The Strathclyde E4D team has been collaborating with partners in Malawi and Scotland in response to the COVID-19 crisis.

Through our relationships with the University of Malawi Polytechnic and Community Energy Malawi, UoS was aware of local initiatives to develop low cost oxygen concentrators and support the energy needs of rural hospitals.  Linking in with CREATIVenergie and the EnAccess OpenO2 project we are working to improve access to oxygen in Malawi. 

Health services in low resource countries are already extremely under-resourced and face huge challenges in treating the approx.15% of people infected with severe symptoms of COVID-19 requiring oxygen therapy.  Even with access to appropriate equipment, their energy requirements must be considered.   According to the WHO, only one third of hospitals and clinics in sub-Saharan African countries have the reliable power supply necessary for these to be effective.  

Oxygen is used to treat acute respiratory illness and has been shown to reduce mortality and improve COVID-19 patient outcomes.  An oxygen concentrator is an electrically powered device which produces oxygen from ambient air by removing nitrogen. They are a cost effective way to produce oxygen in health facilities, but many existing designs are not optimised for low resource settings.

A key challenge to running an oxygen concentrator in low resource settings is a lack of uninterrupted reliable access to electricity, which can lead to health facilities being unable to produce oxygen when it is needed, leading to associated negative health impacts.

An early part of this work was engagement with health service providers in rural areas to better understand their challenges.  This work was led by Community Energy Malawi and the summary report can be downloaded here, along with the questionnaire templates for KoBoCollect here and here.

In general, the 7 rural health centers surveyed have an existing capacity for treatment with oxygen and have commenced preparation for possible COVID-19 demand by planning for isolation units and obtaining additional oxygen concentrators and back-up generators.  However, the capacity to deal with even existing oxygen demand appears to be limited and reliance on diesel generators comes with the compromise of pollution and high running costs.

In general, reliable electricity would greatly improve the quality of service delivery in the health centers. All existing and new devices would be able to run efficiently without interruption which could also lead to the center being able to support an increased number of clients. With reliable electricity, the health centers would cut their energy expenditure as the need to run diesel generators would be reduced or eliminated altogether

Availability of low-cost, easy to maintain oxygen concentrators is an urgent requirement to enable an effective response to a rise in COVID-19 patients. The project team are now working to develop prototypes for devices that could address this need. Watch this space for updates!