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ENERGY NEEDS ASSESSMENT REPORT for NYARUGOTE HEALTH CENTER, UGANDA

Produced for the UN Foundation

Energy for Women’s and Children’s Health Initiative

By African Solar Designs Ltd

Report number: UG 063

Audit date: 13/03/2015

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Contents

1 Summary ............................................................................................................................................... 3

2 Introduction and Methodology............................................................................................................. 6

2.1 Purpose of document.................................................................................................................... 6

2.2 Methodology ................................................................................................................................. 6

3 Nyarugote Health Center, Description.................................................................................................. 6

3.1 Site location and layout ................................................................................................................. 6

3.2 Medical services ............................................................................................................................ 7

3.3 Women’s and children’s health services ....................................................................................... 8

3.4 Site infrastructure.......................................................................................................................... 9

4 Current Energy Status ......................................................................................................................... 10

4.1 Electrical and thermal energy summary ..................................................................................... 10

4.2 Electrical energy systems ............................................................................................................ 11

4.3 Electrical energy demand............................................................................................................ 12

4.4 Thermal energy demand ............................................................................................................. 13

4.5 Energy systems management ..................................................................................................... 14

5 Recommendations .............................................................................................................................. 15

5.1 System recommendation: 3 kW Facility-level micro-grid ........................................................... 15

5.2 Technical details of proposed power system ............................................................................. 17

5.3 Estimated cost breakdown ......................................................................................................... 19

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1 Summary

This Need Assessment Report presents an overview of the energy situation at Nyarugote Health Center

and provides recommendations on the best way to meet the center’s critical energy loads, particularly

those requiring electricity. The assessment takes a demand-led approach to evaluating potential power

solutions, recognizing that energy is a means to improved health services, not an end in itself. The

assessment attempts to capture the full suite of power-dependent health services at the center, while

prioritizing those services and issues most relevant to women and children. This is in recognition that

women and children generally bear the brunt of inadequate primary health care services, especially in

resource-constrained environments.

An on-site audit was carried out at Nyarugote Health Center , an HC II level health facility1 in Uganda. The

facility serves the local community at Nyarugote trading center and its surroundings. It offers family

planning, antenatal, delivery and pediatric care as specialized women’s and children’s health services.

Current energy situation: The facility is off-grid with the nearest connection point located more than five

km from the site. The site therefore depends on off-grid energy systems for electricity. It currently has

one solar photovoltaic (PV) system with a total capacity of 0.195 kilowatts (kW), of which all is currently

operational. The facility has an estimated current daily electrical demand of 0.2 kilowatt hours (kWh)/day

that is fully met by the existing system.

Proposed solution: Nyarugote Health Center is recommended to have a 3 kWp Facility-level micro-grid

to meet a future modeled daily energy demand of about 10.9 kWh/day. The power system voltage should

be 48 volts direct current (VDC) for the solar supply and 240 volts alternating current (VAC) for the power

supply. The proposed facility-level micro-grid has a medium potential of being expanded into a community

mini-grid, based on a preliminary assessment of distance to and number of nearby households and

businesses.

It is recommended that all buildings should be connected to the facility-level micro-grid and wired to

240VAC with sockets and fittings. This should be done using appropriately sized cables and sited poles

according to Uganda electrification standards2. Remote monitoring of the system and load limiters in staff

quarters should be used as part of a holistic energy management approach.

The total cost3 of the proposed solar PV system for the facility is estimated at between US$ 12,960 and

US$ 21,450, based on low/high-end equipment costs for Uganda. The table below summarizes proposed

power solutions for this facility.

Table 1.1: Proposed energy solution for critical loads at Nyarugote Health Center 4

Critical Need Current Energy Situation Immediate Solution (proposed

energy source)

Lighting Solar PV - operational, kerosene Facility-level micro-grid

1 A further description of health facility levels in Uganda is found in the Country Summary. 2 Uganda adheres to International Electricity Commission (IEC) standards, outlined further in the Country Summary. 3 Cost estimates include all power system components, transportation, installation, taxes (if applicable) and a contingency amount. They do not include remote monitoring or any recommended appliance costs. 4 Abbreviations used in this table include Information and communications technology (ICT) and liquefied petroleum gas (LPG).

