Distributed Renewables Can Provide Reliable Power to Healthcare Facilities in Sub-Saharan Africa

Kenya experienced its longest nationwide power blackout on August 25,2023, lasting more than 24 hours. While the cause of the system disturbance remains a mystery, the impacts were clear — and severe.

Hundreds of people were stranded in darkness at Jomo Kenyatta International Airport, while many more faced flight delays and cancellations. Suppliers of milk, fish, meat and other perishable products had to throw out their stock due to lack of refrigeration. Restaurants, barbershops, cafes and other small businesses lost revenue from closures.  

Some of the most concerning power losses occurred at hospitals and medical centers, where stable electricity is essential for powering ventilators and other life-saving devices. While some facilities were able to run backup diesel generators, these systems require expensive fuel and emit pollutants. But there was one hospital that remained operational without needing to switch on a generator. 

Top Care Nursing Home, a hospital on the outskirts of Nairobi, uses power generated from an on-site solar PV and storage system, which helped it remain operational during the entire power blackout. People in the nearby community even came to the facility to charge their phones. 

In Kenya and other parts of sub-Saharan Africa where power outages are a regular occurrence, hospitals and medical centers are seeking out stable sources of electricity. Distributed renewable energy installations like those at Top Care are emerging as a resilient and increasingly attractive solution.   

How Decentralized Renewables Can Help Close the Energy Access Gap in Sub-Saharan Africa  

Worldwide, 675 million people still lack access to electricity, with more than 70% — 600 million— living in sub-Saharan Africa. Lack of sufficient power generation capacity and inadequate distribution networks are a big part of the problem. But even many who are connected to the grid face an unreliable power supply due to poor maintenance of transmission and distribution infrastructure.  

Reliable power is especially critical for healthcare services, which need it for lighting, vaccine storage, water provision, sterilization of medical equipment, and operation of critical appliances such as ventilators and oxygen concentrators. Yet 15%  of medical facilities in sub-Saharan Africa lack connection to power, and only 40% of the connected ones receive a reliable supply.  

While electricity access in Kenya has improved tremendously over the last decade, reaching 75% of the total population, 26% of the country’s medical facilities lack a power connection. And only 15% of the grid-connected ones receive uninterrupted electricity.  

Decentralized renewable energy solutions offer many benefits. Due to their ease of installation coupled with onsite power generation capacity, they can help deliver affordable electricity to rural health facilities located in areas where extending the grid may not be economically viable. When integrated with battery storage, these systems can also provide back-up power in areas experiencing irregular electricity supply from the grid, replacing expensive and polluting diesel generators.  

Reduced operational and maintenance costs in the long-term are also a big benefit of distributed renewable energy systems — both in alleviating the need for generators and offering savings compared to grid-provided power. In Makueni County, Kenya, where WRI Africa and Strathmore University are supporting the county government in developing its integrated energy plan, the local government incurs a monthly electricity bill of about $13,000 for just one of its main facilities, Makueni Level 6 hospital, which serves between 1,000 – 1,200 patients daily. The county government is exploring solar energy as a potential option to help reduce costs.

Innovative Financing Models Put Distributed Renewable Energy Within Reach  

One of the biggest challenges of bringing distributed renewable energy to Africa’s healthcare sector is financing. For example, a recent report by Sustainable Energy for All (SE4All) estimates that electrifying Kenya’s healthcare facilities alone will require  $235 million, including $133 million for private facilities and $102 million for public ones. While on-site solar power offers cost savings over the long-term, upfront equipment expenses can be steep.  

Over the last two years, Differ Community Power (DCP)  in collaboration with Population Services (PS) Kenya and WRI Africa have been supporting electrification of five healthcare facilities in Kenya using  solar PV and storage. Top Care Nursing Home’s solar installation project offers an example of how innovative financing models can bring distributed solar within reach even for resource-strapped medical centers.  

DCP (the developer) offers a “lease-to-own” model for solar PV systems. Against a small downpayment (10% of the total investment cost), DCP procures, installs and operates the system over an agreed period — usually 5 to 7 years, by which time the end user (in this case, the nursing home) will have fully paid for the system. In addition to helping reduce the up-front cost of the investment, this model provides a closer business relationship between the developer and end-user, thus removing technology risks associated with potential system failures.  

The team from DCP remotely monitored the system installed at Top Care Nursing Home throughout Kenya’s recent power blackout, providing staff at the facility with real-time support to troubleshoot challenges. This helped the nursing home remain operational for the entire outage without needing to use its standby generator.

Expanding Distributed Renewable Energy to Healthcare Facilities Throughout Sub-Saharan Africa 

Yet despite distributed solar’s potential in sub-Saharan Africa’s healthcare sector, it’s not widely used. Four interventions from investors, renewable energy companies, development financing institutions, donors and policymakers could help accelerate investment and uptake: 

1. Develop a pipeline of bankable projects in the healthcare electrification sector. Public and private sources of finance are needed to electrify Africa’s healthcare sector. A pipeline of fundable projects — complete with information on the geolocation of the opportunity, capacity of the installation needed, information about current and projected power bills (based on expansion of the facility), and a show of commitment from end-users — can help show the scale of the opportunity and build interest from potential investors. Geospatial tools such as WRI’s Energy Access Explorer can help visualize and provide granular data about such options.
2. Support innovative financing mechanisms to unlock capital. DCP’s financing arrangement with Top Care Nursing Home is one such example, which has proven to be viable and scalable in the healthcare sector. Another model is Energy-as-a-Service, where a healthcare facility signs a power purchase agreement with a renewable energy developer, who then installs and maintains the system and sells electricity to the facility over a prolonged period, usually 10 – 15 years. This model takes the burden off the healthcare facility to mobilize the initial capital and procure and maintain the system. SE4ALL has documented a number of other innovative mechanisms being tested by institutions across Africa.
3. Provide long-term and affordable debt financing: While the costs of renewable energy technologies have dropped significantly  in recent decades, the high cost of battery storage remains a major barrier. For example, while Top Care Nursing Home’s management team considered investing in a larger system, increasing the capacity of battery storage would have nearly tripled the overall cost of the investment. The facility would not have been able to afford its monthly repayment costs over the 5 – 7-year payback period. Development financing institutions and impact investors could collaborate with local commercial banks to identify strategies for providing long-term debt financing for distributed renewables, thereby helping lower monthly repayment costs. Further, WRI’s recent report underscores the need to allocate sufficient resources to cover the replacement of batteries, inverters and other components over the energy system’s lifetime — especially in cases where grants only cover capital expenditures.
4. Put in place regulatory frameworks to facilitate public-private partnerships. Partnership between the public and private sectors is key to electrifying government-owned healthcare facilities. However, concerns such as political risks — like incentives changing with administrations — as well as payment risks pose a major bottleneck to collaborations with private sector players. National and sub-national governments can develop public-private partnership frameworks to attract companies. The World Health Organization (WHO) has listed several other important factors for creating an enabling environment for healthcare facility electrification, including: advocating for its political prioritization; linking electricity planning to health policy; and integrating energy demand assessments for healthcare facilities into electrification plans, among others.  

Better Healthcare through Decentralized Renewables 

When healthcare facilities lose power or need to spend scarce resources on expensive generators, it’s ultimately the patients who suffer. Policymakers, investors, development partners, companies and others must realize that renewable energy is not just about generating environmental benefits; it’s about creating resilient and affordable power systems that protect people’s health.