Powering Healthcare Madagascar: Powering Healthcare Market Assessment and Roadmap

This report provides a market assessment and strategic roadmap for the electrification of healthcare facilities (HFs) in Madagascar, specifically focusing on Basic Health Centres (CSBs) and District Reference Hospitals (CHRDs). It identifies a significant energy gap, where 75% of CSBs lack electricity, and proposes an integrated, bottom-up approach to improve health services through sustainable energy solutions, estimated to require USD 83 million over ten years.

• A vast majority of Basic Health Centres (CSBs) lack electricity, with approximately 75% having no access and only 30% having access to basic lighting. While 76% of visited sites had a functioning solar refrigerator, most are off-grid and do not meet required standards.
• District Reference Hospitals (CHRDs) generally have access to some power, but it is often unreliable with frequent power cuts. Approximately 50% of CHRDs are connected to the JIRAMA national grid, while others rely on a mix of private mini-grids, solar plants, and generators.
• The report identifies a potential electrification market of 2,274 healthcare facilities by 2030, comprising 2,174 CSBs and 100 CHRDs. This includes a mix of stand-alone solar solutions for isolated sites and back-up solutions for those connected to the grid or mini-grids.
• Current electrification efforts are described as 'siloed,' often focusing on energy installation without coordinating with the provision of medical equipment, building refurbishment, or staff training. There is a lack of formal inter-ministerial coordination for the health-energy nexus.
• Sustainability is a major challenge because most business models lack reliable long-term funding for Operation and Maintenance (O&M) and equipment replacement. Many projects rely on Technical and Financial Partners (TFPs) to cover CAPEX and only 2-3 years of OPEX, leaving facilities unable to maintain systems thereafter.
• The proposed roadmap (2024-2032) follows a three-phase approach: Structuring & Cluster Testing (2024-2025), Demonstration & Implementation (2025-2028), and Consolidation (2029-2032). It emphasizes a 'bottom-up' approach where facilities apply based on real needs.
• Total investment required to electrify all targeted CSBs and CHRDs over 10 years is estimated at USD 83 million, consisting of USD 52 million for CAPEX and USD 31 million for OPEX.
• Operational challenges include a lack of national electrical standards for healthcare facilities, dilapidated building infrastructures (50% in poor condition), and a shortage of personnel trained in electrical maintenance.
• To improve financial solvency, the report suggests diversifying revenue streams for HFs, such as charging for phone recharging, printing/photocopying, and selling surplus electricity back to mini-grids.

APA

Severi, L., Lazopoulou, M., Tavernier, L., Knight, C., Vallvé, X., Arrieta, U., Mrabit, N., Razanajatovo, L., Mosca, L., González, I., Cabanillas, R., Rakotoarivelo, M., Ratsara, E., & Rakoto, S. (2024). Powering Healthcare Madagascar: Powering Healthcare Market Assessment and Roadmap. Sustainable Energy for All. https://www.seforall.org/system/files/2024-05/PHC-Madagascar-Roadmap-EN-FullReport_compressed.pdf

Chicago

Severi, Luc, Marilena Lazopoulou, Louis Tavernier, Charlie Knight, Xavier Vallvé, Unai Arrieta, Nadia Mrabit, et al. Powering Healthcare Madagascar: Powering Healthcare Market Assessment and Roadmap. Sustainable Energy for All, 2024. https://www.seforall.org/system/files/2024-05/PHC-Madagascar-Roadmap-EN-FullReport_compressed.pdf.

Wikipedia

{{cite report |last1=Severi |first1=Luc |last2=Lazopoulou |first2=Marilena |last3=Tavernier |first3=Louis |last4=Knight |first4=Charlie |last5=Vallvé |first5=Xavier |last6=Arrieta |first6=Unai |last7=Mrabit |first7=Nadia |last8=Razanajatovo |first8=Lauriane |last9=Mosca |first9=Lucas |display-authors=etal |title=Powering Healthcare Madagascar: Powering Healthcare Market Assessment and Roadmap |publisher=Sustainable Energy for All |date=March 2024 |url=https://www.seforall.org/system/files/2024-05/PHC-Madagascar-Roadmap-EN-FullReport_compressed.pdf |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{severi2024powering, author = {Severi, Luc and Lazopoulou, Marilena and Tavernier, Louis and Knight, Charlie and Vallvé, Xavier and Arrieta, Unai and Mrabit, Nadia and Razanajatovo, Lauriane and Mosca, Lucas and González, Isabella and Cabanillas, Rafael and Rakotoarivelo, Manitra and Ratsara, Erick and Rakoto, Sitraka}, title = {{Powering Healthcare Madagascar: Powering Healthcare Market Assessment and Roadmap}}, institution = {Sustainable Energy for All}, year = {2024}, month = mar, url = {https://www.seforall.org/system/files/2024-05/PHC-Madagascar-Roadmap-EN-FullReport_compressed.pdf}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }