This is the 3rd  post in a blog series to be published in 2023 by the Secretariat on behalf of the AU High-Level Panel on Emerging Technologies (APET) and the Calestous Juma Executive Dialogues (CJED)

African countries are progressively improving the quantity and quality of the healthcare available to their citizenry. This is in alignment with the African Union’s Agenda 2063 which envisions a prosperous Africa based on inclusive and sustainable economic development and growth. Africa’s health care has significantly improved as life expectancy has increased from 50.9 years to 53.8 years between 2012 and 2015. This was the most notable increase of any region in the world.[1]

Notably, Africa's healthcare system has managed to reduce child mortality rates. For example, in 2020, for children under the age of one, about 47 children for every 1,000 live births died, and this was down from 183 for 1,000 live births in 1955.[2] This is attributable to the progressively expanded efficiency of local healthcare facilities, advances in nutrition, and increased access to clean drinking water.

Despite the progress that has been made within the African healthcare sector, several challenges still exist. This is because the healthcare system of countries remains underfunded, resulting in significant service delivery challenges such as limited facilities and equipment, a limited skilled workforce due to brain drain, and low availability of electricity to undertake critical medical procedures. Additionally, in spite of the progressive successes that have been observed in the effort to reduce child mortality, the problem persists. For example, countries such as Somalia, the Central African Republic, and Chad are registering child mortality rates of 90.81, and 68 per 1,000 births, respectively (see figure 1). These rates are much higher than countries such as Tunisia, Seychelles, and Mauritius which have observed 11, 9, and 9 children per 1000 births mortality rates, respectively.

Figure 1: African countries with the highest maternal mortality rate in 2017(deaths per 100,000 live births)[3]

Recent reports have estimated mortality rates that are higher in Africa for children under the age of five, with most deaths occurring in rural areas. However, more than half of these fatalities are easily preventable and treatable including malaria, childbirth complications, diarrhoea, pneumonia, and preterm births.[4] Some African countries are progressively improving maternal nutrition to ensure foetal and child nutrition, enhancing immunisation to children against diseases, providing clean drinking water, promoting breastfeeding, and providing proper healthcare.

Interventions such as investing in efficient clinics, medical experts, health information, infrastructure, and cutting-edge equipment, among other things, can significantly improve morbidity challenges and further bolster the strategic and operational mechanisms for children's healthcare. This is especially vital in rural communities where electricity provides power to essential medical equipment such as incubators for pre-term newborn babies. This includes facilities such as operating rooms and delivery rooms to enable efficient and safe newborn baby deliveries. Furthermore, electricity can also provide power to refrigerators for medicines and vaccines.[5]

Hospitals are among the biggest commercial consumers of electricity in Africa, utilising the energy to ensure water supply, temperature control, lighting, and ventilation to a wide variety of clinical equipment. Regrettably, a majority of African hospitals and clinics have limited access to reliable electricity. Consequently, this may result in the spoilage of medications and reduced capacity to undertake essential diagnostics and provide power to medical equipment. Even the absence of basic lighting and communication can make treatments and emergency procedures more difficult. Therefore, the adoption of green energy technology in healthcare can potentially enhance healthcare service delivery.

In some African countries, electricity interruptions occur up to 50% of the time. As a result, hospitals and clinics are substantively relying on diesel generators to access electricity. These generators are not environmentally friendly, unreliable, and expensive to operate. Additionally, the backup generators are unable to stop abrupt blackouts that might harm delicate medical equipment, halt medical procedures, and risk the lives of patients.[6] Therefore, African countries should seek alternative sources of electricity to supplement the grid of power.

The African Union High-Level Panel on Emerging Technologies (APET) recommends that African Union Member States adopt renewable energy such as solar power, wind energy, hydro energy, tidal energy, geothermal energy, and biomass energy to provide energy for essential healthcare activities. African countries are encouraged to exploit the vast potential of renewable energy, particularly solar energy. This can significantly improve healthcare delivery and further prevent healthcare challenges such as child mortality rates in African clinics and hospitals.[7] African countries can leverage the installation costs of solar systems that are progressively becoming affordable and cost-effective. For example, the cost of solar panels has decreased by approximately 80% in the past decade.[8]

Fundamentally, where unreliable power is still a challenge, particularly in distant rural locations, solar energy is offering medical facilities with efficient, affordable, dependable, and independent sources of electricity. This is potentially enhancing and expanding healthcare access and delivery. Furthermore, in an APET report, “Micro-Grids - Empowering Communities and Enabling Transformation in Africa”, APET recommends that African countries adopt cost-effective, dependable, and autonomous sources of electricity.[9] Consequently, these renewable energy sources can be connected through microgrids to substantially expand and enhance healthcare access and delivery, especially in rural areas.[10]

