi S, Campbell H, Peel D, McPake B, Duke T. Providing oxygen to children in hospitals: a realist review. Bulletin of the World Health Organization. 2017;95(4):288–302. doi:10.2471/BLT.16.186676.
- Smith V, Changoor A, McDonald C, et al. A comprehensive approach to medical oxygen ecosystem building: an implementation case study in Kenya, Rwanda, and Ethiopia. Global Health: Science and Practice. 2022;10(6):e2100781. doi:10.9745/GHSP-D-21-00781.
- Smith V, Changoor A, Rummage S, Wolde HF, Zeleke EG, Belay GM, et al. An oxygen supply is not enough: a qualitative analysis of a pressure swing adsorption oxygen plant program in Ethiopian hospitals. Global Health: Science and Practice. 2024;12(4):e2300515. doi:10.9745/GHSP-D-23-00515.
- La Vincente SF, Peel D, Carai S, Weber MW, Enarson P, Maganga ER, et al. The functioning of oxygen concentrators in resource-limited settings: a situation assessment in two countries. International Journal of Tuberculosis and Lung Disease. 2011;15(5):693–699. doi:10.5588/ijtld.10.0544.
- Bradley BD, Chow S, Nyassi E, Cheng YL, Peel D, Howie SRC. A retrospective analysis of oxygen concentrator maintenance needs and costs in a low-resource setting: experience from The Gambia. Health and Technology. 2015;4:319–328. doi:10.1007/s12553-015-0094-2.
- Bradley BD, Light JD, Ebonyi AO, N'Jai PC, Ideh RC, Ebruke BE, et al. Implementation and 8-year follow-up of an uninterrupted oxygen supply system in a hospital in The Gambia. International Journal of Tuberculosis and Lung Disease. 2016;20(8):1130–1134. doi:10.5588/ijtld.15.0889.
- International Organization for Standardization. ISO 55000:2024 Asset management — Vocabulary, overview and principles. Geneva: ISO; 2024.
- International Organization for Standardization. ISO 55001:2024 Asset management — Asset management system — Requirements. Geneva: ISO; 2024.
- Bhatt N, Bhatt B, Gurung S, Dahal S, Jaishi AR, Neupane B, Budhathoki SS. Challenges of hospital oxygen management during the COVID-19 pandemic in rural Nepal. American Journal of Tropical Medicine and Hygiene. 2022;106(4):997–999.
- Duke T, Wandi F, Jonathan M, Matai S, Kaupa M, Saavu M, Subhi R, Peel D. Improved oxygen systems for childhood pneumonia: a multihospital effectiveness study in Papua New Guinea. Lancet. 2008;372(9646):1328–1333. doi:10.1016/S0140-6736(08)61164-2.
- World Health Organization. Medical equipment maintenance programme overview. WHO Medical Device Technical Series. Geneva: World Health Organization; 2011.
- World Health Organization. Computerized maintenance management system. WHO Medical Device Technical Series. Geneva: World Health Organization; 2012.
- World Health Organization. Introduction to medical equipment inventory management. WHO Medical Device Technical Series. Geneva: World Health Organization; 2011.
- World Health Organization. Inventory and maintenance management information system for medical devices. Geneva: World Health Organization; 2025.
- Howie SRC, Hill SE, Peel D, Sanneh M, Njie M, Hill PC, et al. Beyond good intentions: lessons on equipment donation from an African hospital. Bulletin of the World Health Organization. 2008;86(1):52–56. doi:10.2471/BLT.07.042994.
- Wang B, Furst E, Cohen T, Keil OR, Ridgway M, Stiefel R. Medical equipment management strategies. Biomedical Instrumentation & Technology. 2006;40(3):233–237. doi:10.2345/i0899-8205-40-3-233.1.
- Wang B, Fedele J, Pridgen B, Williams A, Rui T, Barnett L, et al. Evidence-based maintenance: Part I—measuring maintenance effectiveness with failure codes. Journal of Clinical Engineering. 2010;35(3):132–144. doi:10.1097/JCE.0b013e3181e6231e.
- International Organization for Standardization. ISO 55012:2024 Asset management — Guidance on people involvement and competence. Geneva: ISO; 2024.
- International Organization for Standardization. ISO 55013:2024 Asset management — Guidance on the management of data assets. Geneva: ISO; 2024.
- Bakare AA, Graham H, Ayede AI, Peel D, Olatinwo O, Oyewole OB, et al. Providing oxygen to children and newborns: a multi-faceted technical and clinical assessment of oxygen access and oxygen use in secondary-level hospitals in southwest Nigeria. International Health. 2020;12(1):60–68. doi:10.1093/inthealth/ihz009.
Pressure swing adsorption (PSA) oxygen plants have become important health-system assets, particularly where
hospitals seek to strengthen local access to medical oxygen and reduce dependence on external supply chains. Yet installed
production capacity does not necessarily translate into a reliable oxygen service. PSA performance also depends on electricity,
supporting infrastructure, maintenance, technical competence, quality assurance, safety, distribution, and the institutional
capacity to sustain these functions over time. This study examined the lifecycle performance of nine hospital-based PSA oxygen
installations, including six existing plants that had undergone rehabilitation and three newly deployed installations. Data were
obtained through document review, structured interviews, direct inspection, and technical measurements. Assessment domains
included needs–capacity alignment, site and equipment readiness, electrical supply, oxygen production and quality control,
infrastructure, maintenance, spare parts, workforce capacity, safety, distribution, operational records, and sustainability
arrangements. Rehabilitation restored several previously unavailable components and recovered substantial technical
capability. Most installations were technically capable of meeting their intended production requirements, although
vulnerabilities remained outside the PSA generator itself, including electrical instability, infrastructure and ventilation
deficiencies, incomplete safety arrangements, maintenance-contract risks, gaps in operational records, and weak longer-term
sustainability mechanisms. Cross-site analysis suggested a useful distinction between installed capacity, operational capacity,
service-delivery capacity, and sustainable performance. These states are not proposed as a maturity model or new framework,
but as analytical boundaries for understanding where asset value may be preserved or lost between installation and clinical
service. Optimizing PSA assets therefore requires attention not only to whether equipment functions, but to whether safe,
quality-assured oxygen can be produced, delivered, and sustained under actual operating conditions.
Keywords :
Medical Oxygen; Pressure Swing Adsorption; PSA Oxygen Plant; Asset Lifecycle Management; Healthcare Technology Management; Asset Performance; Maintenance; Reliability; Sustainability; ISO 55000.