Powering healthcare in Nigeria is possible and achievable albeit we need all relevant stakeholders to work in synergy to achieve this important objective. In the past one year, the pandemic, a health crisis, which ravaged the entire length and breadth of the world, proved to be more disruptive than even the 2008 stock market crash, as it revealed the bottlenecks and previously ignored areas of the health care system in various countries of which Nigeria was not left out. Indeed, an intentional boost in the healthcare system has a non-negotiable impact on the economic stability of any country.
Over time, Primary Health Care Centres (PHCs) across Nigeria have been characterized by infrastructural deficit, loss of health inventory, unavailability of medical equipment, inadequate staffing and poor working conditions. In most PHCs, vaccines are either unavailable or lack proper storage. 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 fossil fuel powered generators and lamps for night emergencies. Heinrich BöllStiftung (HBS) Nigeria reports “that most rural households spend as much as ₦6,660 ($16) on kerosene expenses monthly. In total, an estimated ₦143.3 billion ($348.2 million) is spent monthly on kerosene by households in the entire country” Also, the US National Library of Medicine on PHC in Nigeria says Nigeria has over 30,000 PHCs and most of these PHCs are located in rural unserved and underserved communities and poor settlements. Furthermore, a 2017 report by BudgIT and Open Society Initiative for West Africa (OSIWA) revealed that in Nigeria, lack of appropriate hospital equipment and access to reliable energy supply were the leading barriers to improved health care delivery with 26% and 21% respectively as other barriers included access to drugs, water supply, physical infrastructure, work environment, transportation and training.
Powering healthcare is possible and the mainstreaming of decentralized off-grid renewable energy solutions through Solar PV for lighting, refrigeration amongst other uses in PHCs in Nigeria, is critical to achieving this
The abysmal state of the healthcare sector had also impacted on Nigeria’s response to the COVID-19 pandemic which shutdown the global economy and stretched the bewildered healthcare sector. Access to reliable electricity is critical for the efficient running of PHCs. The delivery can be expedited to PHCs through off-grid decentralized Solar PV solutions, which is more economical and reliable. Before off-grid energy solutions are deployed it is expedient to ensure that energy audits for all primary healthcare facilities are carried out and documented in a prefeasibility report. This would showcase the opportunities that exist for renewable energy players within and outside the country. Also, a power purchase agreement with the National Primary Health Care Development Agency (NPHCDA) or relevant stakeholders should be assured to private and public companies who may seek to invest in the capital expenditure of deploying such projects. This should reference an agreed mode of payment for electricity supply either through smart metering on a pay-as-you-go basis or monthly, quarterly or biannual rates.
Effective measures to secure these off-grid energy infrastructure should be set in place because most of these PHCs are in remote locations and theft of the off-grid equipment could pose a challenge. This could also create a potential niche market for insurance companies who may want to mitigate or reduce the risk for prospective investors. Identifying other productive users in the clusters where these PHCs are sited could also prove positive as investors can be assured of effective daily consumption of power generated at these sites meaning no wastage as power is being generated.
Furthermore, renewable energy players interested in participating in powering these PHCs in rural areas should be subjected to effective due diligence processes and the quality of off-grid energy equipment should be checked and only grade A or top tier quality infrastructure should be used for such installations. These renewable energy players should be required to give industry verified guarantee for the quality of service they would be rendering and also policies for system repairs and failure should be considered. The government would be required to show support in various ways that engender investor friendliness and ease of doing business, which may include enabling policies, tax incentives, construction of access roads, safety & security amongst others.
Powering healthcare is possible and the mainstreaming of decentralized off-grid renewable energy solutions through Solar PV for lighting, refrigeration amongst other uses in PHCs in Nigeria, is critical to achieving this. It is also important that the practice of transparency, accountability, effective planning and management of resources in the entire process is not compromised. However, there is a need to prioritize the energy demands of PHCs to encourage the provision of 24-hour electricity supply services, since Nigeria’s electricity grid remains constrained. It is also important to note that electricity supply remains a business and the more deliberate actions are taken to ensure that it is treated as a profitable business, the more the improved chances of attracting the much needed investment and participation of local and international players.
Engr. Arinze is the Program Officer, Off Grid Energy at Diamond Development Initiatives (DDI), Implementing Partners for the United States African Development Foundation (USADF) in Nigeria.