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Critical Need Current Energy Situation Immediate Solution (proposed

energy source)

ICT None Facility-level micro-grid

Staff electricity None Facility-level micro-grid

Water pumping None Facility-level micro-grid

Refrigeration LPG LPG

Sterilization No heat-based sterilization LPG

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2 Introduction and Methodology

2.1 Purpose of document This report presents the results of an energy audit and needs assessment conducted for the Nyarugote

Health Center. It provides a detailed assessment of the center’s energy usage (demand and supply) and

makes recommendations for how to improve the availability and quality of energy services at the facility.

The recommendations offer suggestions on ways to conserve energy/reduce costs, while maintaining

reliable power supply to ensure continued provision of health care services to the community – women

and children in particular. This report was prepared with support from and as part of the United Nations

(UN) Foundation’s Energy for Women’s and Children Health initiative in Uganda, which seeks to help map

the energy needs of government health facilities across Uganda and design electricity solutions to address

those needs.

2.2 Methodology A three-step process was used to develop this report. The first step involved identifying Nyarugote Health Center for inclusion in this initiative. The facility was chosen (along with roughly 99 other health facilities) following a consultative process with key energy and health sector stakeholders in Uganda. Criteria included high maternal and child health vulnerability or mortality, as well as low electricity access. The government of Uganda approved the inclusion of Nyarugote Health Center in this analysis. The second step involved conducting an on-site energy audit5 on 13rd March 2015, including interviews

with available staff. Auditor teams were trained by African Solar Designs (ASD) prior to the audits and

used a survey tool designed by ASD and UN Foundation specifically for this work. The tool is based on the

United States Agency for International Development (USAID) Powering Health site evaluation tool.

Following the audits, ASD carried out a comprehensive analysis of the data collected on site, using

international best practices to evaluate the most cost effective, sustainable systems to meet the power

needs of health care practitioners and patients.

An accompanying Country Summary report consolidates analysis and recommendations for all facilities in

Uganda.

3 NYARUGOTE HEALTH CENTER Description

3.1 Site location and layout NYARUGOTE HEALTH CENTER is located in Nyarugote trading center, Nyabubare sub-county, Bushenyi

district. The facility is an HC II health center (registration number 5 in Bunyeshi), established in 2000.

The site is located in an area with a population of about 3,900 people, majority of them being farmers.

The vicinity has small business premises, including a salon and a video hall. NYARUGOTE HEALTH CENTER

site area is shown in more detail in Figure 3.1.

5Tebusweke Semakula completed the energy audit under the supervision of ASD and Konserve consult

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Figure 3.1: Site map of NYARUGOTE HEALTH CENTER and the surrounding community in Error! Reference

source not found.

3.2 Medical services This facility provides outpatient services including maternity, reproductive health services and pharmacy.

A summary of key operational information is shown below.

Table 3.1: Key operational information for the NYARUGOTE HEALTH CENTER

Key Information

Opening hours 7

Days of the week open Monday - Friday

Number of buildings 2

Full-time medical staff 4

Support staff 2

Number of beds 9

Estimated number of outpatients per month

500

Figure .3.2: Proportion of male and female outpatients treated per month

30%

70%

Male

Female

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Figure .3.3: The outpatient block

3.3 Women’s and children’s health services At the NYARUGOTE HEALTH CENTER, there are two midwives. Women’s and children’s health care offered

at the facility includes: family planning, antenatal, delivery and pediatric services. The main health issues

reported by women visiting the facility include: (i) malaria, (ii) urinary tract infection, (iii) respiratory tract

infection and (iv) delivery complications. The main children’s health issues reported include: (i) malaria,

and (ii) respiratory tract infection. The maternity ward at the facility is open for 24 hours daily. The

following is a snapshot of the services available for women at this facility:

Table 3.2: Maternal health care at NYARUGOTE

HEALTH CENTER

Maternal Health Summary

Number of maternity beds 9

Number of full time women’s health staff 2

Housing provided on-site for women’s health staff

Yes

Approximate number of births per month

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Figure .3.4The proportion of births during the day and night

per month

40%

60%

Day birth

Night Birth

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3.4 Site infrastructure Medical services buildings: The site contains the following buildings:

Outpatient department block

Maternity building

Figure .3.5: Medical officers walk towards the maternity building

Staff housing: NYARUGOTE HEALTH CENTER site also includes housing for some of their medical staff,

including one midwife. There are two staff units, all of which have no electricity supply.

