Case studies – Stories of success
- Energy for women’s and children’s health: WHO/UN Women/UN Foundation - High Impact Opportunity on Energy and Women’s Health
- Butaro Hospital, Burera District – Rwanda
- Green and Safe Hospitals Initiative – China
- Vaccine supply chain innovations – Project Optimize
- Riviera-Chablais Hospital – Switzerland
Energy for women’s and children’s health: WHO/UN Women/UN Foundation - High Impact Opportunity on Energy and Women’s Health
A new High Impact Opportunity on Energy for Women’s and Children’s Health, led by WHO, UN Foundation, and UN Women and the aims to improve health facility access to electricity in low-income regions that often lack reliable power.
The initiative seeks to address structural, policy, and market barriers limiting access to modern energy sources for health care facilities in low resource settings. It will convene health and energy policy makers to stimulate:
- more comprehensive planning of energy needs in health facilities;
- track needs and gaps;
- build technical capacity; and optimize use of modern energy technologies, including renewable power sources.
The initiative was launched in 2012 as a High Impact Opportunity of the UN Secretary General’s initiative Sustainable Energy for ALL (SE4ALL). It reflected growing awareness and concern with the lack of electricity access in community health facilities in many low-income settings. According to available surveys of 11 major Sub-Saharan African countries, for instance, about one-quarter of health facilities lack any electricity at all, while only about one third of hospitals have reliable electricity access.
Access to energy (in particular access to electricity) is a key factor in health services delivery. Power is required for the operation of many life-saving medical devices used in maternal delivery, emergency procedures and laboratory analysis. It is likewise critical to good lighting, refrigeration, ventilation, communications and computers, water pumping, and safer management of medical waste (e.g. using non-incineration methods).
For all of these reasons, efficient, functioning energy services are critical to attainment of major health and development goals, including the unfinished MDGs.
A programme of work has recently been developed using a partnership approach that leverages key strengths of the different lead agencies involved. Key contributions of WHO to these efforts include:
- Improved measurement, monitoring, and reporting of trends in energy access in health care facilities, including through the expanded use and refinement of health facility survey tools such as WHO’s Service Availability and Readiness Assessment (SARA).
- Convening health and energy sector actors to facilitate improved consideration of energy gaps, needs and issues within health systems policy and planning processes.
- Support capacity-building among health system programme and facility managers to manage reliable, efficient energy systems.
- Outreach, awareness-raising about the importance of efficient, sustainable of energy service provision as part of improved health service delivery.
Butaro Hospital features innovative design measures to control hospital-acquired infections and conserve energy. Opened in 2011, the 150-bed facility serves around 400,000 people of the Burera District, a rural area of northern Rwanda. Due to the temperate climate and use of passive solar design and natural ventilation, the facility can almost entirely dispense with air-conditioning systems. This results in significant energy savings and effectively reduces the transmission of airborne diseases, such as tuberculosis, by up to 35%.
The facility was a joint project between the Rwandan Government, Partners In Health (PIH), and the Clinton Foundation, implemented exclusively by Rwandans. Local construction workers were trained on-site in the use of low-impact materials, such as volcanic rock and wood. Using local material and labour and minimizing machinery reduced the construction cost to USD $ 4.4 million, one third less than the typical cost of a Rwandan hospital. The Butaro District Hospital is an example of how a modern hospital in rural Africa can create a cost-effective, sustainable environment for quality care.
China's Eleventh Five-Year Plan for 2006 to 2010 set binding goals for the environment based on the two basic state policies of saving resources and protecting the environment. In accordance with this national plan, the Jilin Province Health Bureau and Changchun Mayor officially endorsed the WHO’s Green and Safe Hospitals initiative. The goal of the initiative is to improve the health of patients, workers and surrounding communities while also preparing for emergencies, utilizing less toxic chemicals and leading other sectors by example.
The First Hospital of Jilin University was selected to be the pilot hospital for this project, focusing on alternative energy generation and energy efficiency. It saves heating and cooling costs by using a solar wall combined with a heat absorption pump system. The pump also absorbs the energy from waste gas for the heating system. These solar and waste reuse strategies will save $150,000 per year. Additionally, the implementation of LED lights saves 50% of power compared with T5 lights, a savings of $80,000 of power expense per year. Another priority for the First Hospital of Jilin University has been on decreasing the volume of medical waste and mercury exposure. This helps to create a safer and healthier environment, thereby benefiting health workers and occupational health determinants.
Heat-exposed vaccines can spoil if inadequately refrigerated, and until recently, gas-powered refrigerators or solar refrigerators with lead battery systems have been the only options in locations with unreliable or no grid electricity.
Project Optimize, a WHO and PATH collaboration, has joined forces with national ministries of health in Albania, Guatemala, Senegal, Tunisia, and Vietnam. The project aims to implement new immunization information systems and vaccine supply chains for improved logistics and sustainability. For instance, the “net zero” project is testing a comprehensive renewable power system along the entire vaccine supply chain. The project aims to integrate the supply chain system into one chain of refrigeration and delivery. It also aims to use solar energy and energy efficiency measures to reduce the environmental impact of supply storage and transport. Furthermore, a networked digital supply information system is being implemented to improve tracking of vaccine distribution.
Hospitals can be constructed to be serviced by one form of transport, or they can be planned carefully for access by various modes, including bus, rail, mini-bus, cycling, walking and private vehicles. To ensure sustainability and high access by all stakeholders, civil society groups have pushed planners to consider these factors in the design of the Riviera-Chablais Hospital in Switzerland. Groups include: the Communauté d'intérêts pour les transports publics (CITRAP or Community of Interest for Public Transport), the Association of Transport and Environment (ATE) and Conseil Lémanique pour l'Environnement (CLE or Geneva Council for the Environment). These organizations have advocated for a stronger multimodal accessibility strategy to ensure rapid and equitable access to treatment, along with the sustainable development of the broader community.