Health Systems and Policy Contexts of Medical Oxygen

NCT ID: NCT06169514

Last Updated: 2025-11-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

1 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-07-31

Study Completion Date

2027-12-31

Brief Summary

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This is a mixed-methods program evaluation from a health systems and policy perspective, involving (i) stakeholder analysis, (ii) policy-implementation gap analysis, and (iii) comparative country case studies. This study aims to understand how national oxygen strategies achieve impact at national, and subnational level, across country contexts, at what cost.

The the investigators seek to:

1. Involve policymakers, implementers (including private sector), and medical oxygen users in identifying challenges and understanding potential solutions to medical oxygen access;
2. Generate new data on how medical oxygen systems work and can be improved from multiple perspectives;
3. Draw lessons on medical oxygen that can directly inform national and global practice and policy.

This study will be conducted in 6 of the 9 countries participating in the Clinton Health Access Initiative (CHAI) led Medical Oxygen Implementation (MOXY) program (Uganda, Nigeria, Rwanda, Liberia, Lao PDR, Cambodia).

Key informants will be selected representing government, non-governmental agencies, professional associations, private sector, and civil society. This study will be completed over 4 years, with timelines varying between country study sites.

Detailed Description

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The investigators will use a concurrent mixed-methods design, with an overarching comparative case study methodology. The investigators will adopt an iterative approach, using co-design to adapt the study methodology to the specific context of each country and annual learning team meetings with stakeholders to refine the final case study topics (sub-study 3) and methodology.

Three embedded sub-studies are planned:

Sub-study 1 (Stakeholder Analysis) aims to understand the policy environment for medical oxygen services across different country contexts. This will be informed by the MOXY baseline survey, which includes data on oxygen-related facility readiness and clinical practices across the MOXY program areas. Data sources will include stakeholder interviews with participants from different levels (national, provincial, local) and policy perspectives (government, implementing/advising partners, practitioners, beneficiaries). Results will inform sub-study 2 and MOXY program implementation.

Sub-study 2 (Policy-Implementation Gap Analysis) aims to critically analyse the gap between policy intentions and actual implementation. This will be informed by the baseline facility readiness and clinical practice data. Data sources will include a desk review of oxygen-related policies, stakeholder in-depth interviews, and program administrative data. Results will inform implementation of country oxygen strategies and feed into prioritization of focus areas for sub-study 3.

Sub-study 3 (Comparative Country Case Studies) aims to compare oxygen programs across countries, focusing on particular challenges or unique solutions identified in sub-study 1 and 2. Data sources will include repeated desk review of oxygen-related policies and program administrative data, follow-up stakeholder interviews, and triangulation with quantitative survey results on facility readiness and clinical practices.

This research will also draw on national stakeholder dialogues - both to review, refine, and validate preliminary findings of the study team and to draw out feasible solutions/alternatives for both policy and practice and oxygen eco-system. In year 1 the investigators will generate key evidence about how the current strategies and polices are being translated into action, identifying key opportunities for implementing partners to focus support. Over years 2 and 3, the investigators will learn how these activities have affected medical oxygen service coverage, drawing lessons across country contexts and across different implementation approaches.

Conditions

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Hypoxemia Morality Pneumonia

Study Design

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Observational Model Type

OTHER

Study Time Perspective

OTHER

Study Groups

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Policy and stakeholder analysis across 6 countries

Policy and stakeholder analysis across 6 countries

No intervention

Intervention Type OTHER

No intervention

Interventions

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No intervention

No intervention

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Key informants will be selected representing government, non-governmental agencies, professional associations, private sector, and civil society.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Ibadan

OTHER

Sponsor Role collaborator

University of Health Sciences, Lao People's Democratic Republic (PDR)

UNKNOWN

Sponsor Role collaborator

University of Health Sciences, Cambodia

UNKNOWN

Sponsor Role collaborator

Makerere University

OTHER

Sponsor Role collaborator

Ministry of Health, Liberia

OTHER

Sponsor Role collaborator

Ministry of Health, Rwanda

OTHER_GOV

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role collaborator

Murdoch Childrens Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hamish Graham, PhD

Role: PRINCIPAL_INVESTIGATOR

Murdoch Childrens Research Institute

Carina King, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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Cambodia

Phnom Penh, , Cambodia

Site Status RECRUITING

Lao PDR

Vientiane, , Laos

Site Status RECRUITING

Liberia

Monrovia, , Liberia

Site Status RECRUITING

Nigeria

Ibadan, , Nigeria

Site Status RECRUITING

Rwanda

Kigali, , Rwanda

Site Status RECRUITING

Uganda

Kampala, , Uganda

Site Status RECRUITING

Countries

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Cambodia Laos Liberia Nigeria Rwanda Uganda

Central Contacts

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Rami Subhi, MBBS, FRACS, MD (Res)

Role: CONTACT

+61403151186

Hamish Graham, PhD

Role: CONTACT

+61403456262

Facility Contacts

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Siyan Yi, PhD

Role: primary

Mayfong Mayxay, PhD

Role: primary

Readon Ideh, MD

Role: primary

Ayobami Bakare, MD

Role: primary

Corneille Killy Ntihabose, MD

Role: primary

Freddy Kitutu, PhD

Role: primary

256 705 79177

Other Identifiers

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HREC 100143

Identifier Type: -

Identifier Source: org_study_id

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