Institutional Configurations
A variety of public sector and private sector configurations exist for integrating renewable energy into health facility electrification. There are advantages and disadvantages to each.
Management and Implementation by Government
In this institutional configuration, the government ministry of health carries out all aspects of the planning, system design, installation, maintenance, and repair of RE systems.
Advantages:
- National health programs have an established infrastructure of planning, management, technical, and logistical support to rural health centers. This existing infrastructure may be adapted to support RE systems.
- Programs on a national scale may be large enough to have sufficient critical mass to develop and support a service infrastructure.
Disadvantages:
- Government bureaucracies are often inefficient in providing services. Bureaucratic processes are usually slow, particularly when involving purchases and travel expenses for installation, maintenance and repair.
- Technical staffs are often insufficient in numbers to accommodate the needs of all regions of the country.
- Ministry of health technicians, may be familiar with the health care systems, but will need training in the installation, maintenance, and repair of RE systems. They often lack the proper tools and resources.
Management by Government and Implementation by Private Contractor
In this institutional configuration, the government ministry plans the program to utilize RE, and issues requests for bids to provide equipment and services. Private contractors provide equipment along with installation services. The contractor may provide maintenance and repair services under a service agreement. Alternatively, the ministry of health may accept those responsibilities once the installation is complete and accepted.
Advantages:
- Private contractors in the business of selling and installing renewable energy systems are usually equipped with the knowledge, skills, and tools to provide the required services as needed on a contractual basis.
- A ministry of health may be better prepared to establish the scope of work and manage implementation than to actually perform the work with its own personnel.
Disadvantages:
- If no clear specifications exist for procurement of equipment, bidders propose systems with varying specifications. This makes it difficult to evaluate and select from proposals with unequal attributes.
- Many bureaucratic purchasing processes automatically select the lowest bidder without regard for significant differences in the relative quality of proposals submitted.
- There is often a lack of Standards of Acceptance for quality of installation in the field. Deficient installations have a high rate of failure, pose a threat to reliability to health care services, and result in higher costs for maintenance and repair.
- Private contractors are not always competent to install systems professionally in the field. They often are in need of technical training.
- Private contractors are unfamiliar with the specific needs of health care systems.
- Training of the system users is often forgotten or incomplete.
Management and Implementation by Non-Governmental Organizations
Many non-governmental organizations (NGOs) provide health care services in rural communities. In this configuration, the NGO procures, owns, operates, maintains, and repairs the system on its own.
Advantages:
- NGOs are often run by committed and motivated individuals who operate efficiently and effectively on limited budgets. Decision-making and project implementation is generally less bureaucratic than a government process.
- NGOs generally have strong community relationships. As a result, they may be more readily able to generate community support and participation as well as collaborate with other service sectors such as education, agriculture, and enterprise.
Disadvantages:
- NGOs generally operate programs for a limited number of establishments which they operate and maintain themselves. This scale of program does not lend itself to significant support of a commercial service infrastructure.
- NGOs typically do not have the specialized technical knowledge or skills to implement RE technologies without technical assistance.
- Small NGOs often have cash flow problems.