Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

Figures & Tables

Table 1. UN Interagency List of Essential Devices for Reproductive Health Requiring Electricity

Essential Devices	First-Level Clinic	Referral-Level Facility (Non-Hospital)
Doppler	✓	✓
Scanner, ultrasound		✓
Sterilizer, steam ∼24–40 L	✓
Sterilizer, steam ∼39–100 L		✓
Vacuum extractor^a		✓
Breast pump^a		✓
Anesthesia/Resuscitation Equipment
Free-standing anesthesia system		✓
Newborn incubator		✓
Patient monitor		✓
Nebulizer, atomizer, with electric compressor		✓
Phototherapy unit		✓
Pulse oximeter portable unit		✓
Resuscitation table (newborn)		✓
Resuscitation ventilator (adult/child)		✓
Electric baby warmer	✓

Facility appliances, such as electric lights, communication equipment, water pumps, and refrigeration, are not included in the table.
↵a Manual version sometimes available.
Source: Adapted from the “Interagency List of Essential Medical Devices for Reproductive Health.”⁵

Table 2. Electricity Access for Health Care Facilities in Selected sub-Saharan African Countries, by Facility Type

	Percentage With:
Country, Year (No. of Facilities)	No Electricity	Generator Only	Central, Solar, or Other Supply^a	Reliable Electricity
Ethiopia, 2008 (N = 797)²⁰
All facilities	14	5	81	–
Hospital	1	2	96	–
Other facilities	15	6	79	–
The Gambia, 2004 (N = 12)¹⁹
All facilities	0	33	67	25
Hospital	0	20	80	40
Other facilities	0	43	57	14
Ghana, 2002 (N = 428)²²
All facilities	31	–	–	–
Hospital	6	–	–	–
Other facilities	34	–	–	–
Kenya, 2010 (N = 695)¹⁵
All facilities	26	2	72	15
Hospital	2	2	96	24
Other facilities	28	2	70	14
Namibia, 2009 (N = 411)²³
All facilities	4	1	94	49
Hospital	0	0	100	64
Other facilities	5	2	93	47
Nigeria, 2011 (N = 121)²¹
All facilities	30	–	–	–
Hospital	0	–	–	–
Other facilities	32	–	–	–
Rwanda, 2007 (N = 538)¹⁷
All facilities	18	6	76	41
Hospital	2	10	88	52
Other facilities	19	5	75	40
Sierra Leone, 2011 (N = 106)²⁷
All facilities	35	10	54	14
Hospital	0	4	96	23
Other facilities	37	10	53	14
Tanzania, 2006 (N = 611)²⁴
All facilities	50	2	47	19
Hospital	2	6	92	23
Other facilities	52	2	45	19
Uganda, 2007 (N = 491)²⁵
All facilities	58	1	41	15
Hospital	1	5	94	16
Other facilities	60	1	38	15
Zambia, 2005 (N = 430)²⁶
All facilities	20	1	78	46
Hospital	2	7	92	33
Other facilities	21	1	78	47

Because of rounding, the sum of the percentages in the first 3 columns (no electricity, generator only, and central, solar, or other supply) may not total 100.
↵a Includes facilities that reported use of a combination of multiple power sources (for example, central supply and generator).

Table 3. Energy Access Among Health Care Facilities (Mean), by Facility Type, Selected sub-Saharan African Countries^a

Energy Access	Facility Type
Energy Access	All Facilities	Hospitals Only	Other Facilities Besides Hospitals
Access to electricity, % (N = 11 countries)	74	99	72
Source of electricity, % (N = 9 countries)
Generator only	7	6	8
Central, solar, or other	68	93	65
Reliable electricity, % of electrified facilities (N = 8 countries)	28	34	26

↵a Data for access to electricity are averages among 11 countries (Ethiopia, The Gambia, Ghana, Kenya, Namibia, Nigeria, Rwanda, Sierra Leone, Tanzania, Uganda, and Zambia); for source of electricity, among 9 countries (excludes Ghana and Nigeria); and for reliable electricity, among 8 countries (excludes Ethiopia, Ghana, and Nigeria).

Table 5. Trends in Electricity Access in Health Care Facilities, by Facility Type, Kenya and Rwanda

	All Facilities		Hospitals Only		Other Facilities Besides Hospitals
Country and Year	Percentage	Annual Percentage Change	Percentage	Annual Percentage Change	Percentage	Annual Percentage Change
Kenya
2004	65	1.5	98	0	63	1.5
2010	74	1.5	98	0	72	1.5
Rwanda
2001	58	4	92	1	52	5
2007	82	4	98	1	81	5

Table 6. Reliability of Electricity in Electrified Facilities, by Facility Type and Primary Electricity Source, Liberia, 2011-2012

Facility Type and Primary Electricity Source	Electrified Facilities Reporting Reliable Electricity Access^a
	2011	2012
	n/N (%)	n/N (%)
Hospital
Generator	16/18 (89%)	118/20 (90%)
Community/ shared	1/1 (100%)	1/1(100%)
Health center
Generator	13/14 (93%)	13/20 (65%)
Solar	10/14 (71%)	5/6 (83%)
Community/shared	–	1/1 (100%)
Health clinic
Generator	59/100 (59%)	61/116 (52%)
Solar	99/109 (91%)	119/146 (81%)
Community/shared	1/1 (100%)	3/3 (100%)

Data are among all public health facilities but not private facilities.
↵a The 2011 survey defined reliability by whether electricity was available “during all required operational hours,” whereas the 2012 survey asked whether electricity was available “on the day of the survey.”