Powering Health Care: Lessons from Finance Models for Health Facility Electrification in Africa and India

This report by the World Resources Institute examines financing models for the electrification of health facilities in India and Kenya using decentralized renewable energy (DRE), specifically solar photovoltaics and battery storage. It analyzes three primary models—asset ownership, lease-to-own, and energy-as-a-service—highlighting the need to shift from a reliance on upfront grants toward innovative, shared-risk financing to ensure long-term operational sustainability and maintenance.

• Global health facility electrification faces a significant funding gap, with estimated investment requirements between $3.6 billion and $4.9 billion to cover technical expertise, installation, and the long-term replacement of components like batteries.
• The asset ownership (capex) model is the most common approach, where facilities own the DRE system from the start. In India, this is often funded through a mix of philanthropic contributions and corporate social responsibility (CSR) grants, with health care being the second-most favored recipient of CSR spending after education.
• A critical weakness of the asset ownership model is the lack of long-term funding for operations and maintenance (O&M). CSR grants typically cover upfront costs and O&M for only up to five years, after which facilities must find their own funding for maintenance and component replacement or risk the systems becoming nonfunctional.
• In Chhattisgarh, India, the Chhattisgarh Renewable Energy Development Agency (CREDA) successfully solarized over 1,400 public health facilities as of March 2023 by blending public financing from the National Health Mission, the District Mineral Development Fund, and CSR funds to ensure both installation and long-term maintenance.
• In Kenya, the Makueni County government used its own budget to install a 205 kilowatt-peak solar PV system at Makueni County Referral Hospital. The system meets 30% to 33% of the hospital's electricity needs, saving approximately 7 million Kenyan shillings ($54,000) annually with a four-year payback period on a $217,000 capital cost.
• The lease-to-own model, piloted in Kenya, allows private clinics to make regular payments to a developer until ownership transfers. Top Care Nursing Home reported reducing monthly electricity costs from $400 to $100 and eliminating $100 in monthly diesel O&M costs, while maintaining full operations during a power blackout on August 25, 2023.
• To scale service-based models (like lease-to-own or ESCO), the report suggests four adaptations: extending repayment periods via concessional financing, aligning monthly repayments with previous utility costs, lowering downpayments, and using government or philanthropic subsidies to align costs with the repayment capacity of smaller rural facilities.

APA

Chembe, A., Concessao, L., Meenawat, H., & Teferra, B. (2026). Powering Health Care: Lessons from Finance Models for Health Facility Electrification in Africa and India. World Resources Institute. https://www.wri.org/technical-perspectives/powering-health-care-lessons-finance-models-health-facility-electrification

Chicago

Chembe, Anderson, Lanvin Concessao, Harsha Meenawat, and Birouke Teferra. Powering Health Care: Lessons from Finance Models for Health Facility Electrification in Africa and India. World Resources Institute, 2026. https://www.wri.org/technical-perspectives/powering-health-care-lessons-finance-models-health-facility-electrification.

Wikipedia

{{cite report |last1=Chembe |first1=Anderson |last2=Concessao |first2=Lanvin |last3=Meenawat |first3=Harsha |last4=Teferra |first4=Birouke |title=Powering Health Care: Lessons from Finance Models for Health Facility Electrification in Africa and India |publisher=World Resources Institute |date=7 January 2026 |url=https://www.wri.org/technical-perspectives/powering-health-care-lessons-finance-models-health-facility-electrification |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{chembe2026powering, author = {Chembe, Anderson and Concessao, Lanvin and Meenawat, Harsha and Teferra, Birouke}, title = {{Powering Health Care: Lessons from Finance Models for Health Facility Electrification in Africa and India}}, institution = {World Resources Institute}, year = {2026}, month = jan, url = {https://www.wri.org/technical-perspectives/powering-health-care-lessons-finance-models-health-facility-electrification}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }