README.md

---
license: cc-by-4.0
task_categories:
  - tabular-classification
  - tabular-regression
language:
  - en
tags:
  - healthcare
  - supply-chain
  - medical-oxygen
  - hypoxemia
  - pulse-oximetry
  - concentrator
  - PSA-plant
  - pneumonia
  - neonatal
  - sub-saharan-africa
  - lmic
pretty_name: "Medical Oxygen Supply (Availability, Equipment, Hypoxemia Mortality, Supply Chain)"
size_categories:
  - 10K<n<100K
configs:
  - config_name: referral_hospital
    data_files: data/oxygen_referral_hospital.csv
  - config_name: district_hospital
    data_files: data/oxygen_district_hospital.csv
    default: true
  - config_name: rural_health_centre
    data_files: data/oxygen_rural_health_centre.csv
---

# Medical Oxygen Supply Dataset

## Abstract

This dataset provides **30,000 simulated facility-level observations** (10,000 per scenario) of medical oxygen availability, delivery infrastructure, pulse oximetry access, and patient outcomes across three tiers of healthcare in sub-Saharan Africa. Each record represents one facility observation for one monthly period, capturing 40+ variables including oxygen source type, concentrator and cylinder status, pulse oximetry functionality, patient oxygen demand and coverage, hypoxemia-related mortality, shortage root causes, and logistics metrics. Three scenarios model the oxygen access gradient: referral hospital (82% availability), district hospital (50%), and rural health centre (12%).

**This dataset is entirely simulated. It must not be used for clinical decision-making or procurement.**

## 1. Introduction

### 1.1 The Medical Oxygen Crisis

Medical oxygen is classified as an essential medicine by the World Health Organization, yet sub-Saharan Africa faces a profound and chronic oxygen deficit. According to analysis by the Institute for Transformative Technologies and Oxygen Hub, most SSA countries have less than 10% of the oxygen volume needed to treat high-burden conditions including childhood pneumonia, COPD, neonatal respiratory distress syndrome, and severe malaria (Oxygen Hub/ITT, 2021). COVID-19 both exacerbated and exposed this gap, triggering emergency investments that remain insufficient for sustained coverage.

### 1.2 Supply Infrastructure

Historically, the dominant oxygen supply method in SSA has been compressed gas cylinders filled from cryogenic liquid oxygen (LOX) plants — facilities originally built for industrial applications and concentrated in capital cities. The medical oxygen market is dominated by a small number of LOX providers exhibiting monopolistic tendencies, with nearly 6 in 10 SSA countries dependent on a single supplier (PMC, 2022; PMC9771461).

Pressure swing adsorption (PSA) plants have emerged as a decentralised alternative, but maintenance failures are endemic. As of October 2022, at least 165 PSA plants globally needed repair, of which 151 (92%) were located in sub-Saharan Africa (PMC, 2022; PMC9771461). The WHO distributed over 30,000 oxygen concentrators worldwide, yet SSA faces significant challenges related to maintenance, spare parts, and reliable power supply (BMC Health Services Research, 2025; doi:10.1186/s12913-025-12315-6).

### 1.3 Availability at the Facility Level

A systematic assessment found that approximately half of health facilities in resource-limited settings had either no or inconsistent supply of medical oxygen and pulse oximeters, with the situation worst in the poorest countries of sub-Saharan Africa (PMC, 2024; PMC11082622). A scoping review of oxygen delivery systems for adults in SSA documented hypoxemia prevalence ranging from 11% to 89% across study populations, with high mortality among those with undetected or untreated hypoxemia (PMC, 2021; PMC8109278).

### 1.4 Pulse Oximetry: The Detection Gap

Oxygen therapy depends on the ability to detect hypoxemia. Pulse oximetry is the essential screening tool, yet availability is profoundly limited at lower facility levels. Without pulse oximetry, clinical recognition of hypoxemia relies on subjective signs (cyanosis, respiratory distress) that are unreliable, particularly in dark-skinned patients and neonates. The absence of pulse oximetry means that many hypoxemic patients are never identified and never receive oxygen.

### 1.5 Patient Impact and Mortality

Untreated hypoxemia carries high case fatality rates. Childhood pneumonia with hypoxemia has mortality rates of 35–55% without oxygen therapy in LMIC settings, compared with 5–15% when oxygen is provided. Neonatal respiratory distress syndrome, severe malaria, and sepsis all require oxygen as a life-saving intervention. The oxygen-attributable mortality burden in SSA is estimated in the hundreds of thousands annually.

