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Oxygen is an essential and life-saving medicine. The COVID-19 pandemic highlighted and exacerbated an existing global oxygen crisis, with pervasive inequities in the availability of quality oxygen services. Research into oxygen access was ranked as the highest cross-cutting priority for maternal, neonatal, and child health in recent consensus exercises, and this evidence gaps has been recognised by National Governments in a 2023 draft World Health Assembly Resolution on Oxygen Access.The purpose of our study is to provide evidence on how ̽����ѡ oxygen services can effectively be delivered and maintained at scale, ultimately leading to improved survival. This will be addressed through five objectives:Determine the impact of ̽����ѡ oxygen systems strengthening interventions on clinical practiceDetermine the impact of ̽����ѡ oxygen systems strengthening interventions on mortalityUnderstand the bottlenecks, challenges, and opportunities of improved ̽����ѡ oxygen services from a range of stakeholder perspectivesExplore how, why, and for whom oxygen systems strengthening efforts work, and whether there are unintended effectsEstablish best-practice recommendations through cross-country learningWe will address these through two studies in Nigeria and Uganda, covering an estimated 50 million people: 1) estimating oxygen impact at scale through quasi-experimental analyses

2) understanding mechanisms and processes for impact using a realist mixed-methods evaluation.

The introduction of the COVID-19 vaccine has highlighted the problem of vaccine hesitancy in Africa. This trend is in part driven by the spread of anti-vaccine information on social media. As this gains further traction, it could lead to a sharp increase in vaccine hesitancy rates and weaken confidence in other essential vaccines. Several studies have established widespread vaccine hesitancy among health workers in Africa. The aim of this project is to develop and evaluate an innovative peer-led social media intervention that addresses vaccine concerns among health workers in  Ethiopia and Nigeria. These countries were selected because of observed vaccine hesitancy among health workers and because social media use is very common. The intervention will be co-designed by health workers

thereafter peers will promote the messages on social media. The impact of the intervention on the vaccination status of health workers will be assessed through a cluster-randomised trial. Targeting health workers can have positive ripple effects

vaccines can protect health workers as well as the patients they care for, thereby preserving the health system. Increasing trust among health workers can also have the positive effect of building confidence in essential childhood vaccines among the wider population as they are influential role models. Addressing vaccine hesitancy and the underlying misinformation can help build higher acceptance of future vaccines.