Background Sierra Leone has one of the highest child mortality rates in the world. Most of these deaths are due to pneumonia, malnutrition, diarrhoea, malaria and neonatal causes, with hypoxia often being the final factor. Electricity reaches less than 10% of the population in Sierra Leone. This is a significant challenge for health facilities, as without a constant supply of electricity they cannot administer oxygen (provided by oxygen concentrators,) or have reliable lighting. Fuel to run generators is expensive, and there are frequent fuel shortages.
Methods In conjunction with a local non-for-profit organisation we designed a hybrid solar power system to support the electricity needs of a paediatric department in a district hospital in Sierra Leone. The system was designed to provide lighting and electricity to power two oxygen concentrators. The solar power system along with low-energy lights was installed in July 2013. The hospital had received training in ETAT (Emergency Triage, Assessment and Treatment) and set up a paediatric triage sixteen months prior to this.
We retrospectively analysed in-patient paediatric mortality pre and post solar power installation, to evaluate whether there was any impact on mortality. In order to minimise any differences seen being due to seasonal variations in mortality we collected data during the same six months of the year, pre and post solar power installation. Data was analysed in Stata 12.1 using Wilcoxon signed rank test.
Results From August 2012 to January 2013, 920 children were admitted to the paediatric wards, and from August 2013 to January 2014 902 children were admitted. Mean in-paediatric mortality across the six-month period prior to solar panel installation was 3.7% (95% CI 2.0–5.3%), which reduced to 1.8% (95% CI 0.5–3.0%) in the six-month period after solar panel installation; p = 0.028.
Conclusions The installation of solar panels was associated with a reduction in mortality in one paediatric department. The cost effectiveness of this intervention in comparison to other interventions, and its longer-term impact on child mortality requires further evaluation. This initiative could be effective at reducing paediatric mortality in other similar low-resource settings, with limited access to electricity, in combination with other improvements to paediatric hospital care.
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