Electrification of Health-Care Facilities: A Matter of Life and Death

By: Christian Conteh

“These are lives we are dealing with. Imagine you have a health facility with no electricity and a woman is set to deliver this can lead to complications. We usually use the touch light from our phones but that is not acceptable if we wish to provide quality care”

Health is a human right and a public good, and electricity access is a major enabler of Universal Health Coverage. Therefore, electrification of health-care facilities must be considered an utmost development priority requiring greater support and investments from governments, development partners, and financing and development organisations.

According to a World Bank needs analysis, almost two-thirds (64%) of health-care facilities in low and middle-income countries require some form of urgent intervention – for instance, either a new electricity connection or a backup power system – and some US$ 4.9 billion is urgently needed to bring them to a minimal standard of electrification.

Globally

A new report by the World Health Organization (WHO), the World Bank, the International Renewable Energy Agency (IRENA), and Sustainable Energy for All (SEforAll) reveals that nearly 1 billion people in low- and lower-middle income countries, or 1 in 8 of the world’s population, are served by health-care facilities that lack a reliable electricity supply.

This lack of access to electricity is critical for quality health-care provision, including delivering babies, managing emergencies, and offering lifesaving immunisation. Without reliable electricity in all health-care facilities, the goal of Universal Health Coverage cannot be reached.

The report, Energizing Health: Accelerating Electricity Access in Health-Care Facilities, presents the latest data on electrification of health-care facilities in low- and middle-income countries and projects investments required to achieve adequate and reliable electrification.

Dr. Maria Neira, Assistant Director-General for Healthier Populations at WHO states that, “Electricity access in health-care facilities can make the difference between life and death”. Electricity is needed to power basic devices such as lights, communications equipment, refrigeration, and devices that measure vital signs like heartbeat and blood pressure.

Stories From The Field

Sarah Vandi is a nurse at Talia Community Health Centre (CHC) she says the lack of electricity affects them greatly.

“For example when we have cases of road accidents (which we have frequently because Talia is along the Segbwema highway en route to Kenema) and there is no electricity, how do we do suturing? So all we can do is wrap the wound and refer the victim to another health facility. If there is no electricity and you cannot see you cannot work effectively. If it is an emergency the patient would have lost a lot of blood,” she says.

She further notes that another area the lack of electricity affects them is in the maternity area. She maintains that the maternity ward should have constant electricity because a woman can walk into the facility to deliver her baby at any time.

Electricity she emphasises helps you see everything clearly and ensures you provide the best of care for the patient.

“These are lives we are dealing with. Imagine you have a health facility with no electricity and a woman is set to deliver this can lead to complications. We usually use the touch light from our phones but that is not acceptable if we wish to provide quality care. We really have a tough job, imagine giving a patient drug intravenously, how do you find the vein when electricity is not available So most times if we cannot handle the situation we refer,” she says.

In the area of vaccination nurse Vandi says electricity is also very essential because most vaccines for children (BCG which is given at birth for example) are stored in a refrigerator.

She appeals to donors and philanthropists to help provide electricity for their health care facility because most deliveries are done at night and it is only with sustainable electricity that some of the inconveniences and risks can be tackled.

“If a patient presents herself with eclampsia (seizures that occur during a woman’s pregnancy or shortly after giving birth) you cannot care for such a patient in the dark. So what we usually do with such cases is to refer to a hospital in the main town Kenema. This practice itself puts the patient’s life at risk,” she laments.

The Peripheral Health Unit covers twelve catchment villages with a population of over 11 thousand.

Home Grown Solutions

But what are the home grown solutions to these challenges? Mustapha Lolleh is a representative from Light Salone Innovation a platform that brings young people together to solve some of the existing societal problems.

He says, Engineers Without Borders Denmark have done a lot of solar installations in Sierra Leone especially in the Eastern region and he believes all those installations have helped the community people greatly.

“In some areas people can charge their mobile phones which is an essential communication tool, we have also helped provide solar power for health facilities. Imagine nurses delivering babies using flashlights or lights from their mobile phones, our solar intervention now provides 24 hours electricity in some of these health facilities,” Lolleh said.

He however noted that over the years they have faced several challenges, especially the issue of maintenance of the facilities they have installed.

Engineer Lolleh also suggested the need for decentralized sustainable energy solutions, such as solar photovoltaics systems, he says they are cost-effective, clean and rapidly deployable, without the need to wait for the arrival of the central grid.

“Solutions are readily available and the impact for public health would be huge. Reliable electricity in health-care facilities is crucial to pandemic preparedness, as well as achieving universal health coverage, and increasing climate resilience and adaptation,” he says.

Millennium Challenge Cooperation

Meanwhile, Sierra Leone has been selected by the Millennium Challenge Cooperation (MCC) to develop a compact aimed at increasing the availability of reliable and affordable electricity for all Sierra Leoneans. The MCC’s Sierra Leone Country Director, Steven Grudda, has said that collaboration is key to achieving the government’s goals on sustainable energy for all.

The MCC’s team is working closely with the Sierra Leone Compact Development Unit (SLCDU) to design the compact, which follows the successful implementation of a USD 44 million program. The compact contract is set to be signed by late 2023, which would make it one of the fastest compact development processes in the MCC’s history.

In October 2022, the MCC’s team conducted inception missions with the newly hired consultant to kick off the work. Grudda has emphasised that the MCC is here to collaborate with the Government of Sierra Leone and become partners with the private sector and all stakeholders for a desired compact that would make a considerable contribution. He says this compact will be a significant step forward in the country’s efforts to increase access to electricity for all its citizens.

Energy Sector Roundtable

In 2022 the Government of Sierra Leone (GoSL) organised an energy sector roundtable event. This was the first step to establishing the country’s commitment to universal access to affordable, reliable, and sustainable electricity.

The key objectives of the roundtable were to discuss sector issues and activities for achieving sustainable energy, while mapping the way forward and prioritizing initiatives in view of available versus committed donor funds. The engagement also brought to the fore concerns and challenges that hamper achieving universal access to sustainable energy.

According to the World Bank Country Director for Sierra Leone, Ghana and Liberia, Pierre Laporte, access to electricity is a key driver of self-inclusive and resilient economic development, and is also an essential element for the United Nations agenda and an enabler for human capital development

Over the past two years, the World Bank provided over 200 million dollars to finance the electrification of District Headquarter Towns and other areas. The bank’s support for Sierra Leone’s energy sector will play a vital role in the country’s efforts to increase access to electricity for all its citizens and drive economic growth.

The Minister of Energy, Alhaji Kanja Sesay emphasized that his ministry has been charting a sustainable energy path with pillars including a technical audit of the energy sector, robust reform in the energy sector, restoring electricity supply to all district capitals, and encouraging investment in low-cost renewable projects such as solar, hydro, wind, and biomass.

The Minister of Energy noted that the demand for energy has risen nationwide, with peak power demand in Freetown alone rising from 70MW to well over 85MW. More recently, the Russia-Ukraine war has created sharp increases in global oil prices, leading to substantial fiscal impact worldwide and particularly in Sierra Leone, given the country’s generation mix and reliance on thermal generation.