Common barriers to sustainable health facility electrification - - PowerPoint PPT Presentation

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Common barriers to sustainable health facility electrification - - PowerPoint PPT Presentation

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Common barriers to sustainable health facility electrification Carolina Barreto, D. Eng | Renewable Energy Manager Tetra Tech | Complex World, Clear Solutions USAID Contractor 1 Powering Healthcare Webinar. | July 19 th 2016 IHFI IHFI --

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Common barriers to sustainable health facility electrification

Carolina Barreto, D. Eng | Renewable Energy Manager Tetra Tech | Complex World, Clear Solutions™ USAID Contractor Powering Healthcare Webinar.| July 19th 2016

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Main issues with energy infrastructure in Haiti

Power Availability

  • Unreliable grid
  • Off grid
  • Diesel generators
  • Need for battery

back-up systems; possible solar PV… Power Quality

  • Low voltage
  • Voltage

fluctuation

  • Surges
  • Sensitivity of

laboratory equipment Electrical Installations

  • Poor, even

dangerous, wiring

  • Lack of

maintenance

  • Bad habits
  • Unskilled

technicians

  • Ad hoc solutions

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Poor, even dangerous, wiring

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Electrical load distribution panels: unhelpful and unsafe

The protection covers of load distribution panels are often missing and the wiring is messy.

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Lack of maintenance

Batteries terminals are corroded. Distilled water may or may not be added occasionally. The generator room is not clean, causing a potential fire hazard and making it difficult to identify leaks.

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Burned generators or equipment

Example at Saint Antoine de Jérémie Hospital, Grand’Anse

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Battery rooms are often not appropriate

Need ventilation (battery gases) and access space for maintenance (add water, brush electrodes, check voltage).

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Haiti grid power – voltage variations

Volts

La Fossette, EDH – July 2012

105 115 125 135 7/24/12 14:40 7/25/12 7:20 7/26/12 0:00 7/26/12 16:40 Max Volts Date and time Max Volt L1 Max Volt L2 Min nom volt

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Haiti grid power – poor coverage over time

Fame Pereo: EDH 10-18 Aug 2011

2 4 6 8 10 12 We1:00:00 PM Th1:00:00 PMFr1:00:00 PMSa1:00:00 PM Su1:00:00 PM Mo1:00:00 PM Tu1:00:00 PM We1:00:00 PM Max kW Date and Time Max kW

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Effects of poor energy infrastructure:

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Decrease in Service

  • Reduced operating hrs;

unserved population

  • Reduced capacity for lab

tests

  • Nighttime safety concerns
  • Decline in morale of

medical/lab staff

High Cost

  • Generator fuel costs
  • Damage to expensive

instruments

  • Data loss
  • Medicine spoilage
  • Need to redo lab tests
  • Decline in morale of

technical staff

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure 11

Evaluation Technology Training Project Approach Institution

  • Battery/inverter
  • Pilots (solar, LED)
  • Remote monitoring
  • Technicians
  • Hospital staff
  • Administrators
  • Energy assessments; measurements
  • Monitoring
  • Standards
  • Management/planning
  • Training
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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

1 – Energy needs assessments

12 Assessment sites New installation sites A total of 30 health facility assessments have been completed or are under way.

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Energy Assessments: actual electrical load variation

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10 20 30 40 50 60 70 80 90 100 We1:00:00 PM We5:40:00 PM We10:20:00 PM Th3:00:00 AM Th7:40:00 AM Th12:20:00 PM Th5:00:00 PM Th9:40:00 PM Fr2:20:00 AM Fr7:00:00 AM Fr11:40:00 AM Fr4:20:00 PM Fr9:00:00 PM Sa1:40:00 AM Sa6:20:00 AM Sa11:00:00 AM Sa3:40:00 PM Sa8:20:00 PM Su1:00:00 AM Su5:40:00 AM Su10:20:00 AM Su3:00:00 PM Su7:40:00 PM Mo12:20:00 AM Mo5:00:00 AM Mo9:40:00 AM Mo2:20:00 PM Mo7:00:00 PM Mo11:40:00 PM Tu4:20:00 AM Tu9:00:00 AM Tu1:40:00 PM Tu6:20:00 PM Tu11:00:00 PM We3:40:00 AM We8:20:00 AM We1:00:00 PM We5:40:00 PM We10:20:00 PM Th3:00:00 AM Th7:40:00 AM Max_Amp Fame Pereo_ED'H Phase 1,2 10 Aug 2011-18 Aug 2011

  • Max. Amp Phase 1
  • Max. Amp Phase 2
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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

2 - Technology

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Battery-Inverter systems LED lighting retrofit Electrical wiring improvements

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Battery-Inverter backup power systems

Standard designs:

  • -- OutBack inverters
  • -- Rolls-Surrette batteries

The inverter-charger:

  • Grid (or generator) power available

 Charges the batteries (AC to DC)

  • No grid or generator power

 Batteries provide power (DC to AC)

