• S E Hill, O Njie, M Sanneh, M Jallow, D Peel, M Njie, M Weber, P C Hill, R A Adegbola, and S R C Howie.
• Department of Public Health, University of Otago, Wellington, New Zealand.
• Int. J. Tuberc. Lung Dis. 2009 May 1; 13 (5): 587-93.

SettingHealth facilities in The Gambia, West Africa.ObjectivesOxygen treatment is vital in pneumonia, the leading cause of death in children globally. There are shortages of oxygen in developing countries, but little information is available on the extent of the problem. We assessed national oxygen availability and use in The Gambia, a sub-Saharan African country.MethodsA government-led team visited 12 health facilities in The Gambia. A modified World Health Organization assessment tool was used to determine oxygen requirements, current provision and capacity to support effective oxygen use.ResultsEleven of the 12 facilities managed severe pneumonia. Oxygen was reliable in three facilities. Requirement and supply were often mismatched. Both oxygen concentrators and oxygen cylinders were used. Suboptimal electricity and maintenance made using concentrators difficult, while logistical problems and cost hampered cylinder use. Children were usually triaged by trained nurses who reported lack of training in oxygen use. Oxygen was given typically by nasal prongs; pulse oximetry was available in two facilities.ConclusionsNational data showed that oxygen availability did not meet needs in most Gambian health facilities. Remedial options must be carefully assessed for real costs, reliability and site-by-site usability. Training is needed to support oxygen use and equipment maintenance.

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