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What is Powering Health? 

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Powering Health promotes health facility electrification efforts by offering access to interactive tools, best practices and information on technology. (Photo: Walt Ratterman)

Powering Health is a knowledge portal at the crossroads of health, energy and development.  A product of USAID's Energy Team, the site highlights technical information and international best practices regarding access to energy in the health sector, as well as USAID's own work in the field.

Electricity is an increasingly essential commodity in developing country healthcare facilities. Recent improvements in the distribution of vaccines and other cold chain-dependent supplies, as well as the global push to deliver antiretroviral drugs and services to HIV-positive patients worldwide, have introduced new demands for electricity in sites with little or no access to reliable power.

The objective of Poweringhealth.org is to improve the success rate of health facility electrification efforts in resource-limited communities. It is targeted to a wide range of users - from local health workers to international donors and ministry officials.  As a means of meeting this objective, Powering Health aspires to be an open resource - transfering technical knowledge and best practices, providing quality tools for energy planning in the health sector and serving as a news and information hub for the global health community.  Poweringhealth.org is structured into four main content areas:

Technical information regarding technology options for energy supply and use in health facilities; and management strategies and best practices for energy and healthcare.

We work with a district hospital in Rwanda that often operates without any water or electricity. They have a huge generator but do not have the money to use it for a full day. They cannot run the lab equipment or the x-ray without starting the generator. The phone is powered by a small solar panel that has a bad battery, so when there is cloud cover, the phone disconnects. Lighting in the hospital is minimal.”

— Jeroen van’t Pad Bosch, Elizabeth Glaser Pediatric AIDS Foundation

Quantitative tools used in planning and managing energy resources in the health sector; a clearing-house of materials related to healthcare development and access, including case studies, reference information, training materials and a systematic planning approach; photo and video media resources created by USAID or other orgnazations.

Up-to-the-minute information and resources for countries where USAID's Energy Team is active.  These pages highlight specific activities currently being undertaken to improve healthcare infrastructure in Haiti, Guyana, Ethiopia, Rwanda and Zambia.

A resource for all individuals and organizations interested in global health, energy and development.  Stay up-to-date on  important work being done by USAID and other organizations through our community calendar, news feeds, organization profiles and the Powering Health Stories blogContact Powering Health to submit news, stories, events or ideas.

 

 

Powering Health offers more ways to interact:

    

online tool

This exclusive online version of the HOMER energy optimization tool evaluates hybrid power systems to determine the most cost effective options for delivering continuous electricity to health facilities.

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You can keep up with Powering Health on Facebook, Twitter or through our RSS feed. See all of the newest tools, materials, project updates, photos and Stories blogs as they're posted.

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The Challenge in Powering Health 

The challenge to powering health in resource-limited settings is in bridging the gap between shortfalls in the provision of electricity in the health sector and the continuously expanding needs of remote or underserved healthcare facilities.  Lack of funding, institutional capacity and donor coordination often hamper international, national and communitiy-driven efforts to improve the quality of healthcare in ways that extend beyond the traditional role of health facilities in these settings.  Initiatives to combat diseases such as HIV/AIDS, tuberculosis and malaria, while also tackling myriad other issues such as maternal and infant care, nutrition and vaccination, have placed additional burdens on health facilities already stressed for money, personnel and power.  Following are some of the unique energy challenges and requirements facing these facilities.

The provision of energy services to developing country health facilities is complicated by several factors:

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Poor wiring in Haiti, an example of the infrastructure challenges faced by many health facilities. (Photo: Kim Domptail)
  • Poor Planning and Donor Coordination: Often the health sector support programs providing medical equipment and other electrical loads and the energy sector support programs providing energy services to health facilities do not communicate, effectively leading to systems failure.
  • Requirement for Continuous, High Quality Power: From the engineering standpoint, the energy requirements of health facilities are often more demanding than other public facilities and residences. The continuous and high quality electricity required to run medical equipment and power the cold chain often requires on-site technologies operated by trained users.
  • Insufficient Human Capacity and Institutional Support Structures: Health sector institutions, from the Ministry of Health (MOH) to the clinic, are typically not well staffed to deal with infrastructure issues.
  • Lack of Financial Resources and Revenue Stream: Public health facilities in developing countries typically do not have a revenue flow sufficient to purchase, maintain and operate energy systems.
  • Weak Local Energy Sectors/Service Providers: Health facilities which receive poor quality power from the grid or other service providers are faced with the challenge of improving the quality and reliability of that power on-site. Improving the operations of service providers in developing countries is a critical step to improving the energy services at critical health facilities.
  • Antiquated Physical Infrastructure: Many health facilities in developing countries have antiquated internal electrical distribution systems and building wiring. As new loads have been added to the facilities the wiring has not been updated causing safety hazards and operational challenges.

