Adhikharhi works as a Programme Coordinator at On Call Africa (OCA) and led the implementation of OCA’s Solar for Improved Rural Health Systems Project. She is a global health leader and Global Health Corps alumni with over seven years of experience in health systems strengthening. She is motivated to improve access to and quality of healthcare in rural communities through the implementation of projects that are designed, implemented, and monitored in collaboration with all levels of the Ministry of Health. Adhi is passionate about the inclusion of community voices in all areas of programme development and delivery, and remains committed to finding new and innovative ways to increase inclusivity in development projects.
Reliable electricity supply is key to development. How has the situation improved in your project?
Since the inception of the project, three rural health facilities have increased access to reliable solar power. This access to power has increased the ability of these facilities to perform minor surgeries using equipment they did not have access to before the intervention. The facilities are also able to provide services to patients any time of day or night with improved lighting. Prior to the project, there were challenges providing services at night due to poor lighting, with midwives often conducting deliveries with a phone torch. Lastly, the project has led to reduced vaccine wastage as the access to improved power means the facility can reliably run vaccine fridges.
How do the citizens benefit from the improved energy infrastructure in your project?
Community members benefit from improved solar infrastructure at healthcare facilities through an improved access to services closer to the home. Access to power increases the variety and quality of services offered by a health center which means patients can now access services they may have had to travel long distances (to a district hospital, for example) for in the past.
This project also utilizes a Productive Use of Energy (PUE) technology to produce low-cost chlorine which is distributed to health facilities and at-risk communities for water purification, and sterilization of health facilities and equipment. Community members benefit from this intervention through reduced risk of facility-acquired infection, increased hygiene, and improved access to clean water.
Schools, health stations or refugee shelters generally have high financial needs. What do you think social institutions need to be able to finance high-performance solar systems?
When looking at the financial needs of solar infrastructure in rural areas, we need to consider the upfront capital costs, the ongoing operations and maintenance costs and the replacement costs. Most costs are incurred when purchasing the solar panels, inverters, batteries, and wiring to install the solar power at a health facility. In our context of rural Zambia, this capital cost will primarily need to be covered by central government or an external partner. The ongoing operations and maintenance costs, as well as preparing for the replacement costs of equipment like solar panels and batteries, can then be passed to the local authority, district health offices or community-based structures, with appropriate training and support structures in place.
In our case, we have supported tailor-made financing mechanisms by building upon on an existing community-based financing model, where contributions are put into a pooled fund which then translate into income generating activities (IGAs). OCA’s model empowers community structures, Neighborhood Health Committees, with access to grants, financed by chlorine sales at the district level, which they can use to start IGAs that raise funds to contribute to the ongoing operations and maintenance costs of the local solar infrastructure. The district health office also retains a portion of profits from sales for a savings fund which is used to maintain and improve solar infrastructure in the district.
Financing is one thing. At least as important is a long service life and thus the maintenance and care of the systems. How can this be managed well?
This can be managed through already existing structures at the health facility, such as Neighborhood Health Committees (NHCs). Our project works with NHCs to train on how to maintain and care for the infrastructure and to understand clear reporting mechanisms when required. This has created community ownership of the installed systems. For me, community buy-in throughout project development, implementation and monitoring is a critical step in ensuring that the systems are well managed over time.
Often, different government institutions are involved in the projects, the ministries of health and energy, implementing agencies and local communities. With many stakeholders, how can the processes be accelerated?
From my experience managing stakeholders throughout this project, processes can be accelerated by engaging government institutions and local communities from the design stage of the project. When engaged from project inception, there is clear ownership and motivation for institutions and communities to work effectively towards a shared goal.
Social institutions are often a central meeting point for communities. Does it make sense to use them to bring forward the dissemination of more solar installations in rural areas?
The improvement of infrastructure of social institutions is key to the development of rural communities. These centers play a vital role in providing basic services (health, education, etc.) to rural populations and the improvement of these facilities benefits the community at-large and improves access to and quality of public services. While improving access and quality, improved solar infrastructure can also increase community motivation to utilize social services by improving community confidence in these institutions.
By increasing access and reliability of solar infrastructure in social institutions, communities will gain exposure to this technology and see the value and opportunities that this power can provide in their lives. This increased understanding and awareness can increase the demand for solar infrastructure at the community and household level and can empower communities to lobby local government and political leaders to support initiatives which increase access to solar power.
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