Hivos International

Energy's Vital Role As An Enabler of Healthcare Delivery in Malawi

Universal health and universal access to energy are both global and Malawi development goals. However, not enough attention is given to their interdependence and their strong relationship. There are grave consequences of energy poverty on health indicators. Hivos Southern Africa's partner under the Green and Inclusive Eenergy programme, Malawi Health Equity Network (MHEN), trained community groups at the Endindeni Health Centre in Mzimba district, located in a rural area in northern Malawi on the importance of linking energy supply to health outcomes. In addition, the trainining was designed to equip the community groups on advocacy and advocacy strategy development.

Endindeni Health Centre: A Case of Energy Poverty

Endindeni Health Centre suffers from severe energy poverty. The facility’s only sources of energy are candles for lighting and firewood for sterilising equipment for both the out patient and the maternity ward. There is only one midwife at the facility who starts her day by gathering fire wood that she uses to heat water to sterilise equipment for deliveries. Wood is the primary source of energy at this remote and rural health centre.

"In our maternity ward, we have no option but to use firewood for sterilization. We depend on the fire wood which is brought by patients and their guardians but I have a task of ensuring that we have collected enough wood for the day," said the nurse.

Impact of the Lack of Energy on Community Health

Lack of access to modern forms of energy – or energy poverty – has both direct and indirect harmful effects on the health of citizens in  many parts of Malawi. Whats makes the case of Endindeni Health Centre disturbing is that the facility is only 21 kilometres from the national grid.

Due to lack of access to energy, staff at the health facility are forced to treat maternity cases and emergency patients in the dark. The health facility also lacks energy to store vaccines or sterilise medical supplies and record data.  Poor lighting is affecting emergency night-time care and lighting for major health-care priorities such as improving maternal and child health and reducing mortality. 

"For critical and urgent health services such as emergency treatments and childbirth, we have no option but to cope as well as operate in low light or completely in the dark, increasing the risk for all patients, including mothers and babies," said the only nurse at the facility.

Following the training of community groups, MHEN developed an advocacy strategy which will be used to push for solutions to some of the energy problems at the health facility. MHEN will be follow up on the progress of the strategies and take unresolved issues to national level for advocacy.

State of Energy Access in Malawi

With an electrification rate of only around 10%, Malawi has one of the most severely constrained power sectors in sub-Saharan Africa. Malawi’s energy balance is dominated by biomass (firewood, charcoal, agricultural and industrial wastes), which accounts for 97 per cent of the total primary energy supply and this is mainly for heating. Given the low rates of energy access in Malawi, off grid, renewable energy solutions can certainly be a much needed alternative. The advantages for implementing offgrid solutions can be huge: fighting energy poverty can result in improved health indicators at rural health centres in Malawi such as Endindeni Health Centre.

"In Malawi, the allocation of resources to the energy component in health care centres is minimal but the demand is very high. Most of our rural health facilities do not have electrivity which makes it difficult for delievery of babies at night and storage of medicenes especially vacinnes. As it is, we are advocating for more resources to be provided into the energy requirements of health care sector," said George Jobe, Executive Director at MHEN, adding that government of Malawi is now considering use of solar energy to power rural based health care facilities.

Indeed solar energy could be a bane to the problem of energy poverty at Malawi's rural health centre. The technology is already proven. The sun is in abundant in Malawi. So there is no reason why health centres in Malawi should continue to suffer from the burden of energy poverty.