Institutional aspects of policy, planning, management, financing, service infrastructure, community participation, and user interface are critical to the successful use of any chosen technology. While focusing mostly on various institutional, organizational, and social issues that should be addressed prior to initiating a larges scale project, much of this information is applicable to smaller scale projects as well.
A national policy framework is key to the integration of RE into health clinic electrification. Without an established policy at the highest level and commitment at every other level, efforts to implement RE technologies run a high risk of failure. Many health professionals responsible for allocation of limited financial and human resources for public health programs see RE technologies as costly, experimental technologies with a history of failures. They may be unaware of the benefits of successful applications. Promotion of RE development should be accompanied by the removal of barriers such as import duties and subsidies for fossil fuel power. Partnerships offer the ability to share resources, costs and benefits. Collaboration with other community sectors such as education and agriculture is beneficial to the mission of public health programs. Similar needs such as light for education and safe community water supply can share the same service and share its costs. Collaboration between public and private entities should seek to support public health with private commercial services.
In some instances RE systems failed to prove reliable. These experiences have often left the perception that RE is more costly and requires special skills and knowledge. Without quality standards and proper service these failures will be repeated. The selection and procurement of quality systems and service must be based upon standards of acceptance and quality control. Adequate resources for logistics, servicing, and maintenance must be allocated.
Higher quality service is the strongest argument for integrating RE into health care. Cost analysis is usually based upon the initial cost. LCC analysis can be a favorable argument for renewable energy choices but is not a determinant.
Although the technologies are mature, there lacks a well-developed, reliable service industry to install, maintain, and repair systems in the field. This infrastructure can be developed more cost effectively through partnerships with other human service sectors to share costs. System designers and field technicians must receive regular training and information to retain current knowledge and skills. There must be enough pay for their services to keep them available and prepared. Spare parts must be available. The system users must be aware of the proper operation and care for the system. Training must be adequate and regular.
Availability of financing for purchase of equipment will put the benefits of RE technologies within the reach of those that need them most. National governments and international donors have provided significant capital funds for clinic electrification with marginal results. The lack of operating funds for maintenance and repair soon renders the equipment unusable. There are numerous examples of revolving credit funds to support productive use enterprises and enable individuals to purchase solar lighting systems as a means of rural electrification. The principles of these successes should be applied to community-based health facilities and enterprises. Strategies to generate income at the local level can enable recovery of the loan funds and provide operating funds to maintain the equipment.
Dynamics within the community play an important role in making or breaking the success of a project. The community and its individuals may support, ignore, abandon, or even subvert the system. Systems and services provided must be in the appropriate language and level of education to be understood.
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Last updated: September 28, 2011
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