Access to energy is a prerequisite for quality health care and is fundamental to the achievement of universal health care coverage and the Sustainable Development Goals. Yet, an estimated one in four health facilities in Sub-Saharan Africa lack access to electricity, and three in four facilities lack reliable power.
There is no better example that illustrates the critical role of energy in advancing human development, health and well-being than a story out of Sierra Leone. On 19 November 2017 three babies at Bo Government Hospital died when a power shortage cut off their oxygen supply. The story was shared over social media by Dr. Niall Conroy, who was overseeing the neo-natal intensive care unit at the hospital.
Lack of sufficient and reliable power is jeopardizing the well-being of hundreds of millions of people, especially women and children, who often bear the brunt of inadequate primary health-care services. In fact, worldwide, more than 289,000 women die every year from pregnancy- and childbirth-related complications, many of which could be averted with the provision of better lighting and other electricity-dependent medical services.
The recent Clean Energy for Health Care Conference in Nairobi, Kenya sparked much-needed, cross-sector thinking around how to deliver energy to health facilities in resource-constrained environments. A resounding takeaway was that distributed solar power and energy efficient medical devices hold great potential for creating stronger and more resilient health systems in Africa and beyond.
Examples like Uganda’s Energy for Rural Transformation project, Kenya’s Off-Grid Solar Access Project (KOSAP) for Underserved Counties, and Karuna Trust’s work in India are all proving that these solutions can have a transformative impact on people’s lives, especially in off-grid communities. These three projects alone are electrifying over a thousand health facilities with clean and holistic solar solutions while building and leveraging their country’s institutional capacities to ensure such efforts are country- and community-led.
We need more successes like these if we are to achieve the UN’s Sustainable Development Goals around health and energy (SDG3 and SDG7) by 2030. However, as the conference highlighted, scaling-up off-grid solutions and bringing vital power services to health facilities in Africa hinges on our ability to make progress in three key areas.
1. Improved collaboration across sectors
Despite the intuitive links between energy and health care, these sectors seldom work together in practice. Policy-makers, businesses, researchers and NGOs all need to stop treating goals for improved energy access and health-care delivery as separate.
Harnessing the enormous potential of clean energy to improve energy access for health-care facilities requires collaboration and cooperation between the health and energy sectors, as well as the investment community, which can help finance capital-intensive projects in the absence of public resources. To this end, the conference in Nairobi brought together both energy and health sector stakeholders, including government ministries, practitioners and development partners to facilitate inter-sectoral dialogue and to build coalitions.
Midwives met solar energy experts, ministers spoke with doctors, and development professionals talked to members of the private sector. Touchpoints like these are just a first step towards breaking down the silos that limit progress in developing innovative solutions that will power health facilities.
2. The need for innovative business models
Despite a growing number of innovative and decentralized solar systems being installed in health facilities in low- and middle-income countries, some of these systems prematurely fail or underperform due to poor quality designs and inadequate attention given to long-term maintenance and management. This leads to the perception that renewable technologies are too new and unreliable to continuously serve the needs of communities.
To help address this challenge, the UN Foundation and Sustainable Energy for All launched the Lasting Impact: Sustainable Off-Grid Solar Delivery Models to Power Health and Education report, which uses case studies to shed light on what kind of delivery models are contributing to – and likewise, hindering – sustainability.
As the report finds, and as the conference participants confirmed, there is a need for innovation in the way off-grid health facility electrification projects are designed and financed if they are to stand the test of time. This is precisely what projects like KOSAP are trying to do.
Rather than taking the traditional approach of just procuring and installing solar panels on a health facility, KOSAP is adopting long-term, performance-based operation and maintenance contracts (10-15 years) that can be serviced by skilled, private entities. Approaches like this illustrate the importance of aligning incentives and resources along a project’s entire lifespan.
3. Putting energy efficiency first
Energy-efficient medical devices and practices have the potential to generate considerable savings for health facilities in resource-constrained environments. However, medical equipment designers have traditionally paid little attention to energy consumption in their devices due to the relatively low cost of and abundance of electricity in the developed world. Fortunately, this is beginning to change.
There is an increasing array of innovative medical devices designed to use low-voltage, direct current power supplied by solar photovoltaic systems. These include solar direct drive vaccine refrigerators and battery-operated and portable fetal dopplers. These technologies are proving useful in environments where access to the grid is limited, and where on-site generation is solar- or battery-powered.
However, such technologies are not yet widely available, and they are often more expensive compared to mainstream equipment. Government support and public-private partnership can be directed towards ensuring energy efficient medical equipment lands in communities and health facilities more likely to suffer from power intermittencies.
This week, the World Health Assembly takes place at the World Health Organization’s headquarters in Geneva, Switzerland from 20-28 May 2019. The topic of energy and health will feature prominently in the Assembly’s agenda and discussions, as well as at several associated events. This includes the launch of the ‘Health and Energy Platform of Action’, which aims to strengthen political cooperation between the energy and the health sectors.
The official Technical Briefing on ‘Green, Sustainable & Climate Resilient Health Care Facilities’ and a side-event organized by the UN Foundation and the Clean Cooking Alliance on ‘Cross-Sectoral Collaboration and Leadership in the Energy-Health Nexus’ will all bring further attention to the areas of energy access in health facilities and the need for innovative business models that ensure reliable, lasting power to these facilities.
Outcomes from these sessions can give greater momentum to the global push to build healthier futures through sustainable energy while ensuring no one is left behind.
Photos by Edward Echwalu UN Foundation / Powering Health Care