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

Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C.; Hebert, Ryan; Fletcher, Elaine

doi:10.9745/ghsp-d-13-00037

Cited by 137 publications

(119 citation statements)

References 2 publications

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“…The importance of an enabling environment in order for health workers to deliver good-quality care has been emphasised previously (Maclean 2003). Although the United Nations' fifth Millennium Development Goal (MDG) era promoted access to health facilities and skilled birth attendance, basic infrastructure and logistics management at health facilities remain a challenge in several settings (Adair-Rohani 2013). …”

Section: Discussionmentioning

confidence: 99%

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

Munabi‐Babigumira

Glenton

Lewin

et al. 2017

Cochrane Database of Systematic Reviews

158

163

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BackgroundIn many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care.ObjectivesTo explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies.Search methodsOur search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016).Selection criteriaWe included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle-income countries.Data collection and analysisOne review author extracted data and assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review.Main resultsWe included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America.Our synthesis pointed to a number of factors affecting SBAs’ provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always...

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Section: Discussionmentioning

confidence: 99%

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

Munabi‐Babigumira

Glenton

Lewin

et al. 2017

Cochrane Database of Systematic Reviews

158

163

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“…A review of healthcare facilities in several sub-Saharan countries showed that, on average, 26% of the facilities examined had no access to electricity; 28% had reliable access to electricity, and 7% relied solely on generators. 54 WHO has proposed a multi-tier metric for assessing access to electricity in health-care facilities, and this metric includes peak power capacity, daily energy capacity, duration of supply, evening peak hours supply, aff ordability, quality, reliability, operational sustainability, environmental sustainability, and environmental health. 55 This metric has yet to be operationalised, but the Lancet Countdown will draw on this measure for reporting on energy access in the health-care sector where feasible.…”

Section: 4: Energy Access For Health Facilitiesmentioning

confidence: 99%

The Lancet Countdown: tracking progress on health and climate change

et al. 2017

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The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be "the greatest global health opportunity of the 21st century". The Lancet Countdown aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefi ts of climate change mitigation; economics and fi nance; and political and broader engagement. These focus areas form the fi ve thematic working groups of the Lancet Countdown and represent diff erent aspects of the complex association between health and climate change. These thematic groups will provide indicators for a global overview of health and climate change; national case studies highlighting countries leading the way or going against the trend; and engagement with a range of stakeholders. The Lancet Countdown ultimately aims to report annually on a series of indicators across these fi ve working groups. This paper outlines the potential indicators and indicator domains to be tracked by the collaboration, with suggestions on the methodologies and datasets available to achieve this end. The proposed indicator domains require further refi nement, and mark the beginning of an ongoing consultation process-from November, 2016 to early 2017-to develop these domains, identify key areas not currently covered, and change indicators where necessary. This collaboration will actively seek to engage with existing monitoring processes, such as the UN Sustainable Development Goals and WHO's climate and health country profi les. The indicators will also evolve over time through ongoing collaboration with experts and a range of stakeholders, and be dependent on the emergence of new evidence and knowledge. During the course of its work, the Lancet Countdown will adopt a collaborative and iterative process, which aims to complement existing initiatives, welcome engagement with new partners, and be open to developing new research projects on health and climate change.

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“…Ventilators and other equipment in the operating theater and ICU at the hospital, when available, are often older, outdated, or have been donated and no longer work due to inability to obtain parts, inappropriate design for an environment with erratic power supplies, and lack of biomedical engineering training and maintenance [6,8,9,39,40]. Oxygen supply is variable and challenging and is provided by oxygen concentrators that are expensive but easy to maintain [6,8,36].…”

Section: Support Servicesmentioning

confidence: 99%

“…Only 34% of hospitals in SubSaharan Africa that are electrified have a reliable electricity source [40], and only 22% of hospitals in Tanzania have been shown to have the basic infrastructure necessary to provide emergency and surgical care [24]. The lack of a reliable electricity supply is even more urgent when oxygen concentrators are in use and power surges can damage monitoring equipment and ventilators.…”

Section: Infrastructurementioning

confidence: 99%

Challenges to the Provision of Emergency Services and Critical Care in Resource-Constrained Settings

Stafford

Morrison

Godfrey

et al. 2014

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The practice of intensive care unit (ICU) care in Sub-Saharan Africa is challenging and can have a significant impact on the lives of people in the region. Sub-Saharan Africa bears a disproportionate global burden of disease compared with the rest of the world. Inadequate emergency care services and transportation infrastructure; long lead times to hospital admission, evaluation, treatment and transfer to ICU; inadequate ICU and hospital infrastructure and, unreliable consumable and medical equipment supply chains all present significant challenges to the provision of ICU care in Sub-Saharan Africa. These challenges, coupled with an inadequate supply of trained healthcare workers and biomedical technicians and a lack of formal ICU-related research in Sub-Saharan Africa, would seem to be insurmountable. However, ICU care is being provided in district and regional hospitals throughout the region. We describe some of the challenges to the provision of emergency services and critical care in Tanzania.

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

Cited by 137 publications

References 2 publications

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

The Lancet Countdown: tracking progress on health and climate change

Challenges to the Provision of Emergency Services and Critical Care in Resource-Constrained Settings

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