Oxygen Implementation Project, Papua New Guinea and Nigeria

Project Details

This project is led by Professor Trevor Duke and Dr Hamish Graham.

The Centre for International Child Health is leading the implementation of solar powered oxygen delivery systems in district hospitals in Papua New Guinea and Nigeria, two countries with high child mortality from pneumonia.

Pneumonia is the largest cause of child mortality in Papua New Guinea, Nigeria, and globally. Hypoxaemia is the biggest risk factor for death in childhood pneumonia, and occurs in at least 13% of children presenting to hospitals with pneumonia. Better oxygen systems, which includes oxygen therapy using concentrators and pulse oximetry, have been shown to reduce mortality from pneumonia by up to 35% in provincial hospitals.  However oxygen is often unavailable in remote rural settings where other services, including where power is limited or unreliable.

The project aims to install comprehensive oxygen delivery systems and solar power in 36 health facilities in PNG and 12 hospitals in Nigeria.  The project takes a holistic approach to continuous quality improvement and health centre functioning.  This includes training for use and maintenance of oxygen equipment, education, data collection and use, strengthen the broader health care delivery and education systems.  The project will evaluate the clinical, technical, administrative, logistical, and health system needs and effects of such an intervention and explore challenges and opportunities for future implementation.

The project is being run in collaboration with the University of Ibadan the University College Hospital, Ibadan, Nigeria, the Papua New Guinea Department of Health, and the School of Medicine and Health Sciences at the University of PNG, with support from the Bill and Melinda Gates Foundation.


  • Professor Trevor Duke
  • Dr Hamish Graham


  • University of Ibadan, Nigeria
  • University College Hospital, Ibadan, Nigeria,
  • Papua New Guinea Department of Health
  • School of Medicine and Health Sciences, University of PNG


  • Bill and Melinda Gates Foundation

Research Outcomes

  • Duke T, Graham H, Peel D, Izadnegahdar R, Duke C. Solar powered health care. Int J Tuberc Lung Dis 2016;20(5):572-3.
  • Duke T, Peel D, Graham S, Howie S, Enarson PM, Jacobson R. Oxygen concentrators: a practical guide for clinicians and technicians in developing countries. Annals of Tropical Paediatrics 2010;87-101.
  • Duke T, Peel D, Wandi F, Subhi R, Sa'avu M, Matai S. Oxygen supplies for hospitals in Papua New Guinea: a comparison of the feasibility and cost-effectiveness of methods for different settings. PNG Med J 2010;53:126-38.
    World Health Organization. Oxygen Therapy for Children. Geneva: WHO http://www.who.int/maternal_child_adolescent/documents/child-oxygen-therapy/en/ (accessed March 2016); 2016.
  • Duke T, Wandi F, Jonathan M, Matai S, Kaupa M, Sa'avu M et al. Improved oxygen systems for childhood pneumonia: a multihospital effectiveness study in Papua New Guinea. Lancet 2008;372:1328-33.
  • Duke T, Blaschke AJ, Sialis S, Bonkowsky JL. Hypoxaemia in acute respiratory and non-respiratory illness in neonates and children in a developing country. Arch Dis Child 2002;86:108-12.
  • Duke T, Frank D, Mgone J. Hypoxaemia in children with severe pneumonia in Papua New Guinea. Int J TB Lung Dis 2000;5(6):511-9.
    Duke T, Subhi R, Peel D, Frey B. Pulse oximetry: technology to reduce child mortality in developing countries. Ann Trop Paediatr 2009;29(3):165-75.

Research Group

Centre for International Child Health

Faculty Research Themes

Infection and Immunology, Child Health

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre


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