Extending REA COVID-19 Off Grid Solar Support to Primary Health Care Centers

Energy plays the most vital role in the economic growth, progress and development as well as poverty eradication and security of any nation. Uninterrupted energy supply is a vital issue for all countries today. Future economic growth crucially depends on the long term availability of energy from sources that are affordable, accessible, and environmentally friendly.

Security, climate change and public health are closely interrelated with energy in which all the above statement is lacking in Nigeria’s Primary Health Care Centers, a country so called giant of Africa with abundant manpower and resources. Energy provision is essential for health care (refrigeration of vaccines, emergency and intensive care etc.).

The council for renewable Energy of Nigeria estimates that power outages brought about loss of N126 billion (US $ 984.38 million) annually. Apart from the huge incurred loss, it has also resulted in health hazards due to the exposure to carbon emission caused by constant use of backyard generators.

Since Nigeria is blessed with abundant renewable energy resources such as hydroelectric, solar, wind, tidal and biomass, there is need to harness these resources to the health sector in particular Primary Health Care Centre.

The Director, Planning & Research Statistics Nigeria Primary Health Centre Development Agency (NPHCDA), said no Primary Health Care Centre in the North Central zone of Nigeria that met the five star requirements. For a PHC to meet the requirement it must be well equipped with steady electricity, functional and well equipped laboratory, and fully staffed with presence of a doctor and nurses. Though the federal government says it has been revitalizing some Primary Health Care Centers across the country, many still need attention.

Part of the mandate of Nigerian Rural Electrification Agency (REA) is to provide affordable power supply for residential, commercial, industrial and social activities in the rural and peri-urban areas of the country. The Agency is now mandated to concentrate on providing off-grid solutions to rural dwellers such as mini grids and solar home system.

REA is the agency of government who is saddle with the responsibility of providing solar hybrid mini grids to unserved and underserved areas across the country. A similar gesture should also be extended to all the 36,000 existing Primary HealthCare Centers across the nation to compliment the quick intervention the agency have made in providing 53.1kwp solar hybrid mini grid at the University of Abuja Teaching Hospital COVID- 19 Isolation Centre and other three centers one in Lagos and two in Ogun state. This will further increase the number of patients that seeks Health Care at the Primary HealthCare Centre in Nigeria. Because not having access to 24hours of electricity have grossly affected the ideas of setting up the Primary HealthCare Centre in the last 3 decades. It will also encourage the Community Health Extension Workers (CHEWS) and Junior Community Health Extension Workers (JCHEWS) to perform their duties has being expected of them.

In addition, several PHCs are unable to render services beyond 5 p.m. due to lack of power to provide illumination at night. Medical personnel therefore rely on rechargeable lamps, kerosene lanterns, or petrol powered generators for night emergencies.

Most PHCs are located in rural communities and poor settlements; out of visibility of Government and elected representatives. Ironically, the annual budget for the construction and rehabilitation of both new and existing PHCs run into millions, if not billions of Naira; with costs ranging from N12 million to N30 million [depending on the PHC model; Type 1 or 2], yet the PHCs remain in deplorable conditions, with inconsistent power supply at the heart of the problem.

The study explores the energy situation in Primary Health Care Centers (PHCs) in Nigeria, using 60 PHCs in the Federal Capital Territory, Abuja as a case study. 57% of the surveyed PHCs are on-grid, while 43% are off-grid. Evidence from these study shows that on average a Primary Health Care Centre spends between N3,500 and N19,000 monthly paying electricity bills from the grid, which provides power for an average of 4 hours or less a day. To augment the poor grid supply, the PHCs turn to petrol powered generator sets, which they run for an average of 6 hours or more a day. The average monthly cost for this is between N20, 000 and N29, 000 on fueling (excluding maintenance and repairs). This averages between N23,500 – N48,000 a month, and between N282,000 and N576,000 a year to access electricity for 10 hours using unreliable grid electricity and polluting petrol generator sets. This still does not cover the required standard of 24 hours uninterrupted clean electricity supply all health care centers”. – Hbs (2018)

Access to reliable electricity is critical for the efficient running of Primary Health Care Centers (PHCs). This can speedily be delivered to PHCs through off-grid.

In a recent published article by one of the Civil Society Organizations, “Good Governance Team“, it Advocated for more actions for sustained mainstreaming of renewable clean energy solutions for the electrification of COVID-19 Isolation Centre’s, dedicated laboratories and other critical healthcare facilities, including PHCs across the country which cannot be overemphasized; that long before the outbreak of COVID-19 pandemic, Nigerians healthcare delivery system is known to have been totally neglected and remain in comatose.

“Primary Health Care is about caring for people, rather than simply treating specific diseases or conditions. PHCs are usually the first point of contact people have with the health care system. They are designed to provide comprehensive, accessible, community-based care that meets the health needs of individuals throughout their lives. This includes a spectrum of services from prevention (i.e. vaccinations and family planning) to the management of chronic health conditions and palliative care”. – WHO (2018)

A 2017 survey by BudgIT titled “from darkness to death” gathers the opinions of health workers on what they perceived as barriers to improved performance in healthcare centres. The survey revealed that in Nigeria, lack of appropriate hospital equipment and surprisingly access to reliable energy supply were the leading barriers to improved health care delivery with 26% and 21% respectively.

While there is a pressing need to increase the budget allocation to the health sector, specifically to Primary Health Care Development Agencies/ Boards, there is also the very urgent need to push for and inculcate the practice of transparency, accountability, better planning and better management of resources in the entire process.

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