Making Hypoxemia Visible: Co-Creating Routine Oxygen Data Systems through Participatory Evidence Generation in Nigeria
1
Clinton Health Access Initiative, Maitama, Abuja, Nigeria
2
National Oxygen Desk, Federal Ministry of Health, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A3831
ABSTRACT
BACKGROUND:
Until recently, Nigeria’s National Health Management Information System (NHMIS), did not capture data on hypoxemia screening, diagnosis, or oxygen therapy. Consequently, cases of low blood oxygen levels were not routinely reported, limiting policymakers’ ability to quantify oxygen needs or inform planning and budgeting. To close this gap, the Federal Ministry of Health (FMoH), supported by the Clinton Health Access Initiative (CHAI), co-developed and integrated standardized hypoxemia and oxygen indicators into the NHMIS for routine surveillance and reporting.
METHODS:
Through the National Oxygen Desk (NOD), FMoH and CHAI led a participatory process to define indicators for hypoxemia screening, diagnosis, oxygen therapy, and monitoring. In 2024, these indicators were pilot tested across 270 health facilities (primary, secondary, and tertiary) in five states (Imo, Kaduna, Kano, Lagos & Rivers). A structured training cascade built capacity of 1400 health workers, 500 medical records officers including local government M&E staff to measure oxygen saturation using pulse oximeters, document findings in revised registers, and submit monthly summaries through a dedicated DHIS2 module.
RESULTS:
With CHAI’s support, the FMoH approved the inclusion of these hypoxemia and oxygen indicators in revised NHMIS tools and initiated a phased national pilot. Within the first month, registers were deployed and actively used in 91% of the 270 facilities, demonstrating strong early adoption of routine reporting. Early lessons underscore the importance of government co-ownership, comprehensive training, and multi-level coordination. In Kano State, pilot findings have already informed requests for technical support to strengthen diagnostic access and referral pathways for hypoxemic patients.
CONCLUSIONS:
Starting from a baseline of zero hypoxemia indicators, this initiative lays the foundation for routine national surveillance of oxygen diagnosis and treatment. It shows how participatory indicator development and embedded reporting can transform invisible clinical needs into actionable data that strengthens planning, accountability, and access to essential oxygen services.
Until recently, Nigeria’s National Health Management Information System (NHMIS), did not capture data on hypoxemia screening, diagnosis, or oxygen therapy. Consequently, cases of low blood oxygen levels were not routinely reported, limiting policymakers’ ability to quantify oxygen needs or inform planning and budgeting. To close this gap, the Federal Ministry of Health (FMoH), supported by the Clinton Health Access Initiative (CHAI), co-developed and integrated standardized hypoxemia and oxygen indicators into the NHMIS for routine surveillance and reporting.
METHODS:
Through the National Oxygen Desk (NOD), FMoH and CHAI led a participatory process to define indicators for hypoxemia screening, diagnosis, oxygen therapy, and monitoring. In 2024, these indicators were pilot tested across 270 health facilities (primary, secondary, and tertiary) in five states (Imo, Kaduna, Kano, Lagos & Rivers). A structured training cascade built capacity of 1400 health workers, 500 medical records officers including local government M&E staff to measure oxygen saturation using pulse oximeters, document findings in revised registers, and submit monthly summaries through a dedicated DHIS2 module.
RESULTS:
With CHAI’s support, the FMoH approved the inclusion of these hypoxemia and oxygen indicators in revised NHMIS tools and initiated a phased national pilot. Within the first month, registers were deployed and actively used in 91% of the 270 facilities, demonstrating strong early adoption of routine reporting. Early lessons underscore the importance of government co-ownership, comprehensive training, and multi-level coordination. In Kano State, pilot findings have already informed requests for technical support to strengthen diagnostic access and referral pathways for hypoxemic patients.
CONCLUSIONS:
Starting from a baseline of zero hypoxemia indicators, this initiative lays the foundation for routine national surveillance of oxygen diagnosis and treatment. It shows how participatory indicator development and embedded reporting can transform invisible clinical needs into actionable data that strengthens planning, accountability, and access to essential oxygen services.
| eISSN: | 2654-1459 |
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