Facility-level access to electricity and the efficiency of maternal and child health service

Access to energy is critical in the facilitation and promotion of healthcare, particularly maternal and child health services and in low income countries. Health facilities require basic electricity for services such as lighting during child delivery and emergency night-time care, and refrigeration of essential vaccines. Yet, the majority of healthcare facilities in sub-Saharan Africa lack access to basic energy. A recent multi-country analysis of clinic-level access to electricity found that health workers in sub-Saharan Africa operate quite literally “in the dark”, with only 28% of the health facilities reporting reliable access to electricity (Adair-Rohani et. al, 2003).

To ensure universal access to energy, and in recognition of the importance of energy in improving health services, the United Nations Sustainable Energy for All initiative (SE4All) designated energy for women’s and children’s health as a High Impact Opportunity (HIO) (SE4All, 2012). This high-level policy initiative is aimed at scaling up facility access to electricity in order to improve essential maternal and child healthcare by 2030.

Adoption of the SE4All initiative has progressed rapidly, with nearly 90% of Sub-Saharan African countries currently formulating action plans. This process requires a strong evidence base to ensure effective design of cross-sector investment projects and programmes. Currently, empirical evidence on the link between energy and health is very scant.

This study responds to the call for research by the WHO, World Bank, and SE4All and provides empirical evidence on the link between facility-level access to electricity and the productivity of maternal and child health service provision in sub-Saharan Africa, using Zambia as a case study. The research will answer the following questions:

  1. Does access to electricity increase the productivity or efficiency of maternal and child health provision in Zambia?
  2. How does the productivity of electricity provision differ by type of health care platform, location of facility, service type, and catchment density?
  3. What is the potential for expansion of maternal and child health service provision if all health facilities achieved 100% access to reliable energy?

The results of this study will directly inform ongoing country-level planning for increasing energy access and health services in Zambia and sub-Saharan Africa.