Solar powering public health centers: A systems thinking lens

Around 300,000 women around the world die every year due to complications during pregnancy and childbirth. An estimated 19.9 million children do not receive critical vaccinations putting them at serious risk of potentially fatal diseases. These risks and deaths are preventable with appropriate management and care. Access to healthcare in low resource settings requires a comprehensive approach that strengthens infrastructure, systems, and medical and human resources. The lack of access to energy within infrastructure strengthening dramatically contributes to the immense healthcare challenge faced by developing countries. Electricity is essential for access to health services, as essential as the healthcare center, human resources, equipment, medicines etc. Universal Health Coverage cannot be achieved without energy access in healthcare facilities.

Healthcare today, without counting the potential services to the un-catered populations in the world, contributes to GHG emissions, equivalent to the 5th most polluting country in the world. Furthermore, if we must meet the goals of access to health today, it cannot be considered via traditional models of electrification, keeping both the health of the people andthe planetary boundaries in mind. Clean energy and particularly solar energy, if planned and deployed in a manner that is decentralized, need-based along with accounting for local capacities and conditions for sustenance - can become a ‘silver bullet’ in catalyzing healthcare access to under-resourced settings. Given low-resource settings and last mile healthcare requirements this article only takes into consideration off-grid solar systems, which could be one of the primary ways for health centers to become resilient and contribute to climate mitigation, irrespective of prevailing grid and on-grid conditions.

With multiple similar programs for solar powering public health facilities over the past decade there are learnings that emerge from across the globe. One of the key learnings is the need for a system thinking lens while deploying decentralized solar for health programs that sustain from a long-term perspective. Systems thinking is an approach that enables one to consider the health system as a whole, while designing demand driven solar powering programs for driving access to healthcare goals. This can be done by breaking down all aspects of solar powering and ensuring that within each aspect, the need is well-understood, the key stakeholders and their priorities are considered and capacities and relationships are accounted for. Moreover, systems are put in place for customization, expansion, and maintenance over time. The suggestions and examples provided below prioritize healthcare needs while driving enabling conditions for design and sustenance of solar for meeting current and future healthcare challenges. While healthcare systems require multiple levels of both curative and preventative healthcare, the considerations below are primarily for last mile public health curative infrastructure. Below, some best practices are elaborated across the following aspects for solar powering health:

1. Assessment

2. Technical Design

3. Financials and Budgeting

4. Procurement

5. Operations and Maintenance

6. Capacity Building