Health clinics need reliable energy to:

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A health facility worker at a clinic in Kigali, Rwanda has sufficient energy for this high-powered light that is required for complex medical procedures. (Photo: Walt Ratterman)
  • Power Medical Equipment: A stable and reliable power supply is essential for health facilities to run refrigerators, operate diagnostic equipment, and provide lighting for evening deliveries and procedures. Power anomalies can damage sensitive and expensive laboratory equipment, air-conditioners, electronics, and x-ray machines.
  • Store Cold Chain Dependent Supplies: A lack of or an unsteady power supply can result in the destruction of cold-chain dependent blood, testing reagents, vaccines, ARV drugs, and rapid test kits. Electrification of health clinics helps preserve the cold chain. Data examined for six countries found that the cold chain was significantly stronger in electrified clinics than in those without electricity.
  • Improve Health Services: Intermittent or unavailable power can limit the ability of health facilities to deliver basic and preventive care and treatment to local populations. Health facilities can benefit directly from electrification by having longer opening hours. An analysis of health facility survey data for two countries – Bangladesh and Kenya – found that electrified clinics are indeed open for, on average, one hour longer each day.
  • Attract and Retain Staff: Electrified health facilities and staff quarters can help to attract staff to rural areas and reduce staff absenteeism. In Bangladesh, a study found that health workers were significantly more likely to live in the same community as the facility if there was electricity – and that living locally greatly reduced the probability of the worker being absent from the facility for the whole day.

 

6 Steps to Powering Health 

Over the years, significant effort and funds have been dedicated to providing energy services to health facilities – with a particular focus on expanding the vaccination cold chain. Unfortunately, many of these efforts have proven not to be sustainable over the long term.  Powering Health promotes a step-wise approach to planning for and implementing improvements to health facility power supply.  Fulfilling the energy needs of such facilities over the long term requires careful preparation, a comittment to maintenance and dedicated funding.  Powering Health has a six-step approach to to understanding a health facility’s energy needs and designing an energy system to meet those needs in a cost effective way:

  1. Identify your health center’s current energy demands;

  2. Determine whether your energy demands will change in the near-term;

  3. Investigate the viability of local service providers;

  4. Assess, evaluate, and select the most appropriate technology needed to meet the target;

  5. Design, procure, and install sytem with the help of an expert; and

  6. Operate, maintain, and manage your energy system.

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Installation of photovoltaic panels on the roof of a health clinic in Kigali, Rwanda. (Photo: Walt Ratterman)

The first three steps are supported by quantitative tools for conducting an energy audit, energy load calculation, and energy system optimization. The tools consist of interactive data tables where users can input information on health center energy needs and determine energy targets. The tools will also enable users to select the appropriate energy system based on a life-cycle cost analysis.

Steps four and five are supported through our informative technology and managment sections.  The information on these pages is a valuable resource that can be used to educate health facility managers, technicians and practitioners on important considerations and constraints to implementing energy technologies appropriately and successfully within the health sector.  We also provide a listing of standards relevant to specifying, designing and installing energy systems utilizing various technologies, such standards will help ensure that energy investments go toward high quality systems.

Step six is critical in acheiving long-term benefits from energy investments.  The technology and management sections also provide information on how to maintain, operate and protect energy systems.  Be sure to see our trainging materials page for materials and resources used to train hospital technicans on proper maintenance and operation.

To date, the methodology outlined on Powering Health.org has been implemented in collaboration with the USG PEPFAR program in Ethiopia, Guyana, Haiti, and Rwanda. The full country assessment reports can be found here.

 

The Improving Health Facility Infrastructure (IHFI) Project 

The Improving Health Facility Infrastructure (IHFI) project is an ongoing, multi-year, USAID-funded effort to assess and enhance energy supply to under-served health facilities in a number of countries.  The project has focused its primary efforts in Haiti and Guyana - performing needs assessments; implementing practical, cost-effective technological solutions to ensuring a stable power supply, and; building institutional capacity through standardization, training programs and monitoring and evaluation.  The four core focuses of the IHFI project: evaluation, technology, institution, and training, are outlined below, as well as activites corresponding to each.