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Figure 3.6: Staff housing units at Nyarugote health center

Sanitation: There are four pit latrines with slab on site, none of which has lights. Waste at this site is

separated into bio-medical and organic waste, where there are separate disposal procedures and areas

for each type. Waste disposal utilities available are a rubbish pit and a placenta pit.

On-site water services: There is no running water on site. The source of water is rain harvesting, where

water is collected and delivered through gravitational flow. There is an estimated 10,000 liter (L) water

storage capacity on site.

Caregiver infrastructure: The facility offers family and friends of inpatients a sleeping area.

4 Current Energy Status

4.1 Electrical and thermal energy6 summary Energy sources

Nyarugote Health Center does not have grid electricity and is located more than five km from the nearest

connection point. Existing off-grid systems at the site are summarized below and discussed in more detail

in Sections 4.2 and 4.4.

Table 4.1: Summary of off-grid energy on-site

Energy Source Number of Systems Total Capacity

Solar PV 1 0.195 kW

LPG 1 13kg gas cylinder

Kerosene n/a n/a

6 Thermal energy sources are associated with heat production and include wood, charcoal, liquefied petroleum gas (LPG), kerosene, gasoline, etc.

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Energy applications

During the site audit, a census of energy dependent appliances was taken. The table below shows energy

applications at both the medical departments and staff housing.

Table 4.2: Details of energy consuming appliances on-site

Application Detail Qty Current Energy Source

GS PV Ke Ma LPG WC SWH Grid

Energy Applications at Medical Departments

Lighting Interior LED7 4

Security LED 1

Lantern 1

Refrigeration and cold chain

Vaccine fridge 1

Water heating Stove

Water supply Rain water-gravity fed n/a

Staff housing

Lighting Lantern

Current energy source codes: GS = Genset, PV = Photovoltaic, Ke = Kerosene, Ma = Manual, LPG = LPG gas, WC= Wood/Charcoal,

SWH = Solar Water Heating, Grid = National Grid. Colored dots: Green = Operational, Red = System Failure

4.2 Electrical energy systems The primary electrical sources at the site are solar PV systems. An overview of the off-grid power systems

is given in Tables 4.3 and 4.4. Only one of the staff houses has an off-grid power system.

Table 4.3: Summary of medical department electrical power systems

System Description8 Applications Comments

Solar PV system 1

(Maternity)

-195Wp Solar Modules

-200Ah sealed lead acid

batteries

-12V system

-Phocos charge controller

- Lighting - System is operational.

- Donated by sub-

county officials.

-Installation date

unknown.

The total installed generating capacity at the facility is 0.195 kW, of which all is currently operational. See

Figure 4.1.

7 Light emitting diode (LED) 8 Abbreviations used in Tables 4.3 and 4.4 include watt peak (wP), ampere hours (Ah), and liters (L).

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Figure 4.1: Installed and working generating capacity on-site. Green = operational and red = faulty

Figure 4.2: solar PV array on the maternity block

4.3 Electrical energy demand The facility has a relatively low energy demand. Figure 4.3 illustrates the electrical consumption of the

equipment audited during the site visit. The total electricity demand on-site is 0.2 kWh/day.

The critical electrical loads currently powered at this site are:

Lighting – 4 to 12 hours a day, 3W, maternity and security lights are working.

Figure 4.3: A breakdown of the current electrical demands by application and operational status

Mat lights, 100.0%

Total installed solar capacity = 0.195 kW

0.0 0.1 0.1 0.2 0.2

Lighting

Daily energy requirement [kWh]

Operational

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Figure 4.4: An LED bulb in the maternity

4.4 Thermal energy demand This health facility has thermal energy demands in addition to the electrical demands discussed above.

The site audit indicated that LPG and kerosene are used at the health facility though fuel records were

unavailable at the time of the audit.

Table 4.5: Summary of thermal energy use at the health facility

Thermal source Applications Comment

LPG -Refrigeration -13kg gas cylinder refilled by DHO as soon as gas

is reported to be exhausted.

