Without reliable electricity, pregnant women deliver in the dark or are unable to undergo an emergency cesarean section at night. Children do not have access to life-saving vaccines or critical emergency care. Women do not have full access to vital pre- and post-natal maternal health care services. And communities, lacking critical infrastructure, are less resilient to the effects of climate change.
An initiative led by the United Nations Foundation, the World Health Organization (WHO), and UN Women is focusing on clinic electrification within the UN and World Bank’s Sustainable Energy for All initiative and highlighting the value of an integrated approach to energy access in health facilities. The initiative will help strengthen health systems, reduce maternal and newborn mortality, and support broader improvement in overall health care delivery. The initial focus for this work is five African countries including Ghana, Liberia, Malawi, Sierra Leone, and Uganda.
After sufficient data has been mapped to give a clear indicator of the status of clinic electrification in each of the five countries, key health facilities will be selected for more detailed assessments of their needs to determine design specifications for solutions.
The work underway has been complicated by the current Ebola outbreak in West Africa, which has overburdened already fragile health systems. In Liberia, even at the best of times as it is still recovering from a long civil war, many clinics and hospitals lack grid electricity. Others suffer from insufficient and sporadic power. In those clinics with diesel generators, the high cost of fuel often limits the ability to run them. Renewable solutions including solar power can therefore be a good initial solution in areas not served by the grid, and as a complement to or replacement for diesel generators, to help secure a more reliable power supply.
In other countries, attracting and retaining medical staff is undermined by the poor quality of clinic infrastructure in rural areas. Providing electricity both in the clinic, but also in staff quarters to power lights, a fan, radio, and television helps improve the delivery of medical services. And it can also help support better retention of health care workers serving these communities.
While evaluating the provision of electricity to clinics is one aspect of this initiative, broader considerations on structure and design of solutions are also critical. Key parameters include a need to focus on the comprehensive energy services needed in the clinic, including:
- Ensuring gender aspects are evaluated: Provision of external security lighting may be necessary to help women feel safe in venturing to the clinic at night;
- Covering vaccine/medication refrigeration, but also the lighting needed in the delivery room;
- Evaluating the efficiency of the medical equipment to optimize system sizing;
- Not neglecting to light latrines;
- Including energy provision to staff quarters;
- Looking at the clinic’s related water needs and the ability to provide needed solutions such as a solar hot water heater or a water pump; and
- Considering ongoing needs for servicing and maintaining installed solutions, and building it into the design parameters, including local procurement of batteries and other spare parts.
The information gained will help inform a comprehensive set of design solutions more effectively tailored to meet the community health needs. The second phase of the initiative is expected to work with public and private sector partners to secure the resources needed to power clinics in these areas.
The WHO conference on health and climate this week in Geneva and the UN Climate Summit in September are key moments to highlight these immediate needs of clinics and the sustainable energy required to enable the provision of health care especially for women and their newborns. At the same time, they reflect a critical opportunity to help build broader community resilience in addressing global climate change challenges.
Photo: WE CARE Solar