Description
Electricity is required for running basic diagnostics and procedures, ventilation, sterilization, to store medicines and vaccines. This is in addition to the needs for water pumping, sanitation, lighting, cooling, heating, and tele-medicine services. Electricity also plays a role creating a conducive and safe environment for patients and staff.
However, a joint report led by WHO estimates that globally, nearly one billion people access health facilities that are either unelectrified or have unreliable electricity. In India, over 18,000 sub-centres and primary health centres function without an electricity connection. Many health facilities therefore rely on polluting diesel generators, which cause health-related concerns, and contribute to healthcare’s global carbon footprint that is equivalent to 4.4% of global emissions.
To overcome challenges to reliable electricity, and simultaneously build adaptive capacity to climate change impacts, energy-poor health facilities across India have been adopting decentralized renewable energy (DRE) solutions, mainly through solar energy. Though there has been limited research in understanding the effects that clean energy solutions have on healthcare outcomes. To analyze this correlation and build local evidence, this research explores the role of DRE interventions in rural health facilities and its linkages to healthcare service delivery. The study looked at a sample of 22 health facilities, that form part of 3,000 health facilities solarized under various government and non-government initiatives in India across 6 Indian states. The health facilities sampled capture the heterogeneity of the Indian health system based on the geographic location, patients served, affordability of care, tiers of healthcare, and electricity infrastructure adopted.
The study adopts a qualitative survey-based evaluation to understand the changes in healthcare service delivery through semi-structured interviews with medical staff, implementing agencies, technology providers and financiers. The findings reflect on the various technical, financing, and operating models adopted to conduct needs assessment, site selection, energy system design, technology provider selection, and energy system maintenance.
80% of the solarized health facilities surveyed had an existing grid connection and reported varying hours of power outages (up to 16 hours per day). Despite the uptake of DRE solutions, many energy systems are underutilized by not accessing the energy system’s capacity to meet the demand of the health facility. Energy system sizes across health facilities of the same level of care remained constant although the size of population served, disease prevalence, and types of services provided varied. Although energy monitoring systems have been installed, issues of added cost, network availability, hardware malfunction, and data transmission were observed. On the aspect of operations and maintenance (O&M), building medical staff awareness and capacity to run these energy systems need further attention. Moreover, the responsibility of O&M seemed like an additional burden for staff, and therefore it becomes relevant to identify the right stakeholders or agency within the health system to maintain the solar energy system. On financing, there is a need for public and philanthropic capital to shift towards extended-term capital financing, so that the outcomes of their investments could be realized in terms of changes to health service delivery.
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