How is a donor-funded oxygen plant handed over to the ministry?

The checklist, written by Build Health International for the Global Fund's Project BOXER, is meant to guide the Country Team, Principal Recipient, Sub-Recipient, Ministry of Health, facility directors and plant staff through the handover of an oxygen plant to the responsible party, and to support a clear, orderly transition of equipment and responsibilities. It says it is not exhaustive and can be adapted to different implementation arrangements and country contexts.

Before commissioning

• Key documents received in the agreed language: warranty terms, information on the supplier's maintenance (a contract, service level agreement or questionnaire), the maintenance schedule, and manuals and training materials in the language the operators understand best.
• Warranty terms received, reviewed and understood by the Principal Recipient and the facility, including its administration and plant operators; commissioning should not start until then.
• A preventive maintenance budget planned across the relevant grant cycles, with the host facility confirming that costs the warranty does not cover are in its maintenance budget.
• Spare parts and consumables organised and inventoried, and tools for the operators' exclusive use on the oxygen system.

The checklist adds that active supplier preventive maintenance must be in place, without gaps in service, to keep the warranty valid.

At commissioning

Global Fund commissioning guidance (28 August 2024) says commissioning should conclude with a formal handover meeting between the supplier or its representative and the hospital, allowing both to sign off the completeness of the supplier's work, and that the documents should be handed over in the country's lingua franca. The checklist asks for a signed copy of the commissioning documents to be shared with the facility and the Principal Recipient, and for maintenance logbooks to track maintenance, service and repairs. UNDP (REQ-OXY-001, effective 1 January 2025) asks for the final handover to include end-user acceptance reports, training reports, drawings, test and calibration reports, warranties and manuals, and in its process flow the installation and commissioning stage ends with registering the equipment and officially commissioning the plant. The full list is on what documents come with an oxygen plant handover.

Planning for the years after the project

PATH's report on PSA plant disrepair (November 2023) found that facility managers and plant operators are often not involved in purchasing decisions yet are expected to allocate limited resources to sustain the plants, and that donations can create a dependency on external support to restore or replace them. It recommends ownership transition plans for donated plants beyond the initial warranty or coverage period, more involvement of biomedical engineers and facility managers in purchasing, and, for donors, a robust ownership transition plan built with the recipients and a quantified total cost of ownership.

Global Fund sustainability guidance (22 August 2024) says operational costs such as spare parts, scheduled maintenance, repairs, electricity, diesel, distribution and staff salaries can be integrated into the hospital's annual budget, asks for financial planning over a life cycle it puts at 10 years on average, and says the terms of any maintenance agreement should be fully understood by the service provider, the operators, hospital management and the central governance level; staffing should be planned before installation. UNDP asks its Country Offices to develop a sustainability roadmap with the end users, and the end users to plan and allocate a budget for operation, maintenance and repair.

Two published examples

UNICEF Burundi reported on 17 June 2024 that, besides oxygen plants for four hospitals funded by Canada in partnership with UNICEF, UNICEF had committed to support their maintenance and train the staff in charge of it for one year; the Bururi hospital can sell its surplus to nearby health facilities, and UNICEF writes that the revenue will contribute to running the plant over time. A UNOPS press release of 28 April 2026 reported that Zambia's Minister of Health commissioned the sixth and final plant of a programme implemented by UNOPS with Global Fund funding, where a Global Fund representative said that responsibility now shifts from infrastructure delivery to performance, reporting and sustainability.

Ultra Controlo

For ULTRAOX plants, the ULTRAOX datasheet (2022, p. 6) describes UltraCare: Ultra Controlo selects people in each country, trains technicians to care for its products, and runs an installation post-monitoring system under ISO 13485 with a preventive maintenance and monitoring programme. See what UltraCare is.