Improving products alone will not increase access to oxygen in low-resource contexts: machines break or may be used incorrectly. Alongside product innovation, since PATHs 'Oxygen as a Utility' Report in 2020, there has been a recognition that there is potential for service model innovation to break the cycle of technologies ending up in equipment graveyards. Oxygen-as-a-Service (O2aaS) models are emerging as an innovative solution tailored to the oxygen access challenges present in under-resourced settings. Rather than just selling equipment, services-based models provide integrated solutions bundling concentrators with cylinders, pulse oximetry, maintenance, training, and technical support. Health facilities pay recurring fees based on service delivery outcomes, not capital assets. 

Just as with electricity or water, governments and/or facilities pay for oxygen as a reliable utility. If something breaks (as it often does), suppliers are responsible for fixing it. The management and functioning of the oxygen system is the supplier's sole responsibility, so that health workers can focus on delivering quality healthcare. By externalising maintenance and costs, these models can overcome many of the limitations of traditional purchasing (upfront cost, unpredictable cost, skill gaps, etc). Therefore we believe they hold immense potential for closing oxygen access gaps and preventing unnecessary deaths in low-resource settings.