# What should be checked before accepting a donated oxygen plant?

**What should a ministry or hospital check before accepting a donated oxygen plant, so that it can actually run and be maintained?**

WHO's guidance on medical device donations (second edition, July 2024) says a recipient should check, before accepting, that the equipment suits national policy, the facility and its staff, that accessories, consumables, manuals and some spare parts are included, and who pays for transport, customs, installation and commissioning.

## Before saying yes (WHO, 2024)

Table 2 of WHO's Medical device donations: considerations for solicitation and provision lists the essential elements of a recipient's policy for accepting donations of equipment, including these checks:

- Check that national regulations allow such goods to be imported, and that the donor has the capacity to fulfil the request.
- Check that the equipment conforms to national policy and is suitable for the recipient facility and staff, and confirm that it needs only spare parts and consumables that are affordable from the available budget.
- Check whether the relevant accessories, consumables, manuals and some spare parts are included, so that the equipment can function and be used.
- Confirm whether the donor covers transport (including within the recipient country), freight, insurance, import duties, customs clearance, storage during customs clearance, and installation and commissioning costs; if not, ensure that money is set aside.
- Check whether a locally produced device is available at a cost-effective price, in which case it could be appropriate to negotiate a cash donation instead.

The guidance also says recipients have to be actively involved in all stages of a donation, including ensuring, for the suggested brand and model, that consumables, accessories and spare parts are available on the local market or can be readily purchased, that trained technical support for preventive and corrective maintenance is available or included, and considering local working conditions, including temperature, humidity, dust or an unstable power supply.

## WHO criteria for evaluating an offer

| Criterion | Examples from Table 1 of the WHO guidance |
|---|---|
| Appropriate to the setting | Suitable for local maintenance support capacity; compatible with existing utilities and energy supplies once upgraded if necessary; suited to the local climate, geography and working conditions; can be run economically with local resources and safely decommissioned at the end of its working life |
| Quality and safety | Approved for market by well-established regulators; provided by a reputable, reliable, licensed manufacturer or registered supplier; user and maintenance manuals written in local languages |
| Affordable | Costs of freight, insurance and import tax, of installation, commissioning and staff training, and of operating, maintaining and disposing of the equipment |
| Ease of use and maintenance | Local after-sales support with proven technical skills; service contracts possible; preferably a warranty of reasonable length with well understood terms; assured availability of supplies for a reasonable period (up to 10 years) |

## Points that matter for an oxygen plant

A 2008 case study in the Bulletin of the World Health Organization (Howie et al.) describes donated oxygen concentrators at an African referral hospital that broke down: a technical assessment showed that all units had the wrong voltage and frequency, which caused overheating and breakdown, and the hospital did not have the expertise to assess or maintain them; a hospital donations committee was then established to oversee donations. For oxygen generator plants, WHO's Technical specifications for health facility based medical oxygen systems (December 2024) ask buyers to ensure that voltage, frequency and plug type (if applicable) are locally compatible, specify continuous operation within specification at ambient temperatures of at least 5 to 40 °C with 15 to 95% relative humidity, ask the vendor to propose protective measures where the operating environment is outside this range, and ask for spare parts to remain available for at least 10 years from acceptance.

A PATH analysis of PSA plant failures (November 2023) recommends ownership transition plans for donated plants beyond the initial warranty or coverage period, noting that facility managers and plant operators are often not involved in purchasing decisions yet are expected to allocate limited resources to sustain the plants. Global Fund sustainability guidance (22 August 2024) says that, in the absence of a local service agent, for example for previously installed and repaired plants outside warranty and maintenance contract, a maintenance plan to be carried out by the host facility's engineers should be developed, and staff may need advanced training. See also [why PSA plants stop working](https://library.ultracontrolo.com/answers/why-do-psa-oxygen-plants-stop-working/).

### Who pays to install a donated oxygen plant?

WHO's donation guidance (2024) asks the recipient to confirm before accepting whether the donor covers transport, freight, insurance, import duties, customs clearance, installation and commissioning, and to set money aside if not.

### Should a donated plant come with spare parts?

The same guidance asks recipients to check that accessories, consumables, manuals and some spare parts are included, and that further spare parts and consumables are affordable from the available budget.

## Sources

- [WHO, Medical device donations: considerations for solicitation and provision, second edition (29 July 2024), Tables 1 and 2](https://iris.who.int/server/api/core/bitstreams/7493cd2a-1c91-41cc-908a-7b9c0731169c/content)
- [Howie SRC et al., Beyond good intentions: lessons on equipment donation from an African hospital, Bull World Health Organ 2008;86(1):52-56](https://researchonline.lshtm.ac.uk/id/eprint/8015/1/07-042994.pdf)
- [WHO, Technical specifications for health facility based medical oxygen systems (December 2024), oxygen generator plants, lines 26, 35 and 43](https://iris.who.int/server/api/core/bitstreams/ff437601-add3-44c8-8149-b85f0cdb2b52/content)
- [PATH, Pressure swing adsorption plants: common issues and solutions to prevent future disrepair (November 2023)](https://media.path.org/documents/Root_cause_analysis_report_external_clean.pdf)
- [Global Fund / Build Health International, Overview: Sustainability Guidance for PSA Oxygen Plants (22 August 2024)](https://resources.theglobalfund.org/media/bwrp43cm/cr_c19rm-psa-oxygen-plant-sustainability_overview_en.pdf)

Reviewed: 2026-10-23. Ultra Controlo engineering. https://library.ultracontrolo.com/answers/what-to-check-before-accepting-a-donated-oxygen-plant/