Contact vs. No-Contact

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

IHFIinstalled 33 battery-inverter backup power systems in 8 departments

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

LED lighting retrofit demo

  • 180 T12 fluorescent lamps -- typical
  • 24/7 lighting – if power available
  • 44W per lamp – high consumption
  • 66 lumens/W – low efficacy

4-ft LED replacement tubes

  • LED international standards
  • 90 lumens/W – high efficacy
  • 50% reduction in electricity use
  • 2-year payback

Source: ASAMLED, 2012

Existing lighting Hôpital de la Communauté Haïtienne (HCH), Port-au-Prince

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Electrical wiring improvement

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Hôpital Universitaire d’Etat d’Haiti (HUEH), Port-au-Prince Before Installation of ceiling lamps, outlets and fans After

Emergency room

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

3 - Institutions

Partners

  • Haitian Ministry of Public Health and Population
  • (MSPP)’s Project Unit (UGP)
  • National Reference Laboratory (LNSP)
  • CDC

Institutional Activities

  • Standard designs, ToR template
  • Monitoring/communications database
  • Supervision of local installation companies
  • USAID environmental compliance
  • US National Electrical Code compliance

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Guyana Health Facilities Intervention

  • Remote hospitals and clinics

– Two standard PV systems designed based on assessment loads – 1kW and 1.25kW – Local installers bid for installation at 9 sites Results: 12 Installations completed by June 2013

Partners

  • Guyana Energy Agency (GEA)
  • Ministry of Health
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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure 21

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure 22

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200 400 600 800 1000

Baramita Arakaka Aishalton

Pre and Post Vaccination Rates

2012 2013 2014

  • Data collected from posts

records published by the Ministry of Health.

  • 1 to 3 year old population

chosen for more constant vaccination rates through the years

  • Pre PV system the vaccines

were administered the day they were delivered. Post PV system the vaccines are administered

  • n demand.
  • PV system impact can not be

measured trough vaccination rates data from ministry, as this depends on actual vaccine supply and not refrigeration

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  • Load simplicity contributed to system

longevity and lower maintenance levels

  • Load complexity is required for higher

Energy-Health impact/ remote areas health staff retention

  • Partnering with an energy agency has been

highly effective on system endurance

  • Facility maintenance staff in within the

Ministry of Health has not been responsive

  • Health (vaccination) statistical data is

affected by other factors that do not allow a fair measurement energy impact

Guyana Health Facilities Lessons Learned

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

4 - Training program

Train administrators

  • n the importance of

maintenance, budgeting Train hospital staff on system

  • peration

Train technicians in charge of installations Train installers

  • n NEC

and safe practices

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Training activities

  • 150 technicians, installers and administrators trained
  • 9 Technician training sessions (5 days)
  • 2 Hospital Administrator training sessions (1 day)
  • 1 Installer training session (2 days)
  • 20 on-site medical/lab staff training (1h)
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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

IHFI Data Logging and Management

Technicians

  • Maintain equipment
  • Log operating data
  • Deliver data logs to

Administrators Administrators

  • Manage technicians
  • Budgeting
  • Submit data logs to

data center staff Data center staff

  • Store data
  • Analyze data

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Health Facility UGP / MSPP IHFI Training

Project future needs; Optimize available infrastructure More responsibility for their energy infrastructure Trained technicians closer to their equipment

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Knowledge Management

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  • Monitoring
  • Evaluation
  • Reporting
  • Information dissemination
  • www.poweringhealth.org
  • Facebook page
  • YouTube videos

– Training/information – Documentation

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Project achievements

  • 32-35 backup power systems operating by 2015
  • Network of trained technicians
  • Close collaboration with Haitian government UGP
  • Rewired installations for safety and patient comfort
  • Several capable local electrical installation companies
  • Introduction of knowledge of NEC, environmental aspects

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Questions on some decisions taken…

  • Standardization of equipment

– Pros: ease of procurement, installation, training – Cons: obsolescence, lack of broader familiarity; sustainability?

  • Use of grid, instead of going off-grid (i.e., no solar PV)

– Pros: more installations at lower cost – Cons: counting on grid improvement in the future

  • Use of local contractors for installations

– Pros: capacity building; leveraging of small IHFI team – Cons: slower response; bidding, negotiation

  • Introduction of equipment new to Haiti (batteries)

– Pros: bigger capacity, easier design – Cons: unfamiliar, high watering requirement, expensive to replace – Ongoing questions about “wet” vs. “dry” batteries

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Strategy for sustainability

  • Local team of engineers
  • Programmatic approach; standard designs
  • Training for 4 vocations
  • Monitoring of installations; establishment of logging cycle
  • Collaboration with local counterpart institutions

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Challenges still facing

  • Unplanned loads added
  • Ownership of backup power systems
  • Lack of budget and/or access to distilled water for the batteries
  • No budget for end-of-life battery replacement
  • Institutionalization
  • Inevitable load growth in health facilities

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IHFI IHFI --

  • - Haiti

Haiti

Improving Health Facility Infrastructure

Thank you! Please visit www.poweringhealth.org