How can a ministry train enough technicians for its oxygen plants?

What governments have been asked to do

WHA76.3 (30 May 2023) urges Member States to provide for adequate numbers of qualified staff, including engineers, to establish demand for, select, set up, operate and maintain oxygen production, storage and distribution equipment and infrastructure, and asks WHO to support them with guidelines, technical specifications, forecasting tools and training materials, and to support their efforts to provide adequate, predictable and sustainable financing for the trained workforce needed to install, operate and maintain oxygen systems safely. WHO's Foundations of medical oxygen systems (2023) lists a trained clinical and technical workforce among the requirements for access to oxygen, and says training on oxygen generation systems should be generic, so that the workforce can operate and maintain any of the systems.

Where the gap is

PATH's analysis of PSA plant failures (November 2023) found that few of the assessed facilities had on-site staff with technical training in plant maintenance and repair, that many countries have low numbers of trained biomedical engineers and technicians because of insufficient local training capacity and difficulty retaining skilled workers, and that technicians have at times taught themselves the basic skills to run a plant. It also reports that some suppliers restrict training and documentation such as service manuals and spare part lists in local languages.

What PATH recommends (November 2023)

• Ministries of health: assess workforce capacity and allocate biomedical engineers and technicians according to each facility's needs.
• Ministries of health: develop biomedical engineering and technician training programmes; more broadly, PATH also recommends improving countries' biomedical engineering capacity through educational, training and retention programmes.
• Ministries of health: deploy retention schemes with fair compensation, work-life balance and clear growth and development paths.
• Across the plant life cycle: upskill on-site technicians on how to assess plants and obtain support, and conduct regular training on plant operation and maintenance, especially when there is staff turnover.
• Public procurement entities: stipulate in tenders independent quality checks, training, operating and maintenance manuals and spare part lists in the applicable local languages.

Training at each level

Global Fund sustainability guidance (22 August 2024) asks for a national strategy for oxygen investment and capacity building, for the competencies needed to be defined before the manufacturer's training, and for capacity-building programmes to supplement supplier training. In UNDP procurement, REQ-OXY-001 (effective 1 January 2025) asks country offices to facilitate ongoing training for end users on preventive maintenance, troubleshooting, energy optimisation and resource efficiency, and WHO's 2024 technical specifications suggest a continuous development training programme paired with the service level agreement. What the supplier itself should teach at handover is on what training a PSA supplier should provide, and staffing levels on what staff are needed to run a PSA plant.

Ultra Controlo

On large ULTRAOX plants, installation, initial start-up and staff training are supervised by Ultra Controlo factory technicians (ULTRAOX SC datasheet, p. 3), and through UltraCare the company selects people in each country and trains technicians to look after its equipment (ULTRAOX datasheet 2022, p. 6).