In November 29, 2018 – At the Uganda Reproductive Health Assembly in Kampala, Dr. Laura Stachel joined with Honorable Jane Aceng, Minister of Health, to announce that Uganda has pledged to “Light Every Birth” as part of the global initiative to support healthy childbirth with affordable, accessible and clean solar lighting and electricity.
“Light Every Birth” is ensuring that medical lighting and power is available for maternal health centers that lack reliable lighting and electricity so essential for safe deliveries. To celebrate the launch, We Care Solar is donating 350 Solar Suitcases to health centers lacking reliable electricity, with major support from the UBS Optimus Foundation, Wells Fargo Foundation, The Meadow Fund, and Music for Relief Foundation. This builds upon prior efforts that equipped 450 Ugandan health facilities with Solar Suitcases.
“Effective quality of care for mothers and newborns is critical to prevent and manage complications and is dependent upon light and electricity. Even the best-trained practitioners are handicapped in darkness.” said Honorable Jane Aceng. “The Light Every Birth initiative will complement our efforts to achieve universal healthcare access and improve maternal and newborn survival in rural communities.”
Honorable Rebecca Kadaga, Speaker of Parliament was delighted that the Solar Suitcase program is expanding throughout Uganda, “The Light Every Birth initiative will bridge the energy access gaps, ensuring round the clock management of deliveries, pediatric emergencies and administration of emergency obstetric care.”
We Care Solar Executive Director Laura Stachel added, “All women have the right to deliver safely in clinics with reliable lighting and power. We look forward to working closely with the Ministry of Health and all our Light Every Birth partners to support Safe Childbirth.”
Light Every Birth is part of a global call to action where all mothers can access prompt, appropriate obstetric care provided in well-equipped health centers. Globally, 300,000 women and more than one million newborns die every year from complications of childbirth. In hundreds of thousands of health centers lacking reliable electricity, midwives and doctors struggle to provide critical care in near-darkness. The consequences are tragic.
We Care Solar designed an innovative, compact, rugged “Solar Suitcase” tailored for maternal health facilities and created programs to build local capacity in solar installation, operation, and maintenance. In Uganda, We Care Solar has partnered with UNICEF, CUAMM, Doctors with Africa, Save the Children, Pathfinder International, and Safe Mothers Save Babies to conduct successful programs since 2012. 2018 implementation partners include Brick by Brick, Healthy Child Uganda, Intrahealth, and Ekide Ltd.
Light Every Birth Uganda builds upon the Electrification for Rural Transformation project and supports governmental efforts to strengthen the capacity of rural health facilities to lower maternal and newborn deaths. Through this collaborative and bold initiative, Uganda will become a “Model of Excellence” for electrification of maternity care.
The Impact of Reliable Electricity on Maternal and Newborn Healthcare in Rural Uganda
Every year in sub-Saharan Africa, 1.2 million women and newborns die in delivery or shortly thereafter. Policies and programs aimed at reducing home births have led to dramatic increases in births in health care facilities. Yet, these gains have not always translated into meaningful improvements in maternal and newborn health outcomes. One potential reason behind this disconnect is poor access to quality infrastructure in facilities—namely reliable electricity and lighting.
Poor lighting has major implications for delivering routine and emergency obstetric and newborn care—hindering the ability to monitor the progression of labor, manage emergency complications, and, when needed, provide timely life-saving care. Expanding the electrical grid to generate access to reliable electricity for facilities, however, often requires significant investments in resources and infrastructure. Could a solar electric system designed for maternity care facilities in low-resource environments provide reliable electricity to improve the quality of maternal and newborn health care?
In Uganda, where this evaluation takes place, nearly all women (97 percent) receive antenatal care from a skilled provider and 73 percent of births are delivered in a health facility. Yet, the maternal mortality ratio remains high at 375 deaths per 100,000 as of 2017. Often health care facilities rely on kerosene lamps to address their lighting needs, which are unreliable, dangerous, and do not provide the focused, bright light that maternity and newborn care requires. To better understand interventions that could overcome these obstacles, researchers are evaluating the impact of a solar electric system designed to provide reliable light in maternity care facilities.
We Care Solar partnered with researchers to evaluate the impact of the We Care Solar Suitcase on the reliability and quality of light during and following birth, the quality of obstetric and newborn care, and health worker satisfaction. The Solar Suitcase is a complete solar electric system that provides essential lighting and power for charging phones and small medical devices. Installations were done by a local solar contracting firm. One Solar Suitcase was installed in each facility, with 2–4 overhead LED lights for each delivery room, depending on its size. Health workers received training on how to use and maintain the Solar Suitcase during installation and on subsequent check-ins done in person or over the phone. Installers also followed up with maintenance requests. Health facilities did not incur any cost during the evaluation for installation, operation, or maintenance.
Researchers evaluated the Solar Suitcase in thirty public sector health facilities without reliable electricity in the Central, Eastern, and Western regions of Uganda. Type of health facilities ranged from the first point of contact with the formal health sector, covering outpatient services and some maternity care when necessary, to more advanced facilities covering emergency medical and obstetrical care (none of the facilities did caesarean sections). Researchers staggered the installation of Solar Suitcases creating two groups to which facilities were randomly assigned: 15 facilities in Sequence 1 received Solar Suitcases first, while facilities in Sequence 2 received the intervention 10-12 weeks later. By the end of the study, Solar Suitcases were installed in all thirty facilities.
Over the course of the evaluation, researchers captured data on the availability and brightness of light in the health care facility, quality of intrapartum care, and health worker satisfaction. In addition to directly observing light and electricity, researchers installed light sensors in delivery rooms which collected light voltage data for the duration of the evaluation and, in facilities connected to the grid, detected whether the grid power was on or off. Through direct observation of deliveries, enumerators monitored the quality and timeliness of care provided using a quality checklist. Enumerators also conducted interviews with health facility providers and administrative staff.