Muriel Hauser, visiting research postgraduate at the Grantham Institute, considers why electricity is so important for healthcare, and how improving access to energy can improve access to healthcare for all people.
Have you ever worried that a blackout might occur when you’re in hospital? That an operation could be interrupted because of a power outage, or that it could be impossible to get an X-ray because there is not enough energy available? If you live in a developed western society, probably not! In developing countries however, energy supply is a vastly neglected factor when it comes to healthcare provision. The lack of reliable energy has a considerable impact on the quality of healthcare, and can have life-threatening consequences.
What kind of health services require energy?
A consistent energy supply is essential not just for complex surgery, but basic medical procedures and routine treatments. Ultrasounds, blood analysis and simple examinations that require a good source of light are energy dependent; certain medicines and vaccines require constant cooling to maintain their effectiveness; and processes such as sterilization or medical waste incineration need energy in the form of heat. For large hospitals and smaller health centres alike, a reliable energy supply is crucial for providing elementary services.
How many health centres in developing countries have electricity?
Surprisingly for such an important issue, information on the energy supply of health centres is scarce. There is no global database that assembles and compares the energy supply of health centres in different developing countries. Instead, evaluations often focus on the staff availability, medicines and treated diseases, rather than the actual infrastructure of health centres.
One study, however, has calculated an electricity access rate for health facilities in Sub-Saharan Africa based on publicly available data. The results (below) show that, while on average, 74% of health centres have access to electricity, the smaller and more rural a health centre is, the poorer its energy supply.
However, access to electricity doesn’t mean that energy is available at all times. Indeed, in Sub-Saharan Africa, the majority of health facilities experience blackouts that last longer than two hours during regular service hours on any given day. As you can imagine, power outages like these can be life-threatening.
As mentioned above, a vast range of common procedures, treatments, vaccines and medications rely on a continuous supply of energy. Unstable power and the associated changes in voltage can damage expensive medical instruments such as monitors and defibrillators – and repairing them is difficult without the right expertise, tools and spare parts, which few facilities have.
How much energy does a health centre require?
The first step to improving health centre energy supply is to identify the energy requirements. This way, more appropriate solutions can be developed to supply electricity in a reliable, low-carbon and cost-efficient way. However, accurately predicting energy requirements is complex. It depends on the equipment, the number of patients being treated and the timing of the procedures – which varies greatly depending on geographic, demographic or cultural conditions.
Efforts have been made by organisations like the World Health Organisation to categorize health centres according to their size and responsibilities, and therefore energy requirements, but there are big discrepancies even within these categories. What adds to this uncertainty is that, for particular medical devices, the energy requirements fluctuate a lot. For example, an X-ray machine in standby mode requires relatively little energy, but during a scan, the power requirements increase dramatically for a short period. This can be challenging for an already-strained energy system to cope with.
How to better supply energy to health centres?
Different propositions have been made to improve access to electricity for health centres. One way to ensure the availability of certain health services is by turning the most essential equipment into stand-alone devices that generate their own energy, so they are unaffected by power outages. Such devices, like medical refrigerators or portable power units for obstetric care, already exist on the market. However, this doesn’t really tackle the root of the problem.
Another approach is to install mini-grids based on renewable energy sources like solar and hydro power. These self-sufficient energy systems have already proven to be viable solutions to electrify rural villages. Gram Oorja, for example, has deployed mini-grids and brought a reliable electricity supply to 200 villages in India. My own research shows that using mini-grids to supply energy not only to a village, but also a health centre, is a win-win. On the one hand, the health centre gains a reliable energy supply. On the other, it decreases the costs of the electricity to the mini-grid operator as the health centre uses more of the energy generated, reducing excess energy that would have otherwise been wasted.
What is needed now?
Solutions to improve the inadequate energy supply of health centres in developing countries do exist, but they haven’t yet been proven on a large scale. The majority of health centres still face costly and potential life-threatening power outages. Before we can move forward, more research is required. We need a comprehensive understanding of the energy needs of health centres, and more detail on electrification rates. Only then, will we be able to develop more efficient, tailored solutions that can be successful.
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