Kenya is still ill prepared to respond to an emergency if a pandemic broke out requiring medical oxygen, a new study shows.

Only one out of 10 newly installed oxygen plants across the country is operating optimally, Africa Population and Health Research Center (APHRC) has found out.

The study says nine are either partially functional or completely, not.

A number of facilities, the study points out, lack spare parts making it difficult for them to refill oxygen cylinders because there are no compressors.

“There are likely to be high costs incurred on non-functional equipment and other medical oxygen infrastructure, with public health facilities turning into grave yards of disused medical oxygen equipment,” a section of the study paints a picture of the sorry situation.

Also, there is a lack of reliable power supply to fully to optimally operationalise plants.

Unstructured supply

The study released on Monday says, medical oxygen and supply landscape in the public health sphere is also unstructured, most starkly in the realm of equipment donation and support.

An average allocation of all the 47 counties is only at 24 per cent, with a paltry 18 percent seen in some four counties that were involved in the study.

Nairobi, Laikipia, Mombasa and Kitui, had an average allocation of 18 percent in the financial years 2018/19 and 2021/2022.

“In 2022, Kitui was leading in allocation for the commodity, at 28 per cent, followed by Mombasa at 22 per cent, Laikipia at 9 per cent while Nairobi allocated only one per cent,” the study points out.

Despite oxygen being zero rated, other components of its supply such as gas cylinders subject them to excise duty and Value Added Tax (VAT).

The same study highlights that reliance on imported cylinders further exposes purchasers to impact of fluctuating foreign exchange rates and disruptions in the global supply chain like the Russia and Ukraine war.

Also, primary method of medical oxygen supply is oxygen cylinders, which are owned by suppliers who charge rental fees for their use.

“Medical oxygen is VAT exempt, but inputs needed in its administration are taxable. Kenya does not currently manufacture its own gas cylinder, all cylinders are imported, and approximately 75 per cent of the cost of a medical gas cylinder is taken up by taxes,” the report makes it clearer.

And the ideal situation according to the study is to list and zero-rate all items needed in the administration of medical oxygen.

Made of steel

Additionally, most of the cylinders are made of steel while advanced economies have transitioned into longer lasting aluminum cylinders.

“Whereas medical supply through piping is documented to be more efficient distribution mechanism, few are equipped with piping infrastructure.” the study adds.

The study was conducted last year, within the eight regions, formerly provincial headquarters, with another study done by the International Partnership for Budgeting (IPB).

In the eight regions, the study was meant to look at oxygen supply within the Kenyan health system, including; Nairobi, Eastern, Rift Valley, Nyanza, Western, Coast, Central and North Eastern.

APHRC Director Catherine Kyobutungi said despite medical oxygen having gained prominence during Covid-19 pandemic, in actual fact, there has been a long standing problem, and that “Covid-19 pandemic was very visible”.

“You will find oxygen in theatre, and there is no surgeon who will carry out operation without oxygen. Newborn in ICU and pregnant women in ICU all require oxygen,” said Kyobutungi.

Kyobutungi raised an issue with inadequateness of human resource to handle oxygen, saying such affects service delivery.

Trained personnel

According to the study, Kenya require 1,200 trained personnel to handle oxygen but there are only 169 employees.

“If you look at the people needed to run value chain in the whole country, we need about 1,200. These are technician who run the machine, and ensure pipes are working and working in theatres but we found 169 personnel only. It is really very low,” observed the official.

The study was conducted after Bungoma Senator Wafula Wakoli demanded to know state of oxygen supply in the country.

Further observations in the study show that piping reduces reliance on rented medical oxygen cylinders, and is cost effective.

“At least 90 per cent of emergency care centres across the country do not have medical piping. And while there might be piping systems in some of the facilities, it is not done using the right materials as copper pipelines, tend to be costly,” adds the study.