Tools and Technology for Off-Grid Rural Health
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How distributed renewables are impacting indicators of health and wellbeing in Uganda.
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Tools and Technology for Off-Grid Rural Health
- 1. Technology and Tools: Improving Health and Tracking Impacts Let There Be Light International, USA KACCAD, Uganda
- 2. *Education *Outreach *Access *Prevention Improved Health and Safety GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org
- 3. GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org
- 4. Reported Benefits of Solar Electrification GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org
- 5. Increase in Patients treated pre/post GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org
- 6. GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org Education Outreach and the Seeding of Solar Markets
- 7. Challenges and Program Modifications *Remote locations *Connecting with staff *Lack of staff training *Drug shortages due to increased patient loads GIVING LIGHTS, CHANGING LIVES www.LetThereBeLightInternational.org
Notes de l'éditeur
- Sustainable Development cannot happen without healthy communities, and healthy communities cannot be sustained without energy. I represent an NGO that is supporting partner NGOs working in low-resource communities in sub-Saharan Africa on energy poverty and sustainable development. In particular, we address SDGs targeting health, wellness, safety, energy, climate, and partnerships through the provision of solar health systems and solar lights to at-risk families. Many of us in the sustainable development and energy nexus realize that access to safe and, ideally, renewable energy is an important tool in our sustainable development toolbox. Prior to the adoption of the MDGs in 2015, both health and energy were considered important for development but their inextricable links were not fully explored. Today, we see that health and energy cannot be unlinked, and indeed, the need for tools and technology to aid in sustainable development and health care is paramount in low resource communities. In sub-Saharan African countries in which the data is available, 25% of all health clinics have no access to any electricity, and many of those clinics are far off-grid, making the probability of their electrification via conventional methods unlikely any time soon.
- In May, LTBLI conducted a follow-up survey in Uganda of 9 rural health centers that we solar-electrified over the past 3 years to determine how technology and tools are impacting health access and delivery in off-grid health centers. At least 3 clinicians and administrators were interviewed by trained field officers at each site with a total of 29 healthcare workers interviewed over the course of two weeks. The clinics all lack on-grid electricity and are, on average, 15 km from the nearest grid. The nine clinics serve a total population of 128,000 people. A pre-post evaluation design was used and assessment data was collected in person, or when necessary, over the phone and entered into our data-base using handheld Asus Tablets with installed and pre-designed questionnaires. After being completed offline in the field, surveys were uploaded and sent to Let There Be Light International where staff carried out the data analysis. The clinics targeted by Let There Be Light International's Solar Health program were Health Center II and III facilities located at the parish, village or subcounty level and overseen by a nurse or a non-MD clinician or a midwife. All clinics provide first-line emergency and outpatient care and some include a maternity unit and a simple laboratory. None of the health centers had refrigerators or other technical equipment or were targeted for on-grid electrification. The systems installed at the facilities are capable of powering lights and small appliances (such as radios and televisions) and charging mobile telephones used by healthcare providers to support referrals and on-time reporting.
- Here’s a slide from a 2006 European Commission report describing the potential impacts of access to energy on health services. It’s very dense. Don't worry about reading it. I included it to outline some of the “potential impacts of stable energy provision on health services performance.” Now, our project was not able to provide electrification for a clinic with modern technology, but we were able to demonstrate that providing even small systems to firstline health clinics can make a significant impact on healthcare access and delivery. Because we were only providing lighting and electricity for basic services, we could not realize the first two items under disease prevention. However, every other potential impact was realized in our findings. Every one.
- Here's what we found using tools and technology. The 29 health workers surveyed responded that the primary benefits of working in solar electrified clinics were the increased hours of operation, the ability to charge mobile phones, and the increased number of emergencies that they could handle during the night. According to the staff and district health ministry, the ability to charge mobile phones improved communication between health workers and the district health authorities as well as on-time medical reporting. Increased patient and staff safety also were reported to be valuable outputs as well as an increase in staff retention. The decreased cost of maintaining the health facilities was another major benefit, because the funds received by clinics to cover monthly expenses was not seen as adequate to cover all costs. 16 health workers also reported that members of the community and the staff now perceive the health facilities to be modern, adding to the willingness of community members to access services at the clinics.
- Regarding our impact on women and children, we found that the number of children treated weekly increased 48%. At clinics providing maternity services, attended births increased nearly 200%. Notably, the increase in attended births was cited by surveyed community members and healthcare staff as an important marker of increased community healthcare access. Other findings include: All 9 clinics increased their hours operation and their days/week of operation, increasing the number of patients treated by an average of 37%. In short, clinical staff were able to provide more healthcare for more people for more hours with higher rates of satisfaction among providers and patients. The conclusion was drawn by multiple stakeholders that the adoption of low-cost, high-impact solar interventions in concert with tablet-based survey evaluation can improve proximal community health indicators in low-resource, off-grid communities, while building the knowledge base to better target intervention and investment.
- Given the large volume of people accessing clinic services and the limited staffing available to conduct outreach education, we recognized an opportunity to complement programming through the design and dissemination of a solar health flier. Here you can see a volunteer putting one up by a clinic. 1,000 fliers currently are being distributed for display at health clinics, schools and community centers. The posters include visual and written information about how solar lights work, their safety relative to kerosene, how to contact local vendors who are selling the appropriate technology; and whom to contact to find out more information. We also are training teachers and staff at schools, clinics and community centers to understand the technology and the potential health and safety impacts. In addition to our poster outreach, we conduct biweekly Solar Awareness sessions at health clinics. Over the past 18 months 1,325 community members have attended these Solar Awareness sessions, where they are free to ask questions, handle a variety of lighting-africa-approved solar lights, and purchase lights from vendors who are invited to attend the sessions.
- Challenges to collecting data included the distances to the remote locations of the health centers and the difficulty encountered by field officers in conducting in-person interviews with targeted healthcare staff. Due to the unfamiliarity of some staff with the new technological equipment, overloads and improper connections occasionally required maintenance. To address the lack of awareness about the capacity of the solar electrification systems and battery storage, we designed, printed and disseminated appropriate use posters that are now displayed next to the systems for the continuing education of the health clinic staff. To further support clinic staff, we developed ongoing educational programming and we conduct free sessions at the health clinics to educate providers, patients, and community members about the health, safety and environmental dangers of using kerosene and candles for lighting. The District Health Officer (with whom we work closely) reports that she has created a battery-replacement fund. She also is working with the regional health ministry to increase the stock of drugs available to each clinic in order to anticipate and curb shortages in available medications. The pairing of an increase in medication stocks with health center electrification should be considered for future projects. The solar electrification of health centers is an integral part of LTBLI’s efforts to use tools and technology to support sustainable development in low-resource communities. Other projects include: raising awareness about energy poverty; address extreme energy poverty in pre-market, vulnerable communities; and seeding solar markets in remote off-grid locations. To-date, LTBLI has donated on a long-term loan basis nearly 5,000 solar lights via local social service delivery channels to off-grid families with handicapped children, elders, and new babies as part of our Solar Home and Health initiative, impacting about 27,000 people. According to the World Bank’s report, Progress Toward Sustainable Energy, “Analysis of the nexus between energy systems and other key areas of development — water, food, health, and gender— suggests that numerous opportunities can arise from wider cross-sector perspectives and more holistic decision-making in energy.” As demonstrated here, access to training and technology can help to connect last mile populations with first line resources and can support local programming and expertise with the tools and technology to enhance the success of their interventions.