-Monthly consumption unknown

Kerosene -Lighting

-Water heating

-Monthly consumption unknown

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Figure 4.5: Kerosene powered lantern and stove at the health center

4.5 Energy systems management A brief assessment of the current procedures and challenges for managing the off-grid energy systems

follows.

Table 4.6: Management and maintenance of existing energy systems

Parameter Site Assessment

Existing system meets health facility needs No, it only powers maternity lights

Spare parts available on site or by request No

Training on equipment use provided upon installation Unknown

Manual(s) available for use of system Unknown

Procedure in place for repair / replacement of parts Yes – Report to the sub county officials.

Specific person on site responsible for system

maintenance

The health center in charge.

Budget available for system maintenance Unknown

Guard or other security on site to protect from

system theft

Staff on site double up as security.

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5 Recommendations

5.1 System recommendation: 3 kW Facility-level micro-grid

System design overview

Nyarugote Health Center has an estimated current daily electrical demand of 0.2 kWh/day that is fully

met by the existing system. Future modeled daily energy demand9 will be about 10.9 kWh/day. The

following system is recommended to meet the forecasted demand:

Table 5.1: Proposed system overview

Parameter Value

Electricity demand 10.9 kWh/day

Type of configuration Facility-level micro-grid

System size (kW) 3 kW

System voltage Power supply: 240VAC

PV System: 48VDC

Mini-grid potential Medium potential for community mini-grid.

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9 This figure is based on a modeled future load in which six essential energy demands were identified for all sites: lighting (interior, security and medical), refrigeration, medical equipment, ICT (phone charging and computer), staff housing and water pumping. Site-specific characteristics determined calculations on what these loads – even if not presently on site – might be in future. The figure includes a 20% growth factor, with an additional 25% to account for system losses. More detail regarding the load modeling is in the Country Summary.

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Figure 5.1: Suggested layout of the system

Summary of services to be supplied by proposed energy system

Table 5.2: Proposed energy for essential services on site

Key Energy Service Proposed Energy System Recommended Appliance Upgrades

Lighting Facility-level micro-grid All 12VDC lighting fixtures should be replaced

or be converted to 240VAC. Security, general

lighting and specialized high intensity LED

theatre lights to be supplied.

Security lighting [4]

General lighting [12]

Delivery lamp [1]

ICT Facility-level micro-grid 240VAC sockets for cell phone charging, a

computer and a printer.

Refrigeration LPG in the short term Upgrade to an energy efficient electric vaccine

fridge powered by the micro-grid in the long

term.

Water pumping Facility-level micro-grid A submersible water pump that matches water

requirements at the facility should be

considered.

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Key Energy Service Proposed Energy System Recommended Appliance Upgrades

Sterilization LPG sterilization should be

considered in the short term.

The facility-level micro-grid

cannot supply power for

sterilization.

Steam sterilizer

Staff electricity

needs

Two staff units to be connected

to 240VAC micro-grid [limit to

one socket per staff unit].

Load limiters should be installed in staff quarters for energy management purposes.

5.2 Technical details of proposed power system

This section describes in more detail the 6 kW facility-level micro-grid proposed for the site. The solar PV

array has been sized to provide sufficient energy to meet the future modeled daily energy demand, in

which in which 20% energy growth has been accounted for. A back-up diesel generator has been included

in the system design to allow for 100% power reliability for those days where solar resource is limited yet

the facility still requires power.

Power System Equipment

The proposed off-grid solution consists of a solar PV10 array generating DC electricity into a DC bus where

a maximum power point tracking (MPPT) charge controller charges the batteries. Through a pure sine

wave inverter the DC electricity is converted into AC for the final delivery to the health facility. A generator

is included as an optional feature in the event the site wants to provide backup for full-time power11. The

following diagram illustrates the two main components of the proposed system:

Power system equipment (blue dotted line) and

Different consumption units (loads) that the power system provides power to (red dotted line.)

10 Uganda has strong solar resources and less well understood wind resources. Wind is highly site specific and was not assessed as part of this work. 11 For backup power to a PV/battery system, a diesel generator is generally preferable as it is dispatchable (available on demand), can be used to recharge existing batteries in times of low solar resource, and is more cost effective than additional batteries for the same purpose. For the limited portion of the time that the solar resource isn't available (e.g. rainy days), a small generator is most effective.

