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Best Practices and Lessons Learned

This section provides a short summary of some key lessons learned concerning efforts to provide reliable energy supplies to developing country health facilities.


Design and Installation

  • Evaluation of energy system cost based only upon initial cost discourages the choice for RE sources. Life cycle costs should be used and can be calculated using the online homer tool
  • Perceptions are often inaccurate or over simplified. Common misperceptions are that RE power systems are unaffordable, are a viable option for the entire load of large hospitals, or that they require no maintenance.
  • Anti-theft measures should be considered in all design plans.
  • "Maintenance free" gel seal batteries are a good option for health facilities.
  • Professional installation with proper labeling is critical for long term system operation.
  • Battery-based systems designed for and dedicated to a specific load (e.g. computer, vaccine refrigerator) have the highest success rate. Duplicate systems should be considered for a given facility (e.g. a stand alone isolated system for different critical loads).
  • For solar PV systems, annual average PSH values should only be used for locations with very little month to month variability.
  • Oversizing battery banks to provide multiple days of autonomy often results in continuously discharged batteries unless the size of the solar array is also increased or a generator is added to the system.
  • In order to recharge batteries and reduce system size and cost, Diesel/PV hybrid systems are recommended for all but the smallest health centers (as opposed to solar only systems).
  • Invertors which easily allow users to override low voltage cutoff are not recommended. Low voltage cutoff settings should often be increased from factory set default values to prolong battery life in developing country settings.
  • Access to locally available spare parts should be a consideration in initial equipment procurement.


Operations and Maintenance

  • Lack of maintenance is a common cause of system failure.
  • Users are often unaware of the proper operation, care, or limitations of systems. Training all users on energy management is critical
  • System overloading is a common reason for battery-based system failure. An oversight mechanisms must be in place to ensure that additional loads are not added to a system in excess of what it was designed to support.
  • Training must be thorough and ongoing and at multiple different levels. Health facility staff must be trained on energy management, health facility technicians or maintenance staff must be trained on routine system maintenance, and a higher level engineer in the Ministry of Health or private sector must be trained to solve more complex system problems.
  • Training is not sufficient to ensure system operability. A source of maintenance funds must be identified in advance of system installation.
  • Health Facilities are often reluctant to sign maintenance contracts with the private sector because of the expense. Building the capacity of engineers at the health facility or within the Ministry of Health is often required.


Policy and Institutional

  • Sustainable energy systems at public health facilities requires significant institutional capacity building. Ministries of Health and health care facilities are typically not well prepared to procure, install, operate or maintain energy systems.
  • Donor funded programs often fail for lack of operating funds and the local service infrastructure.
  • Existing local service infrastructures may be adapted to provide routine maintenance and timely repair. However, experience has demonstrated that relying on local service providers for the design and installation of renewable energy systems should be closely monitored for quality.
  • Energy supply in the local community can generate income to support operating expenses. However, many instances have been observed where different revenue generation schemes (cell charging, etc) did not produce sufficient revenue to cover operating and maintenance expenses so alternative sources of funding should be identified.


Programmatic Approaches

  • Health sector support programs which will increase the overall electrical load of a health facility (e.g. by adding equipment, new buildings, cold storage requirements, etc) should assess the impact on the energy system (on-site generation, wiring, etc.)
  • It is essential to consider sources of operational and maintenance funds before any health facility electrification program is implemented. Many efforts, regardless of technology, fail because the health facility, or Ministry of Health, is unable to support the operational and maintenance costs of donor purchased equipment.
  • If possible, an independent service provider should be considered for supplying reliable energy services to a health facility. Developing country Health facilities are inherently ill-suited to operating and maintaining their own energy systems.

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