By Rakiya A.Muhammad
For the past three years, the primary healthcare centre in Karu, on the outskirts of Abuja, has enjoyed an uninterrupted power supply, which has changed the narrative for healthcare delivery care in the community.
Before installing a mini-grid, which ensures consistent and sustainable power for the facility, the epileptic electricity supply impeded the centre’s ability to deliver even the basic services.
A health centre’s electricity woes
There was inadequate power provision for vaccine storage, lifesaving medical equipment and supplies, emergency care, and nighttime light.
“It was a great worry for us in Karu when our primary health centre had electricity issues, delivering babies in the dark,” Chinyere Bende harks back to the PHC’s pre-pandemic state.
“The darkness that enveloped the centre at night was of security concern to many in the community.”
From vaccine and pharmaceutical loss because of breaks in the cold chain to disruption to medical procedures and compromised patient care and work environment, electricity difficulties dealt a devastating blow to health service delivery at the Karu PHC, which had to stop night operations following inadequate power supply from the national grid and generator.
Ali Gabriel Dogo, a community health practitioner at the centre, recalls how they often had to discard medical supplies compromised due to the power failure. “Our vaccines and drugs usually get damaged because they do not get the continuous storage at specific temperatures to maintain viability.”
Also, the Nurse in charge of the Antenatal and Maternity unit, Madam Layatu, recounts their experience of the absence of light to illuminate critical services during night shifts.
“Can you imagine a nurse taking delivery using her handset or local lantern? We had to use whatever because we didn’t have a regular power supply,” she discloses.
“Even the husbands of our clients were not happy with us.”
Karu’s experience of an epileptic power supply despite being connected to the national grid is typical of many health centres across Nigeria, which has continued to grapple with the power sector challenges despite the country’s rich oil, gas, hydro and solar resources.
The nation has the potential to generate 12,522 MW of electric power from existing plants, according to the Nigeria Power Africa Factsheet.
In low and lower-middle-income countries in South Asia and Sub-Saharan Africa, approximately 12 per cent and 15 per cent of healthcare facilities have no electricity access, notes the World Health Observatory Database on electrification of healthcare facilities.
It adds that about one billion people worldwide are served by healthcare facilities with no electricity access or with unreliable electricity supply.
The Powering Healthcare Nigeria Market Assessment and Roadmap, which the Sustainable Energy for All (SEforALL), developed under the Power Africa-funded Powering Healthcare Africa Project, provides more insight into the situation.
“By the Federal Ministry of Health estimates, Nigeria currently has roughly 1.4 healthcare facilities per 10,000 people,” it states.
“An estimated 30 to 40 per cent of the public PHCs are considered functional, and around 40 per cent of the functional PHCs are without access to electricity.”
It points out: “More detailed (but less nationally representative) needs assessments indicate that PHCs have on average 6-10 hours of power supply, with less than 20 per cent of PHCs using solar power.”
Solar technology to the rescue
As rural areas continue to grapple with the challenge of unreliable electricity, which severely impacts the quality of health services, there is growing attention towards implementing mini and microgrids, which the African Union High Panel on Emerging Technologies (APET) describes as a priority area of relevance for alleviating Africa energy insufficiency.
The move towards reliable power sources gained more prominence during COVID-19 as the pandemic further exposed the energy gap in healthcare.
‘COVID-19 and Beyond’ intervention, a component under the Nigeria Electrification Project (NEP) initiated during the pandemic, is among projects empowering health through sustainable energy solutions.
The initiative targets 100 isolation and treatment centres (ITCs) and 400 primary healthcare centres across the country, serving over a million patients and creating more than 13,000 direct and indirect jobs in the health sector.
The $70 million project aims to energise health facilities and improve healthcare services across Nigeria, deploying 15MW of newly installed off-grid power.
“In Nigeria and across the world, there is a nexus between quality healthcare delivery services and sustainable energy,” says Ahmad Salihijo, Managing Director of the Rural Electrification Agency (REA).
“The Nigerian government is exploring the nexus through delivering impactful renewable projects.”
REA, which is implementing the initiative, says they have completed over 50 projects and that many more are under construction.
“The impact is cutting down on carbon emissions, aiding quality healthcare delivery, cutting down on cost and enabling a better environment for healthcare workers.”
Implementing mini-grids and microgrids has proven to be a transformative solution, ensuring consistent and sustainable power for facilities such as Karu Health Centre, where Volsus Energy Limited installed a VSFH 12-kilowatt power (KWP) solar power mini-grid with 58-kilowatt hour (KWH) battery bank in the thick of the COVID-19 pandemic.
Three years later, the initiative triggered the desired positive impact to reverse the ugly situation.
