马达加斯加医疗保健供电：市场评估和卫生设施电气化路线图

Market Assessment and Roadmap forHealth Facility Electrification M A R C H 2 0 2 4 Acknowledgements Thisdocument was drafted by Sustainable Energy for All(SEforALL)and the consultancy teams at TTA(TramaTecnoAmbiental global consulting and engineering company)and AIDES(Sustainable InvestmentSupportLtd.),inclosecollaborationwiththeMinistryofPublicHealth(MSanP)andtheMinistryofEnergyandHydrocarbons(MEH),aspartofaprogrammefundedbytheGlobalEnergyAllianceforPeopleandPlanet(GEAPP). TheteamandauthorsareLucSeveri,MarilenaLazopoulou,LouisTavernierandCharlieKnight(SEforALL);theTTAconsultancy team(particularly Xavier Vallvé,Unai Arrieta,Nadia Mrabit,Lauriane Razanajatovo,LucasMosca,IsabellaGonzálezandRafaelCabanillas);andtheAIDESconsultancyteam(ManitraRakotoarivelo,ErickRatsaraandSitrakaRakoto). Wewouldliketowarmlythankthekeypartnersandstakeholdersfortheirinvaluablesupport,contributionsandfeedback,includingtheMSanPandparticularlytheDepartmentofBasicHealthcare(DSSB),theDepartmentofDistrict-levelReferralHospitals(DHRD)andtheDepartmentofStudiesandInformationSystemPlanning(DEPSI),theMinistryofEnergyandHydrocarbons(MEH)inparticulartheDepartmentofEnergyEmergence(DER),theRuralElectrification Development Agency(ADER),the Ministry of Decentralization and Territorial Planning(MDTP)inparticulartheDepartmentofCommunityCooperation(DCC),theMinistryofEconomyandFinance(MEF),theWorldBank,GIZ,USAID,UNDPandUNICEF. Finally,wewouldliketothanktheprivatesector,inparticularANKAMadagascar,WeLight,AfricaGreenTec,MadagreenpowerandNanoéforsharingtheirexperience,andtoalltheotherstakeholders(TFPs,NGOsandtheprivatesector)involvedintheelectrificationofhealthcarefacilitiesinMadagascar. Acronyms Glossary / Key Definitions Table of 01. IntroductionObjectives, Methodology and Approach7802. Market AssessmentMadagascar's healthcare systemHF Electrification: CSBs and CHRDs12132303. Current and Future ChallengesChallenges in Electrification PlanningOperational ChallengesChallenges for SustainabilityChallenges for Vulnerable GroupsChallenges in Integration384145495658 05. Conclusions10406. AppendicesA. Preliminary GIS mappingB. Stakeholder mappingC. Intervention mappingD. Policy and regulatory frameworkE. Energy needs assessment for CSBsF. Technical SpecificationsG. Questionnaire for field visits10810911012012412512913004. Solutions and recommendationsTechnologyBusiness modelsIntegrationRoadmap for HF electrification6065798993 Objectives,Methodology andApproach JUSTIFICATION HEALTHCARE FACILITY DATA COORDINATION BETWEEN PLAYERS Limited data access and reliability, stored inmultiple locations, neither centralized noreasily accessible Limited, between energy and health sectors The Roadmap for the Electrification ofHealthcare Facilities in Madagascar wasdeveloped by SEforALL in closecollaboration with the Ministry of PublicHealth (MSanP) and the Ministry ofEnergy and Hydocarbons (MEH), andfunded by the Global Energy Alliancefor People and Planet (GEAPP). INVESTMENT NEEDSLimited knowledge TECHNICAL SOLUTIONS ANDSUSTAINABLE DELIVERY MODELS Lack of technological options and sustainablefinancial models adapted to local realities DUPLICATION BETWEEN MULTIPLEINITIATIVES E.g. needs assessment tools, electricitydelivery model pilots, etc. OBJECTIVES OF THE ROADMAP To provide the government and its TFPs with data onthe extent of the energy deficit that persists in thehealthcare sector, including non-electrified and semi-electrified facilities. To provide the strategic information andimplementation guidelines that the government and itspartners need to allocate the investments required toimplement sustainable electrification of healthcarefacilities (HFs). To propose long-term sustainable model options,including innovative approaches for the provision ofcontinuous and reliable electricity services. This doesnot involve formulating a tailored solution for eachHF. METHODOLOGY APPROACH Themarket assessment and roadmap consists of several elements,includingstakeholder and intervention mapping,data analysis,technologyassessment,financingmechanisms,businessmodelsandaroadmapfor the electrification of HFs in Madagascar.The marketassessmentandroadmapforthetwotypesofHFs-CSBsandCHRDs-arepresentedinthefollowingchapters. Datawerecollectedusingbothquantitativeandqualitativemethods,andfromavarietyofsources: TheMarketAssessmentandRoadmapfortheElectrificationofHealthcareFacilitieswasdevelopedinclosecollaborationwithkeystakeholdersinthesector:thegovernment,TFPs,NGOsandtheprivatesector. Field visits conducted and feedback gathered from various stakeholders forbetter understanding of the realities FIELD VISITS •Asample of 10 CSBs and 5 CHRDs to be visited was determinedaccordingtocriteriaandsitesvalidatedbytheMSanP,allowingabroadrepresentationwhilerespectingthetimeandbudgetfactorsimposedbySEforALL. •EachvisitincludedinterviewswithHFhumanresources,completionofadetailed1 multi-dimensional questionnaire(including medical aspects,electricalsystems,humanresources