### 1.6 Rationale for This Dataset

Despite growing investment post-COVID, no open, standardised dataset integrates oxygen source infrastructure, equipment functionality, pulse oximetry access, patient-level demand and coverage, and mortality outcomes into a single analytical resource. This dataset fills that gap for supply chain modelling, equipment investment prioritisation, and health systems research.

## 2. Methodology

### 2.1 Epidemiological Parameterization

| Parameter | Referral Hospital | District Hospital | Rural HC | Source |
| --- | --- | --- | --- | --- |
| Oxygen available | 82% | 50% | 12% | [6] ~50% facilities lack oxygen |
| Sufficient for demand | 65% | 35% | 8% | [1] <10% volume needed |
| Pulse oximeter functional | 85% | 14% | 0.4% | [4][6] Limited at lower levels |
| Concentrator functional rate | 70% | 45% | 15% | [5] Maintenance challenges |
| PSA plant functional | 55% | N/A | N/A | [3] 151/165 needing repair |
| Cylinder refill interval | 5 days | 21 days | 45 days | [1] Urban vs rural logistics |
| Mortality untreated hypoxemia | 35% | 45% | 55% | [4] Scoping review |
| Distance to refill | 15 km | 50 km | 120 km | Geographic analysis |

### 2.2 Scenario Design

**Scenario A — Referral/Teaching Hospital**: PSA plant or LOX bulk tank, piped oxygen system, ICU/NICU, pulse oximetry, biomedical technician, reliable power with generator backup. Analogous to Muhimbili (Tanzania), Kenyatta (Kenya), Mulago (Uganda).

**Scenario B — District Hospital**: Oxygen concentrators and/or portable cylinders, limited pulse oximetry (35% have device, 40% functional), no ICU, clinical officer manages oxygen, unreliable power. Analogous to district hospitals in Malawi, Rwanda, Mozambique.

**Scenario C — Rural Health Centre**: No permanent oxygen source (70% have none), no pulse oximetry, nurse-managed, no power grid. Occasional cylinder if transport available. Analogous to health centres in Niger, DRC, South Sudan, rural Ethiopia.

## 3. Schema

### 3.1 Facility Infrastructure

| Column | Type | Description |
| --- | --- | --- |
| facility_level | categorical | referral_hospital / district_hospital / rural_health_centre |
| bed_count | int | Total bed capacity |
| has_icu | binary | Intensive care unit present |
| has_nicu | binary | Neonatal ICU present |
| has_piped_oxygen | binary | Piped oxygen distribution system |
| has_biomedical_technician | binary | Technician for equipment maintenance |

### 3.2 Oxygen Source & Equipment

| Column | Type | Description |
| --- | --- | --- |
| primary_oxygen_source | categorical | PSA_plant_onsite / LOX_bulk_tank / oxygen_concentrator / cylinder_piped / cylinder_portable / none |
| concentrator_count | int | Number of oxygen concentrators |
| concentrator_functional | int | Number currently functional |
| concentrator_mean_age_years | float | Average equipment age |
| concentrator_maintenance_available | binary | Maintenance capacity exists |
| cylinder_count_full | int | Full cylinders on hand |
| cylinder_count_empty | int | Empty cylinders awaiting refill |
| days_since_cylinder_refill | int | Days since last cylinder delivery |
| PSA_plant_functional | binary | On-site PSA plant operational |

### 3.3 Pulse Oximetry

| Column | Type | Description |
| --- | --- | --- |
| pulse_oximeter_available | binary | Device present at facility |
| pulse_oximeter_functional | binary | Device operational |
| SpO2_screening_routine | binary | Routine SpO2 screening practiced |

### 3.4 Availability & Shortage

| Column | Type | Description |
| --- | --- | --- |
| oxygen_available_today | binary | Oxygen available on assessment day |
| oxygen_sufficient_for_demand | binary | Supply meets current patient demand |
| oxygen_stockout_days_last_month | int | Days without oxygen in past month |
| shortage_cause | categorical | 11 root cause categories |

### 3.5 Patient Demand & Outcomes

| Column | Type | Description |
| --- | --- | --- |
| patients_needing_oxygen | int | Patients requiring supplemental oxygen |
| primary_condition | categorical | 12 clinical conditions requiring oxygen |
| patients_received_oxygen | int | Patients who actually received oxygen |
| patients_untreated_hypoxemia | int | Patients with unmet oxygen need |
| flow_rate_adequate | binary | Oxygen delivered at therapeutic flow rate |
| deaths_hypoxemia_related | int | Deaths attributable to untreated hypoxemia |
| referred_for_oxygen | int | Patients referred to higher facility for oxygen |