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Figure 5.2: Proposed system design

Technical description of power system

Table 5.3: Details of the proposed system

TECHNICAL PARAMETER 3kW

Solar Photovoltaic Array Capacity (Watts) 3000 (W)

Total Inverter Nominal Capacity (Watts) 3000 (W)

Total Inverter Maximum Capacity (Watts) 3600 (W)

Charge Controller Size To match max current from solar array + 25%

Total Battery Bank Capacity @ C10

(Ah) 781 (Ah)

Battery Bank Voltage (Volts) 48 (V)

Diesel Generator Size (kVA) 4 -4.5 (kVA)

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The above table details the solar array peak capacity in Watts, the total nominal and maximum capacity

of inverter(s) in Watts, the battery bank capacity for 2.5 days of autonomy (Amp-hours) and the DC bus

system voltage. The charge controller size (Amps) should be 25% greater than the current coming from

the solar array to allow potential overcurrent flows while protecting the equipment.

Detailed technical standards for equipment accompany the Country Summary document.

Remote monitoring of the system for proper management.

Mounting structure to be provided depending on where the system will be mounted - ground or

roof top.

Necessary upgrades for appliances and wiring

All buildings should be connected to the facility-level micro-grid wired for 240VAC with sockets and

fittings. This should be done using appropriately sized cables and sited poles.

Uganda electrification standards should be used for all of these systems. Internal 240VAC wiring will be

completed for:

The outpatient department building

The maternity building

The toilet block

Water pump

staff quarters

Operational features of system

A brief description of expected service levels and parameters follows; full technical specifications are

provided in the Country Summary:

Solar power should provide 100% of the power supply.

Systems should be equipped with online monitoring equipment that will allow remote assessment of operational status and energy use.

Systems should be designed so they can be expanded if necessary.

The distribution system should be designed for eventual connection to the national grid. In particular the cable size will have to match the local country standards for grid interconnectivity.

5.3 Estimated cost breakdown

The total cost, including taxes, of the proposed solar PV system ranges between US$ 12,960 and US$

21,450. Table 5.4 provides a cost breakdown for the main components of a solar PV installation per unit

(Watt) of power.

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Table 5.4: Cost breakdown of proposed system

Item USD/Watt USD/kWh

Lower limit Higher limit EQ

UIP

MEN

T

PV Modules 0.75 1.00

Structure/Mounting 0.20 0.35

MPPT Charge Controller 0.30 0.40

Battery bank 1.27 2.20 100 170

Inverter 0.25 0.35

Balance of System 0.20 0.60

Distribution costs 0.30 0.60

OTH

ERS

Transportation 0.30 0.40

Installation 0.45 0.55

Contingencies 0.30 0.70

TOTAL BEFORE TAXES 4.32 7.15

TAX

ES

VAT and Duty * Solar equipment

in Uganda is VAT and Duty

exempt.

0.00 0.00

TOTAL AFTER TAXES 4.32 7.15

TOTAL COST FOR A 3KW SYSTEM US$12,960 US$21,450

BACK-UP GENERATOR Lower Value (USD) Upper Value (USD)

Cost per KVA 1,000 1,200

Cost for a 4.0-4.5 kVA Generator 4,000 5,400

Notes

1. PV Modules are monocrystalline or polycrystalline. 2. Battery bank – Flooded Lead acid. 3. Balance of System (BoS) – 10% = 15% of the

equipment total costs. Includes all electrical accessories required for installation – wiring, switches. 4. Transportation costs calculated

according to the distance of the HC from the capital – Kampala. 5. Installation costs calculated per country local costs. 6. Contingencies -5%

- 10% of the total system costs. 7. VAT =18% and import duty = 6%-15% depending on the type of product .However, solar energy

equipment were VAT and duty exempt at the time this study was done. 8. Generator costs have not been included.

The generator capital cost has been provided in a separate table, as this power system equipment is

optional equipment that allows for 100% power reliability to the health facility but at relatively high

operating cost for fuel. Costs for remote monitoring systems vary depending on the level of data

collection, and as such have not been included in the above calculations. A typical facility-level micro-grid

monitoring system is usually under US$1,000.