Some progress is being observed in the increasing usage of solar power to provide reliable healthcare and reduce child mortality in Africa. For example, the collaboration between St. Luke Hospital in Wolisso, Ethiopia, and Enel Green Power (EGP) has successfully utilised solar energy to provide power to hospitals and clinics. As such, EGP is installing and implementing a cutting-edge solar hybrid system in St. Luke Hospital.[11] This solar system, consisting of a photovoltaic plant and batteries, produces up to 320 kWh of electricity. This system can also control energy flows in real-time to ensure a steady supply of power. This system has enabled the hospital to provide more effective healthcare to approximately 4000 deliveries annually.[12]

Furthermore, Sierra Leone, Liberia, Uganda, Tanzania, Kenya, Zimbabwe, and Ethiopia have collaborated with the “We Care Solar Works” to bring solar power to remote, off-grid, and under-resourced medical facilities to ensure that women deliver their babies safely.[13] For instance, since 2010, over 2,600 healthcare facilities are benefitting from the We Care Solar project, and about 10,000 health workers have participated in the solar training programmes.  As such, Solar Suitcases have been placed in clinics in 27 countries to serve more than a million mothers and their newborn babies.[14] As a result, more than 1 million babies have been delivered in healthcare facilities that are using Solar Suitcases (see figure 2).[15]

Figure 2: We Care Solar Suitcase[16]

Renewable energy innovation has substantively improved obstetric care in remote communities across Zimbabwe. As such, the system has successfully supported over 180,000 deliveries per year since its introduction.[17] For example, the Kamabarami Health Clinic, in Zimbabwe, is providing healthcare to pregnant mothers, children, and HIV-positive people in need of anti-retroviral therapy (ART).[18] This facility is conducting consultations in the morning and outpatient visits until 4 pm. However, the facility is also handling emergencies even at night. This becomes difficult to undertake since the facility lacks electricity and clinicians scruffle in near darkness to deliver lifesaving healthcare to patients. As a result, the clinic relied on candles to conduct medical services which were scary during complications. For instance, healthcare workers have difficulties administering Nevirapine to newborn babies to reduce the likelihood of maternal HIV transmission. Therefore, We Care Solar’s Solar Suitcase is providing an easy-to-use solar electric system to provide healthcare facilities with highly efficient medical lighting and power for mobile communication and small medical devices.[19]

The Suitcases were originally designed to support emergency obstetric healthcare delivery but can also be utilised in other humanitarian settings. For example, the water-and-dust-tight yellow case can be used as a cabinet to mount to the wall and connected to the solar panels secured on the roof. This system includes rechargeable LED lights, USB ports, a foetal doppler, and an infrared thermometer.[20] The practical and portable source of clean, steady electricity is ensuring night-time deliveries and emergencies. With the foetal doppler, healthcare workers can listen to the foetal heart rate easily, and detect foetal abnormalities in the baby, especially when there is birth asphyxia. Consequently, the clinic has enhanced productivity and substantially decreased maternal mortality rates since the introduction of solar power. The Solar Suitcases are now operational across 759 healthcare centres in Zimbabwe to support more than 180,000 deliveries, annually.[21]

Additionally, the installation of a solar-powered medical oxygen system at a central Somalia hospital has also proven effective in saving lives. For example, the innovative solar oxygen system was installed at Hanaano Hospital, in the central town of Dhusamareb in 2021. As a result, 171 patients received oxygen at the hospital from the solar-powered system from February to October 2022. Of these 171 patients, 163 patients accounting for 95.3% of the patients, fully recovered and were discharged from the hospital. [22]  

In Somalia, approximately 15,000 to 20,000 deaths occur among children under the age of five years because of pneumonia. Regrettably, pneumonia has become the deadliest disease among children under the age of five in Somalia and healthcare authorities had limited access to interventions that could reduce deaths from childhood pneumonia.[23] In addition, it had become challenging for children under one year and children who are born six months to have adequate access to oxygen. However, the advent of innovative solar oxygen systems is enabling access, even when there are shortages of electricity. This is also helping manage children who were born prematurely in clinics and hospitals to maintain high oxygen saturation levels of patients.