 

IHFI activities

In Haiti

IHFI has carried out a number of energy assessments at health facilities throughout the country.  These assessments not only pave the way for comprehensive energy supply interventions, but also create a great deal of useful data on the state of hospital energy infrastructure in the country, such as the size and condition of on-site generators and the availability of grid power.  As a primary means of improving the supply of energy at these facilities, IHFI is installing battery/inverter backup systems to store energy for periods of power loss from the grid and to protect sensitive medical equipment from power surges due to grid fluctuations and generator spikes.  Aside from backup power, IHFI is performing a pilot LED lighting retrofit at one facility in order to bring down operating loads and costs, and is carrying out a wiring renovaiton at Hôpital Universitaire d’Etat d’Haiti (HUEH), in Port-au-Prince. 

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An inverter system installed in Haiti under USAID's Improving Health Facility Infrastructure (IHFI) project. (Photo: Kim Domptail)

Improving energy systems is only one part of IHFI's mission in Haiti; building institutional and technical capacity to perform and maintain such improvements is the second critical aspect of the project.  IHFI works closely the Ministry of Health's (MSPP) Project Unit (UGP) in the selection and development of all projects, with a focus on improving coordination and communication between the Ministry and individual health facilities.  Furthermore, IHFI has teamed with the Center for Disease Control (CDC) and Haiti's national public health lab, Laboratoire National de Sante Publique (LNSP), to develop materials which will facilitate approapriate and sustainable power installations.  The products of these efforts are: standard installation designs, templates for contractual Terms of Reference, standard manuals and procedures and a monitoring database housed at the Ministry of Health.  IHFI also contracts and supervises local contractors for all project work, ensuring that each installations complies with the U.S. National Electric Code (NEC).

Finally, IHFI has developed and implemented multi-tiered training courses for hospital energy technicians, covering proper operation and maintenance of batteries, inverters and generators.  These training sessions not only help to ensure regular maintenance of hospital energy systems, brining down repair costs and downtime, but also develop a sense of ownership among the local technicians, who a provided a set of electrical tools and instruments.  The importance of logging and measurement of system parameters is also ephasized, these data are reported to a central location at the Ministry of Health, further building good will and communication between technicians and Ministry staff.  To access IHFI's training materials for Haitian hospital technicians, go the the training materials page.

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Haitian hospital technicians proudly display certificates after completing a five-day classroom/field training course on maintenance and logging of battery, inverter and generator systems. (Photo: Kim Domptail)

IHFI's accomplishments in Haiti to-date inlcude:

  • 18 energy assessments, with another 12 ongoing
  • 18 battery/inverter backup power installations completed, with 4 ongoing and another 8 planned for the near future
  • 82 hospital technicians trained in the maintenance and operations batteries, inverters and generators
  • LED and solar PV pilot projects
  • Remote monitoring of battery systems

For more information on these activities and an interactive map showing our project sites, please visit the Haiti page.

 

In Guyana

IHFI has developed a standardized photovoltaic system design to electrify remote health outposts that currently rely on expensive, under-maintained diesel generators.  These systems will be installed at 9 sites throughout Guyana, many of which are difficult to access, leading to high fuel and maintenance costs for generator systems.  The PV systems will inlcude a battery bank designed to store enough energy to provide lasting power in Guyana's often cloudly rainforest.  Developed based on an assessment of each facility's minimum laboratory and cold-chain loads, these systems should help extend basic health services to remote populations.

In Guyana's capital, Georgetown, IHFI has teamed up with the Association of Energy Engineers (AEE) to conduct an investment grade energy audit at the Georgetown Public Hospital to identify cost-effective energy efficiency and power quality investments.  This audit was combined with a hands-on training course for a select group of local technicians and engineers.  Over the two-day audit excercise, the group spent classroom time learning about energy auditing fundimentals, such as equipment load inventories, end-use profiles, financial analysis and energy balances.  Energy auditing procedures, including power measurements, estimating operating hours, and overall data collection were practiced through  hands-on, experiential training.  After the audit was conducted, a two-day workshop reviewing auditing procedures and energy management was held for a wider group of local contractors and policy makers.

