Oxygen Compression Systems: Bridging the Oxygen Gap in Low- and Middle-Income Countries
By Doug Richmond, Technical Sales Manager, RIX Industries Doug at drichmond@rixindustries.com or https://www.linkedin.com/in/doug-richmond-01124556/

The case for medical oxygen as a global health priority
In developed countries, healthcare facilities consider oxygen a standard resource, readily available for patient use. Hospitals in the U.S. and Europe enjoy seamless access to oxygen, supported by multiple storage options, such as bulk liquid oxygen, onsite oxygen plants, and pre-filled cylinders. This flexibility ensures uninterrupted oxygen delivery, crucial for patient survival and care.
However, in low- and middle-income countries (LMICs), healthcare facilities often rely on third-party suppliers to deliver their pre-filled oxygen cylinders. Without advanced onsite systems, these facilities must pay a premium per cylinder and are also vulnerable to supply chain interruptions.
Environmental challenges, civil unrest, or unexpected global crises like the COVID-19 pandemic could all stop the flow of life-saving oxygen. International organizations are stepping up, looking for solutions that use infrastructure to address these disparities and provide the necessary oxygen.
The critical role of compressors in LMIC healthcare facilities
Onsite oxygen plants, such as PSA (Pressure Swing Adsorption) or VPSA (Vacuum Pressure Swing Adsorption) systems, add critical oxygen capabilities when implemented in remote facilities. Yet, even with these oxygen generation systems in place, power reliability issues still threaten continuous oxygen delivery. Frequent power outages in remote areas can disrupt the oxygen supply to critical care units, putting lives at risk.
Even as backup diesel generators add value and LMIC hospitals typically rely on them during outages, they are often insufficient and may not support the full range of hospital equipment. In emergencies, administrators face the need to prioritize between powering essential hospital functions or oxygen generation. Additionally, diesel supplies are often scarce in rural areas, leaving hospitals vulnerable to supply disruptions.
Pairing onsite oxygen generators and compressors provides a reliable solution to this problem. A facility equipped with both can generate and store its own oxygen in high-pressure cylinders, avoiding some of the external factors that otherwise cause interruptions and danger to patients. The facility can build a backup oxygen reserve, effectively creating an onsite oxygen inventory that remains accessible even during power outages. Reserve O2 in the form of cylinders also helps stabilize the peak periods of
oxygen demand, with supplies at the ready when a facility needs more O2 than its generator can output.
Strategically sizing oxygen plants for cylinder filling
To ensure adequate oxygen access, hospitals must also size their oxygen plants to deliver a higher volume than typically needed. For example, a facility that normally consumes 500 liters per minute should consider setting up a plant that produces around 700 liters per minute.
Additional oxygen capacity supports routine cylinder filling, building a reserve of high-pressure oxygen or cylinders. When power is disrupted, these pre-filled cylinders provide a critical lifeline. No power is required, as compressed oxygen simply flows directly from the cylinders, supplying essential respiratory support to patients. There is greater autonomy to this approach, vital for emergency and remote field care where portable oxygen access can mean the difference between life and death.
Building oxygen independence with onsite cylinder filling
The advantages of onsite cylinder filling in LMICs extend beyond emergency preparedness. Onsite systems protect hospitals from supply chain breakdowns and empower facilities to minimize dependency on external suppliers. By maintaining an onsite stock of high-pressure cylinders, hospitals can ensure a continuous oxygen supply for patient care, even when environmental or political disruptions block road access.
Additionally, onsite cylinder filling systems can reduce long-term operational costs. Although initial investment in a compressor and generator may be substantial, the hospital realizes long-term savings and creates a more sustainable oxygen delivery model.

Ensuring equitable access to oxygen
Advanced onsite compression systems have the potential to transform healthcare in low-resource settings. The Global Fund and other organizations are working to bridge these divides, supporting healthcare facilities as they build resilient, oxygen-supplying infrastructure. By investing in onsite oxygen compressors and cylinder-filling capacity, hospitals in LMICs can safeguard against oxygen shortages, decrease reliance on external oxygen resources, and ensure safe and reliable patient care. In a world where medical oxygen can be difficult to come by, compression technology helps make access to oxygen a global healthcare reality, empowering LMICs to become self-sufficient in medical oxygen delivery.