“Volsus Energy launched the mini-grid in September 2020; since that time, up to today that we speak, the light we have been using here is from VSFH,” reveals Mr Akila Udoji, the officer in charge of the Karu Primary Health Centre.
“It has served us for three good years uninterrupted; in these three years, we have never had the problem of a power outage.”
He explains: “It has improved our services in the area of laboratory investigations that we run, in the area of the storage of vaccines and in the area of conducting services in the night, especially labour and in the night operations, where we had serious issues.”
Dogo, the community health practitioner, corroborates, adding that the vaccines now last throughout the session with solar energy and are adequate to administer to children.
“Hitherto, we collected a few vaccines because we did not have where to store them. But Volsus brought a mini-grid, battery and refrigerator so we could preserve our vaccines and administer them at all times. More children are now coming for immunisation.”
From glum to bloom: The Karu community members have continued to express delight over the transformation in healthcare delivery.
“It is about the joy that we that are working in Karu and the people in the community of Karu feel,” says Udoji.
“Anytime we hold village or ward development committees, the members of the committees drawn from this community are so grateful for this laudable project.”
Engr Tomiwa Bayo-Ojo, Chief Executive Officer, Volsus Energy, explains that VSFH kickstarted at Karu as part of the company’s corporate social responsibilities to power the primary health centres in Nigeria through a public-private partnership model.
There have been other efforts towards improving healthcare accessibility and reliability through renewable energy integration in rural clinics in Nigeria, such as the US Government-led partnership, Power Africa, and Kaduna State Government/UK Aids initiatives.
Power Africa supports the World Bank and REA’s NEP to provide electricity access to off-grid communities through renewable energy power sources.
The initiative, which aims to increase energy access and end energy poverty in Sub-Saharan Africa, has backed the development of 3,043 megawatts of electricity in Nigeria.
Under the partnership, PowerGen commissioned the first mini-grid under the Nigeria Electrification Project in the Rokota community in 2019, providing power to Rokota Lwemp Health Clinic.
The solar hybrid grid with battery provides power to Rokota Lwemp Health Clinic and local businesses over 400 households.
In 2016, Governor Malam Nasir El Rufai-led administration in Kaduna began the installation of solar systems in PHCs across the state in partnership with the UK Department for International Development.
Described as the first of its kind in northern Nigeria at its initiation, the project was to ensure that the selected healthcare centres, serving over 180,000 patients annually, can be supplied all the power they need to provide quality healthcare round the clock in an environmentally friendly manner.
In the 34 PHCs, the state government notes that an average of 6,000 babies are delivered – 44 per cent of which are at night but that due to lack of electricity access at remote PICs, staff deliver babies that come at night under candlelight.
Also, under the Solar Nigeria Programme launched by the UK Aid and the European Union, EM-ONE, an energy solutions group, had, by January 2020, delivered 13 microgrids at nine rural hospitals and four general, peri-urban hospitals throughout Kaduna state.
“These 13 hospitals and clinics have been able to save a combined $325,800 per year due to no longer having to maintain, fix and refuel unreliable diesel generators,” reveals Lisa DeMarco, Principal Consultant.
“The solar-plus storage-powered EM-BOX solutions have also enabled a total of nearly 1,400 tons of carbon emission per year by offsetting approximately 540,000 litres of diesel per year. Over four million people now have access to more reliable, higher quality frontline medical services as well as cleaner air.”
Addressing energy, achieving SDGs
There has been a significant increase in health facility electrification interventions from 9 interventions cumulatively targeting 339 health facilities in the past six years to a more ambitious 19,659 health facilities targeted by 11 ongoing and planned interventions, according to SEforALL.
However, it observes health facility electrification interventions are still heavily donor-dependent with minimal private sector involvement. At the same time, healthcare delivery is also severely impacted by a lack of infrastructure and resources.
For progress in universal health facility electrification in Nigeria, the Powering Healthcare Nigeria Market Assessment and Roadmap recommends investing in data collection and analysis via comprehensive energy assessments of functional health facilities and building a dynamic national database.
The roadmap also suggests unlocking appropriate financing & risk mitigation vehicles and strengthening coordination between the REA and the National Primary Healthcare Development Agency through existing national energy and health sector strategies.
Experts note empowering healthcare through sustainable energy solutions will drive faster action towards achieving pertinent Sustainable Development Goals (SDGs).
“By utilising technologies to ensure healthcare delivery reaches remote and under-served communities,” notes the United Nations Development Agency, UNDP. “It is helping countries in their efforts to achieve SDGs 3,7 and 17, good health and wellbeing, affordable and clean energy and partnerships.”