An initiative to install bio-medical equipment that utilises solar energy at Hanaano Hospital was developed during the peak of COVID-19 in 2020 since many patients were dying due to respiratory difficulties. As such, hospitals were barely managing the high intake of patients with a cost of a cylinder of oxygen increased to between US$400 to US$600. This is in contrast to pre-pandemic period where only 20% of hospitals and clinics in Somalia had access to the limited supply of oxygen. Currently, Somalia requires up to 3,000 and 4000 m3 of oxygen per day.[24]   

In conclusion, APET notes that solar systems are critical for effective and efficient health care delivery.  These include providing electricity to hospitals for interventions such as refrigeration to store vaccines and drugs at low temperatures, without interruptions. Furthermore, solar systems improve the quality of antenatal care services, vaccination rates, emergency capabilities, and primary healthcare services. This is because these solar-powered facilities can now afford to provide high-quality, reliable, and African countries are thereby encouraged to harness solar technology through investments in infrastructure and human capital development towards effective health service delivery and reduced child mortality. 

 

Featured Bloggers – APET Secretariat

Justina Dugbazah

Barbara Glover

Bhekani Mbuli

Chifundo Kungade

Nhlawulo Shikwambane

 

[1] https://reliefweb.int/report/world/state-health-who-african-region-analysis-status-health-health-services-and-health?gclid=Cj0KCQiAn4SeBhCwARIsANeF9DK14ASUBHGhvSIHrBAr5KU4HQPj0OJf8wW-7DbzfHEhiBRSmEHsS7YaAkpcEALw_wcB.

[2] https://www.weforum.org/agenda/2022/04/infant-mortality-africa-safer-future/.

[3] https://www.statista.com/statistics/1122869/maternal-mortality-rate-in-africa-by-country/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443723/.

[5] https://assets.publishing.service.gov.uk/media/57a08ca3e5274a31e0001336/R8346_mdg_goal4.pdf.

[6] https://www.nationalgeographic.com/science/article/partner-content-energizing-africas-health-care.

[7] https://www.nepad.org/blog/strengthening-africas-healthcare-through-solar-powered-mobile-health-clinics.

[8] https://www.nationalgeographic.com/science/article/partner-content-energizing-africas-health-care.

[9] https://www.nepad.org/publication/micro-grids-empowering-communities-and-enabling-transformation-africa

[10] https://www.nepad.org/blog/strengthening-africas-healthcare-through-solar-powered-mobile-health-clinics.

[11] https://www.enelgreenpower.com/stories/articles/2019/03/photovoltaic-battery-hybrid-system-st-luke-hostpital-ethiopia.

[12] https://www.nationalgeographic.com/science/article/partner-content-energizing-africas-health-care.

[13] https://unfccc.int/resource/mfc2017/project.php?p=project-3.

[14] https://unfccc.int/climate-action/un-global-climate-action-awards/planetary-health/sustainable-energy-for-safe-childbirth-ethiopia-sierra-leone-liberia-uganda-tanzania-kenya-and-nepal.

[15] https://unfccc.int/climate-action/un-global-climate-action-awards/planetary-health/sustainable-energy-for-safe-childbirth-ethiopia-sierra-leone-liberia-uganda-tanzania-kenya-and-nepal.

[16] https://www.saurenergy.com/solar-energy-news/we-care-solar-wins-2019-edison-award-solar-suitcase

[17] https://www.irena.org/news/articles/2021/Jul/How-Solar-Power-is-Reducing-Maternal-Mortality-Rates-in-Zimbabwe.

[18] Chadambuka, A., Katirayi, L., Muchedzi, A. et al. Acceptability of lifelong treatment among HIV-positive pregnant and breastfeeding women (Option B+) in selected health facilities in Zimbabwe: a qualitative study. BMC Public Health 18, 57 (2018). https://doi.org/10.1186/s12889-017-4611-2.

[19] https://innov.afro.who.int/page/59-we-care-solar-suitcase

[20] https://www.sustainability-times.com/uncategorized/how-the-solar-suitcase-is-saving-womens-lives/.

[21] https://businessday.ng/energy/article/how-solar-power-is-reducing-maternal-mortality-rates-in-zimbabwe/.

[22] https://www.emro.who.int/somalia/news/solar-powered-medical-oxygen-systems-saving-lives-in-somalia-using-innovation-to-accelerate-impact-in-a-fragile-setting.html.

[23] https://www.who.int/news-room/fact-sheets/detail/pneumonia.

[24] Alomari, A. H., Aga, O., El Sahmarany, L., Hegazi, M., & Almulla, L. (2021). Public perception towards medical waste generated in the environment during the COVID-19 pandemic in Eastern Province, Saudi Arabia. Heliyon, 7(11), e08363. https://doi.org/10.1016/j.heliyon.2021.e08363.