SELCO Foundation and Societal Thinking – Enabling high performing primary healthcare facilities

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SELCO Foundation, with its deep experience in the past twelve years, has always seen the role of sustainable energy as not just a point solution, but as an enabler for inclusive development. One such area that we have been trying to understand more is healthcare. How can reliable and quality healthcare infrastructure be accessible to all?

According to a report in The Lancet, almost 122 Indians per 100,000 die due to poor quality of care each year. When their livelihoods are already precarious, having to travel long distances to receive quality healthcare further reduces the chances of people from marginalised communities visiting a health centre. A high-performing primary healthcare centre (PHC) offers crucial medical assistance close to their homes, bridging the gap between remote areas and access to quality healthcare. 

But, ensuring quality in healthcare delivery at the PHCs is a significant challenge due to the prevalent energy problem. Remote areas often suffer from inadequate or unstable power supply. Inadequate power supply hinders critical healthcare procedures, such as childbirth, making it unsafe and unfeasible to deliver babies in the dark. The lack of functioning machinery, incubators, and medical equipment further erodes communities’ confidence in the public healthcare system. We started wondering if Decentralised Renewable Energy (DRE) solutions could be the answer to the energy challenges in remote regions. But is that enough for a high-performing healthcare system? What else do we need? 

Building a high-performance Primary Health Centre

We recognize that this problem needs a holistic approach rather than a point solution approach. For any intervention to be useful and sustainable, PHC has to be looked at as a unit of change where change has to happen at multiple levels across diverse issues that the PHC faces today. We realized that SELCO will primarily play the doer role for the energy needs of the PHCs, but that we will also have to play an orchestrator role to bring together diverse actors who can enable a PHC into a high-performing healthcare centre. 

As part of the Scalers journey with Societal Thinking, we are reimagining how to build such high-performance primary healthcare centres, together with actors from Samaaj, Bazaar and Sarkaar. (Civil society, markets and governments). How will this work at the scale of India with its 31000+ PHCs, and small/medium large healthcare facilities? How can we create a public good that can be used and built upon across different contexts and maybe even different nations? How can we establish “performance” that is based on equity, efficiency and resilience?

As a scaler, we will pilot our reimagination with about 25,000 government-run health facilities in India (about 12% of the total health facilities in the country), but we will design for it to work at population scale. The magnitude of problems is huge, not just in India, but many countries in the Global South which, even in 2023, face great challenges both with energy access and delivery of basic health services. 

We are co-exploring this journey across three dimensions:

  • Operations and Maintenance

The operation and maintenance (O&M) aspect of energy infrastructure is vital to ensure a continuous and reliable energy supply to a high-performing healthcare facility. How can we increase visibility into the healthcare centres, including real-time data on operations, movement of resources, and information about what’s working and what needs attention? To achieve this, we will explore building blocks that can establish a robust data-driven system to streamline processes and optimize resource utilization, ultimately enhancing the overall healthcare service delivery of the PHC.  This will also serve as fundamental building block for any public infrastructure across countries and domains.

  • Capacity building

We will focus on capacity building initiatives, and one such strategy is to leverage the expertise of other practitioners in the Societal thinking ecosystem to enhance the capacity of the actors in the healthcare ecosystem. We also see significant potential in leveraging exponential technologies like artificial intelligence in disseminating knowledge and skills development right down to the first mile of healthcare delivery.

  • Community leadership

Building a sense of ownership and cultivating a service orientation among the staff is critical for a PHC to perform well. We want to harness the existing energy and dedication of the people working on the ground by drawing inspiration from their successful practices to create improvement projects for the healthcare sector.

Through this partnership with Societal Thinking, SELCO Foundation will be able to reimagine the problems in first-mile healthcare delivery and take an orchestrator view of what needs to be solved. This will help in strengthening SELCO Foundation’s mission of building a sustainable and performing healthcare system, powered by decentralised renewable energy. 

There is a high resonance with this approach on the field across the healthcare centres, and also a few state Governments where the pilots have begun. Our co-exploration with Societal Thinking on this Scalers journey has just begun in this direction. Exciting days ahead!

About the Author

Rachita Misra

SELCO Foundation

Harish Hande

SELCO Foundation

Vyjayanthi Mala