Across sub-Saharan Africa (SSA), approximately 60% of healthcare facilities are without electricity access. Without such access, healthcare providers face difficult and all-too-often dangerous challenges. Nurses spend hours on the back of a motorbike to pick up and then re-deliver vaccines from a facility that has a vaccine fridge. A midwife must deliver a newborn at night under shaky cell-phone light or by holding up a kerosene lantern. The lack of electricity restricts the ability of healthcare providers to record and track their patients, often limited to a pen and paper. Without access to clean and reliable electricity, these scenarios are the reality for far too many healthcare workers.
Despite a long-standing and clear need, there is limited data and information about the demand for and impact of healthcare facility electrification on health outcomes. To begin to shed light on the topic, using internal research funds, RTI developed and administered a regionally representative survey of health posts in Senegal. We found that 89.8% of on- and off-grid facilities would like to add additional off-grid electricity.
Although there is substantial demand, barriers such as upfront and recurring costs stand in the way (Figure 1). Simply put, both on- and off-grid health posts in Senegal want additional off-grid electricity but cannot afford to purchase the equipment and keep it in operation. The USAID-funded Power Africa Off-grid Project, which RTI implements, is working to develop private-sector business models that are affordable for healthcare facilities and include appropriate incentives to encourage long-term operation and maintenance of the systems.
Despite this ongoing donor-funded work, questions remain: What does electricity mean for health service delivery? How does reliable electricity affect health outcomes? Does reliable electricity attract and retain staff and lead to increased and improved service delivery? Does electricity at a healthcare facility lead to more vaccinations?
As RTI works to address the questions above through our research, there are still substantial data gaps around healthcare facilities’ electrification status and level. Both the global health and energy for development communities need surveys that connect the healthcare facility inventory with the patients they serve. We need case studies of current healthcare facility electrification efforts. We need randomized-controlled trials for pilot healthcare facility electrification interventions. Research in these areas will help move the discussion of healthcare facility electrification beyond a binary discussion on access and help governments and implementers of healthcare facility electrification develop frameworks for estimating the impact on health outcomes.
In the coming months, we will publish results from our research in Senegal to provide some answers to the questions above. We hope that this will spur a conversation and additional work in this important area. We look forward to collaborating with partners and colleagues across the health and energy sectors, putting our collective expertise together to investigate the connections between health service delivery and access to electricity. The more insights we can provide and questions we can answer on healthcare facility electrification, the more effective and efficient we will be in our efforts to power healthcare, strengthen health systems, and improve health outcomes. Together, we can better understand these connections to help ensure every health facility has the electricity it needs to provide quality health services to those in need.
Read more about this topic in Power Africa’s recent newsletter.
This blog was originally published on the RTI International site.
Amer Barghouth specializes in clean energy finance and has multidisciplinary experience in clean technology, sustainable energy, entrepreneurship, private sector engagement, access to finance, international cooperation and market research and analysis.
He is currently managing the Power Africa Off-grid Project, which aims to create 6 million off-grid connections by 2022. Mr. Barghouth and his team are working with private companies to improve business operations and scale up sustainable business models for rural off-grid electrification in over 11 countries in sub-Saharan Africa.
As Energy Specialist at RTI, Alice Brower adeptly leverages a variety of econometric strategies to guide evidence-based policy decisions, including projects about the impact of subsea cable landings in Sub-Saharan Africa and the potential economic impact of Janssen’s Ebola vaccine. Ms. Brower plays a key role in the Camel Leasing to Resilience Activity, studying the potential of camel leasing to increase resilience among Somali pastoralists. In addition, Ms. Brower provides technical assistance across the Energy Division, including to the Power Africa Off-Grid Project.
Justin Larson is an expert energy economist with RTI’s Learning, Energy, and Environment for Development division. He currently serves as the Power Africa Coordinator's Office (PACO) Technical Advisor on the Power Africa Off-grid Project (PAOP), where he acts as a technical liaison between the project and the coordinator's office, leads the research activities on the project, and provides analytical services to support activities through the project team. Dr. Larson also serves as a co-lead on the PAOP COVID-19 Task Force, helping to provide insights and analysis of the off-grid sector and the impacts of the pandemic to various sector stakeholders. He has varied experience in research topics and methods, and his formal academic training is in applied microeconomics, where his dissertation focused on estimation of policy effects in the electric utility sector.
Gordon Shaw is a project management and research professional specializing in energy and emerging markets. He has worked across five African countries conducting quantitative research and designing and executing projects in the energy sector. Mr. Shaw’s engineering background and cross-cultural experience contribute to his ability to develop key insights from projects and research.
Currently, Mr. Shaw handles a variety of technical consulting and project management roles, in addition to supporting business development efforts. He has managed pilot projects for innovative mini-grid systems, applied solar irrigation systems to improve agricultural yields, and researched energy market trends and the energy landscape in multiple countries.