### 3.6 Logistics & Cost

| Column | Type | Description |
| --- | --- | --- |
| monthly_oxygen_cost_usd | float | Monthly oxygen expenditure (USD) |
| distance_to_refill_km | float | Distance to nearest cylinder refill point |
| transport_available_for_cylinders | binary | Vehicle available for cylinder transport |
| power_source | categorical | grid_reliable / grid_unreliable / generator_only / solar / none |
| power_outage_hours_last_week | int | Hours without electricity |

## 4. Validation

<p align="center">
  <img src="validation_report.png" alt="Validation Report" width="100%">
</p>

### 4.1 Key Validation Results

| Metric | Referral | District | Rural | Literature |
| --- | --- | --- | --- | --- |
| Oxygen available | 82% | 50% | 12% | ~50% lack oxygen [6] |
| Sufficient supply | 65% | 35% | 8% | <10% volume [1] |
| Pulse ox functional | 85% | 14% | 0.4% | Limited periphery [4] |
| Mean patients needing O2 | 40 | 12 | 3 | Facility volume |
| Mean patients receiving O2 | 26 | 2.5 | 0 | Coverage gap |
| Mean deaths/observation | 5.0 | 4.3 | 1.7 | High mortality [4] |

## 5. Usage

```python
from datasets import load_dataset

dataset = load_dataset(
    "electricsheepafrica/medical-oxygen-supply",
    "district_hospital"
)
df = dataset["train"].to_pandas()

# Oxygen coverage gap analysis
df['coverage_pct'] = df['patients_received_oxygen'] / df['patients_needing_oxygen'].clip(lower=1) * 100
print(df.groupby('primary_oxygen_source')['coverage_pct'].mean())
```

### 5.1 Suggested Analyses

- **Oxygen access prediction**: Classify facilities at risk of stockout from infrastructure and logistics features.
- **Mortality modelling**: Quantify the relationship between oxygen availability, pulse oximetry, and hypoxemia deaths.
- **Equipment investment**: Compare cost-effectiveness of concentrators vs cylinders vs PSA plants by facility type.
- **Power dependency**: Model the impact of electrification and solar deployment on oxygen availability.

## 6. Limitations

- **Simulated**: Not from real oxygen surveys or health management information systems.
- **No temporal dynamics**: Cross-sectional observations, not longitudinal supply chain tracking.
- **Simplified mortality**: Deaths are modelled from a single probability rather than full clinical pathways.
- **No ambient conditions**: Altitude, temperature, and humidity effects on concentrator performance not modelled.
- **No cost granularity**: Unit costs for cylinders, concentrators, and PSA are approximated, not market-specific.

## 7. References

1. Oxygen Hub / ITT (2021). Closing the medical oxygen gap in sub-Saharan Africa. oxygenhub.org/psaplants
2. PMC (2022). Oxygen inequity in the COVID-19 pandemic and beyond. PMC9972372.
3. PMC (2022). A comprehensive approach to medical oxygen ecosystem building. 151/165 broken PSA plants in SSA. PMC9771461.
4. PMC (2021). Oxygen delivery systems for adults in sub-Saharan Africa: A scoping review. Hypoxemia prevalence 11–89%. PMC8109278.
5. BMC Health Services Research (2025). Design and maintenance of medical oxygen concentrators in SSA. WHO distributed >30,000 OCs. doi:10.1186/s12913-025-12315-6
6. PMC (2024). Functional availability of medical oxygen for management of pneumonia. ~50% facilities lack oxygen. PMC11082622.
7. WHO (2023). Model List of Essential Medicines, 23rd list. Medical oxygen included.

## Citation

```bibtex
@dataset{esa_medical_oxygen_supply_2025,
  title   = {Medical Oxygen Supply Dataset: Availability, Equipment,
             Hypoxemia Mortality, and Supply Chain Across Three Tiers
             of Healthcare in Sub-Saharan Africa},
  author  = {{Electric Sheep Africa}},
  year    = {2025},
  publisher = {Hugging Face},
  url     = {https://huggingface.co/datasets/electricsheepafrica/medical-oxygen-supply},
  note    = {Simulated dataset. Not for clinical or procurement use.}
}
```

## License

[CC-BY-4.0](https://creativecommons.org/licenses/by/4.0/)