Ensuring Reliable Healthcare in Rural and Remote Areas: The Role of Decentralized Solar Energy in Maternal and Child Health using HHFA Framework – A Systematic Review and Meta-Analysis

Abstract

Introduction: An unreliable energy supply in rural and remote healthcare facilities leads to poor quality of health-services affecting health-outcomes. Energy supplied to healthcare facilities has a significant impact especially on maternal-childhealth and emergency care. The present study aims to explore the impact of integrating solar energy in rural and remote healthcare settings on maternal and child health outcomes along with Emergency Obstetric care (EmOC) using HarmonisedHealth-Facility-Assessment (HHFA) framework. The HHFA framework measures service-availability, readiness, quality-ofcare and management in healthcare.

Methods: The steps in this process were conducted according to the PRISMA (Preferred-Reporting-Items-for-Systematicreviews-and-Meta-Analysis) guidelines. The PubMed, Science-Direct, the Cochrane Library were searched including secondary references and the grey literature was retrieved through research-and policy-reports. A total of 144 studies were identified, of which 131 were excluded being not in scope of present study. Further, 4 studies were extracted using grey literature, and finally, a total of 17 studies including 5 studies for meta-analysis were considered as per inclusion criteria across LMIC’s.

Results: The present Systematic review showed improved Maternal and child health-outcomes adhering with the HHFA framework due to solar-based interventions with improved vaccine-storage-management, lighting, and ventilation, resulting in reduced infant and maternal mortality. The Meta-analysis comparing the conventional sources of energy to solar-powered-oxygen-supply for child healthcare indicates the presence of substantial heterogeneity and variation in risk difference estimates across the studies (N=33224; RD=0.03; 95%CI 0.01, 0.05; p<0.001) depicted through forest and funnel plots. The Meta-regression-analysis indicates a positive impact of duration on the effect size indicating the factors responsible for heterogeneity (regression-coefficient r=0.612; 95%CI 0.27, 0.93; p<0.005) emphasizing on the need for solar-powered-oxygen supply over the conventional sources.

Conclusion: The study underscores the transformative impact of integrating solar-energy in rural and remote healthcarefacilities, advocating adoption of climate-resilient technologies in the form of decentralised solar energy solutions as a policy imperative to ensure equitable healthcare-services.