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Guyana's Prime Minister, Samuel Hinds, talks energy efficiency with audit leader Timothy Janos at Georgetown Public Hospital. (Photo: Ujjwal Bhattacharjee) Matthew's Ridge Hospital in Guyana is currently served by solar panels that have been haphazardly installed and poorly maintained and a generator that results in very high fuel costs. (Photo: Ujjwal Bhattacharjee)

In addition to IHFI's activities on the ground, the project also manages and develops the Powering Health website.  Many of the materials, practices and experiences found on this have either been developed as part of the IHFI project, or are directly related to its basic mission: improving energy supply for health.

For a more in-depth introduction to the IHFI project, please view this presentation. 2345678910111213141516171819202122232425262728293031

Further information on IHFI project work in Haiti, Guyana, Ethiopia, Rwanda and Zambia, is available on our Countries pages.

 

IHFI's Partners on the Ground 

IHFI works with a variety of organizations and entities, including NGOs, government ministries and local contractors, to carry out its in-country activities.  IHFI's main partners are highlighted below with descriptions of each organization and a explaination of their role in the IHFI project.

 

In Haiti

Haitian Institutions

 

Unité de Gestion du Projet (UGP) MSPP/PEPFAR - Ministère de la Santé Publique et de la Population (MSPP)

The Ministry of Public Health and Population is the government agency  responsible for formulating and executing national public health  policy .

PEPFAR - Haitimspp

Haiti Tec

HaitiTecis a school ofexcellencewhich aims to improvethe quality of lifeof theHaitian society,at all levels,by promotinghuman resources development, ahealthy environment andsustainable economic growth.  IHFI works with Haiti Tec to develop training sessions for hospital energy technicians.

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Laboratoire National de Santé Publique (LNSP)

Laboratoire National de Santé Publique is the national reference laboratory for Haiti's health system.

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Partners

 

Centers for Disease Control (CDC)

The CDC collaborates to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

CDC

HOMER Energy

The HOMER energy modeling software is a powerful tool for designing and analyzing hybrid power systems, including conventional generators, wind turbines, solar photovoltaics, batteries, biomass and other inputs.  HOMER works with IHFI to develop back-up power installations in Haiti, and provides Powering Health's HOMER online energy optimization tool.

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Management Sciences for Health (MSH)

MSH works collaboratively with health care policymakers, managers, providers, and the private sector to increase the efficacy, efficiency, and sustainability of health services by improving management systems, promoting access to services, and influencing public policy.

msh

SunEPI

The mission of SunEnergy Power International was to promote an increased quality of life in remote, rural regions of the world through the use of renewable energy.

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Local Contractors

 

Charles Fequiere

Charles Fequiere is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

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Dominique Juste

Dominique Juste is a Haitian private contractor working on installation projects for IHFI.

 

Elmecen

Elmecen is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

elmecen

Frantz Gilbert

Frantz Gilbert is a Haitian private contractor working on installation projects for IHFI.

 

Green Energy

Green Energy is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

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Omnitek Engineering

Omnitek Engineering is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

 

Panexus

Panexus is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

panexus

R&P Services

R&P Services is a Haitian equipment vendor and construction contractor working on a number of IHFI projects.

RP-haiti

 

In Guyana

Guyanese Institutions

 

Guyana Energy Agency (GEA)

The GEA is Guyana's government agency charges with informing national energy policy through statistical analysis and efficienct energy management.  IHFI is working with the GEA to develop energy systems for remote health facilities and to perform capacity building for energy efficiency among Guyananese energy technicians.

GEA

Ministry of Health

IHFI is working with Guyana's Ministry of Health to identify and prioritize remote health clinics in need of improved energy supply.

Coat of arms of Guyana

Partners

 

Association of Energy Engineers (AEE)

The Association of Energy Engineers is a professional association certifying engineers in a range of activities related to energy management.  Through the IHFI project, AEE performed an energy audit and training course at Guyana's Georgetown Public Hospital.

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Local Contractors

 

Farfan & Mendes Ltd.

Farfan & Mendes Ltd. is a Guyanese equipment vendor and construction contractor working on IHFI solar installations.

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Gafsons Ltd.

Gafsons Ltd. is a Guyanese equipment vendor and construction contractor working on IHFI solar installations.

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