A recent publication by International Renewable Energy Agency (IRENA) stated that around a billion people today rely on health facilities without electricity supply. While most large hospitals may have round-the-clock access to power, electrification rates drop significantly for rural clinics. In the absence of reliable power, many of the basic life-saving interventions cannot be undertaken safely or at all.
Also, a recent study analyzing over 121,000 health facilities, in 46 low and middle-income countries, found that almost 60% of them lacked access to reliable electricity. Even facilities with electricity access can often suffer from an unreliable supply – negatively affecting the ability of medical professionals in rural communities to deliver modern health services.
Renewable energy is at the forefront of solving this issue. Off-grid (stand-alone and mini-grid) renewable energy solutions represent a cost-effective, rapidly deployable, and reliable option to electrify healthcare centers, transforming lives whilst bolstering global efforts to achieve Sustainable Development Goal 3 – good health and wellbeing.
Lack of sufficient and reliable power is jeopardizing the well-being of millions of people, especially women and children, who often bear the brunt of inadequate primary healthcare 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 (Sustainable Energy For All, 2019).
Like the pilot Energy survey from 10 selected health facilities across seven (7) Local Government Areas (LGAs) of Kano state in August 2020, the expanded phase was also carried out by the Nigerian Energy Support Programme (NESP), a technical assistance programme co-funded by the European Union and the German Government and implemented by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH in collaboration with the Federal Ministry of Power (FMP), in partnership with eHealth Africa. It was conducted in close cooperation with geospatial data experts from INTEGRATION Environment & Energy GmbH (INTee) and Reiner Lemoine Institut (RLI) in Germany. This is part of the effort of the NigeriaSE4ALL Initiative to offer the most up-to-date, ground-truth, electrification data available in Nigeria.
The expanded survey was also carried out using a remote interview method for conducting interviews with the health facility in-charges in selected health facilities across 43 out of 44 LGAs of Kano, and 27 out of 30 LGAs of Osun state.
The findings from the result of the earlier concluded pilot survey necessitated the expansion in the scope of the survey, to gather sufficient information that would help provide a bigger picture of the energy needs, current situation, and guidance for the planning of possible implementation of suitable energy solutions for communities. The expanded scope covered a total of 291 health facilities - 173 health facilities in Kano state and 118 health facilities in Osun state.
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Helpdesk Agents administering questionnaires remotely to Health Facility In-charges in Kano and Osun State
The methodology used in collecting the data is through remote administration of survey questionnaires via phone calls, to ensure adherence to and support the COVID-19 response efforts in Nigeria and minimize the risk of infection through physical contact.
The primary aim is to assess energy gaps and identify the potentials for connection to an off-grid power source (renewable energy) and at the same time, determine the readiness for Covid-19 response at the Primary Health facility level.
The diagram below presents a summary of the implementation approach adopted for the survey.
Figure: Summary of the implementation approach adopted for the survey.
The following four major data sources were utilized;
list of health facilities extracted from the eHA data portal,
Grid Clusters (potential location for off-grid infrastructure),
Senatorial administrative boundary
Contact list for Health Facility representatives
Health facility data and senatorial administrative boundaries were downloaded from the eHA Data portal/ GRID3 as shapefile format, power grid location was downloaded from Nigeria SE4ALL Webmap; in Geojson format, containing the KEDCO - Grid Data MV Lines (2016) and Osun state MV power lines.
Finally, a structured survey was designed to capture the energy required capabilities and capacity of the health facilities.
Fig 2. Map showing the distribution of Primary health facilities in Osun state(Left) and Kano state(Right)
Activities
Remote administration of questionnaires to the health facilities in-charges via phone calls to identify the following:
the health centers’ current electricity supply status
general services provided by the health centers,
their current ability to cope with the COVID-19 response
available infrastructure at the health center that would impact considerations around power requirements
Key Findings
The survey findings indicate that all infrastructures do not meet up the minimal requirement stated by NPHCDA and some health services needed to be upgraded
Power shortages affect the functionality of many types of equipment at the health centers across all assessed facilities thereby, affecting the output and overall performance of the facilities in terms of service delivery.
Benefits of the survey
The outcome of the survey provides visibility on areas and health facilities that require urgent intervention, such as the provision of PPEs to the health facilities and other equipment/infrastructures. Also, the data collected were subsequently published with updated health facilities infrastructure and services information on the eHA data portal for public access and to all for non-commercial use.
Finally, the survey makes readily available information relating to health facilities and the preventive measures taken during the COVID-19 crisis.
Future Survey Use Case Potential:
The remote survey showcased the capacity to effectively gather information on energy sources and requirements whilst supporting efforts in preventing the spread of the COVID-19 virus, without requiring a face-to-face engagement.
Considering the necessity for energy supply, especially at health facilities, these surveys present a clear understanding of current energy systems that may not be sustainable and the need to consider alternative sustainable energy systems that would have minimal impact on climate change and make lives better.
Ultimately, surveys can be conducted nationwide to establish a baseline for the energy requirements of Primary Healthcare facilities.
It is evident that the functionality and efficiency of the Nigerian health systems especially in rural settings, can not be optimized with the use of on-grid electricity, some components of which are affected by unstable weather due to climate change. As such, harnessing renewable energy will be an alternative way of addressing the persistent power challenges in the health sector.
The Program Partners
