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Credit: Innovation Africa
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50%health facilities lackbasic water services
59%births attended by skilled health staff
72%child immunization coverage (DPT-3)
42%sub-Saharan Africans say they have access to high-quality health care
Source: WASH in health care facilities: Global baseline report 2019, WHO & UNICEF, 2019
Source: WHO Source: WHO & UNICEF
200,000women die during pregnancy or childbirth each year
Despite recent progress, quality of health care in sub-Saharan Africa remains a challenge
Source: Gallup World Poll
93%sub-Saharan Africanswithout access to timely, affordable, safe surgeries
Source: The Lancet Commission on Global Surgery Source: WHO
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Infrastructure (including power) is key cost driver for SDG 3
Additional investment required to meet SDG 3Billions of $ (2014)
Source: Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries, Lancet Global Health, 2017
$274 billion / year
Infrastructure
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Quality of care relies on power…
Credit: UNDP Zambia/Slingshot Credit: UNDP Zimbabwe /Slingshot
Credit: UN Foundation
Credit: UNDP Zambia/Slingshot Credit: UN Foundation
Credit: UNDP Zimbabwe /Slingshot
Credit: UN Foundation
Credit: New York Times
Credit: MSF-East Africa Credit: UN Foundation
Credit: Jake Lyell
Credit: WASH in Health Care Facilities
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…yet, too often health care looks like this
Credit: We Care Solar5
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Nearly 600 million Africans live without power
Access deficitMillion people
Source: Energy Access Outlook 2017: From Poverty to Prosperity, International Energy Agency, 2017 6
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Health facilities are not immune to energy poverty
Source of electricity for rural health facilities %
Ethiopia Kenya• Almost 7 out of 10 health facilities have no
electricity. Access to electricity is a major challenge.
• 15% of health facilities in rural areas have electricity from off-grid solar products.
• Almost 2 out of 10 health facilities in rural areas have no access to grid electricity.
• About 15% use off-grid solar solutions as a main source of electricity.
17%
68%
1%
7%
14%
8%
9%
2%
59%
16%
0% 20% 40% 60% 80% 100%
Kenya (rural)
Ethiopia (rural)
No electricity Solar lighting system Solar PV system Generator National grid
n=125
n=63
Source: Energy Sector Management Assistance Program 7
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16%
26%
59%
48%
25%
26%
0% 20% 40% 60% 80% 100%
Kenya (rural)
Ethiopia (rural)
Tier 0 Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
No power
Grid power isn’t a ‘silver bullet’
MTF Tier distribution among grid-connected rural health facilities%
n=39
n=20
Ethiopia KenyaMain issues with the grid electricity• Availability: 25% have <8 hours of electricity• Reliability: 40% having >14 interruptions per week• Quality: 28% experience severe voltage
fluctuations
Main issues with the grid electricity• Reliability: 88% experiencing 4-14 times or
more than 2 hours of interruptions per week.
Source: Energy Sector Management Assistance Program
24-hr power
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With power, comes the opportunity to improve health services
Availability of medical equipment in rural health facilities %
Source: Energy Sector Management Assistance Program 9
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Business-as-usual (grid extension) leaves a big access gap
Electrification rate%
People without accessMillion people
Source: Energy Access Outlook 2017: From Poverty to Prosperity, International Energy Agency, 2017 10
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Facility-based care is more important than ever
Facility-based delivery trends in Africa% of all births taking place within a facility
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020
Ghana Benin Chad
Dem. Rep. Congo Uganda Tanzania
Rwanda Namibia Lesotho
Source: Demographic and Health Surveys Program 11
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Cost of clean energy is lower than ever before…
Solar prices $/W
Source: Bloomberg New Energy Finance
PV module prices have declined 93% in the
last decade
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Solar Kiosks
…enabling a range of decentralized clean energy solutions
Portable Solutions
Mini-gridsFacility-wide ‘Micro-grids’
Stand-alone Solutions
Tier 1
Tier 2
Tier 3
Tier 4
Tier 5
Leve
l of
Acc
ess
Hig
he
rLo
we
r
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Off-grid solutions are least-cost option for remote facilities
Source: Energy Access Outlook 2017: From Poverty to Prosperity, International Energy Agency, 2017
Decentralized energy will be the least-cost electricity solution for 450 million rural Africans
New connections
On-grid
Mini-grid
Off-grid
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Energy efficient medical equipment can drive costs down significantly
Energy Efficient Medical Equipment
Comparative Costs of Stand-alone Power Equipped with…
• Lighting• Refrigeration• Radio• Computer• Lab centrifuge• Microscope• Blood chemical analyzer• Hematology analyzer• CD4 machine
Simulation of rural Kenyan facility @ 8.6kWh/day
15-25%savings
Capital Expense
Operating Expense
Source: Access to Modern Energy Services for Health Facilities in Resource-Constrained SettingsWorld Health Organization & World Bank, 2015
Conventional Medical Equipment
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Distributed energy contributes to more resilient health systems
Credit: REUTERS/Philimon Bulawayo16
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Powering universal health care
Credit: UNDP Zambia/Slingshot
Providing Access
Ensuring Quality
Reducing Costs
Building Resilience
Credit: UNDP / Karin Schermbrucker for Slingshot17