Methodology for Evaluating a Solar-Powered Oxygen System's Impact on Pneumonia-Related Neonatal Mortality in Rural Ghanaian Health Centres

Pneumonia is a leading cause of neonatal mortality in sub-Saharan Africa. Rural health centres frequently lack reliable medical oxygen due to unstable electrical grids, compromising effective treatment. Solar-powered oxygen systems present a potential solution, but rigorous methodologies for evaluating their impact on clinical outcomes in resource-limited settings are required. This methodology article describes the design of a study to evaluate the impact of solar-powered oxygen systems on pneumonia-related neonatal mortality in rural Ghanaian health centres. The primary objective is to determine the change in mortality rate following implementation. Secondary objectives are to assess system usability, cost-effectiveness, and maintenance requirements. A mixed-methods, quasi-experimental design with a historical control group is employed. The study is set in rural health centres in the Brong-Ahafo Region, Ghana. Quantitative data on neonatal admissions, diagnoses, and outcomes are collected retrospectively and prospectively from clinical records. Qualitative data on healthcare worker experiences and operational challenges are gathered through focus group discussions and key informant interviews. An economic evaluation will utilise a cost-consequence analysis framework. This is a methodology article; it presents the study design and protocols, not empirical results. The framework is intended to generate findings on clinical impact, implementation processes, and economic considerations. The described methodology provides a comprehensive and pragmatic framework for evaluating a complex health technology intervention in a low-resource setting. It balances rigorous assessment of clinical outcomes with a contextual understanding of implementation. Researchers evaluating similar interventions should consider mixed-methods approaches to capture both clinical and operational outcomes. Emphasis should be placed on integrating robust data collection into routine health management information systems to ensure sustainability. Medical oxygen, neonatal health, pneumonia, health systems research, implementation science, sub-Saharan Africa, health technology assessment, mixed methods. This article contributes a detailed methodological framework for the real-world evaluation of solar-powered oxygen systems, addressing a critical evidence gap in neonatal care for low-resource, off-grid health facilities.