South West Khasi Hills_LATEST DRAFT_080222

Decentralised Renewable Energy Solutions to Strengthen Public Health Facilities

SOUTH WEST KHASI HILLS

SELCO Foundation in partnership with National Health Mission Meghalaya

About Meghalaya Located amidst the remote and hilly terrains of North Eastern part of India, Meghalaya is home for some of the richest bio-diversity and cultural diversities in the country. With some of the wettest regions in India along with areas of dense subtropical forests and large tribal populations, the state offers unique opportunities and challenges for developing sustainable development programs. Khasis being the largest tribe, followed by Garos and Jaintias, the state’s demography, geography and climate nuances require an approach that not only considers the unique typologies of the land but also the vulnerabilities of the communities while building the enabling ecosystems around various sectors. The current health system in Meghalaya has prioritized both preventive and curative care, with goals to provide affordable, patient-centric universal healthcare to all the residents while also building awareness on the available healthcare services. The idea is for the population to become informed residents with the Health Department taking a proactive role in the dissemination of healthcare services in the State in collaboration with all the stakeholders. As the communities in the districts of the state face challenges of difficult terrain, remoteness, vulnerability to climate risks and natural disasters, decentralization of services, especially decentralized solutions that can power critical healthcare services including immunization, maternal care, deliveries, diagnostics, and contribute to increased monitoring and vaccination that can curtail the spread of COVID 19, and overall healthcare delivery.

NORTH GARO HILLS

WEST GARO HILLS EAST GARO HILLS

SOUTH WEST GARO HILLS SOUTH GARO HILLS

WEST KHASI H

SOUTH WEST KHASI HILLS

RI-BHOI

HILLS WEST JAINTIA HILLS

EAST KHASI HILLS

EAST JAINTIA HILLS

SOUTH WEST KHASI HILLS The South West Khasi Hills District was established in the year 1982 after its bifurcation from the West Khasi Hills District. It covers an area of 1,341 sq. km (518 square mile) and has a population of 1,10,152 as per the 2011 census. The headquarters of the district is located at Mawkyrwat.

CONTENT 1. FOREWARD & ABOUT

1-5

2. KULANG

6-9

3. MAHESHKOLA

10-13

4. MAWPUD

14-17

5. NONGKYNBAH

18-21

6. NONGRYNIANG

22-25

7. PHLANGDILOIN

26-29

8. PHOTJAUD

30-33

9. SHNGI MAWLEIN

34-37

10. ABOUT

38-39

1. FOREWARD & ABOUT

1-5

-About NHM

1

-About CEO

2

-Background & Needs

3

-SELCO Foundation

4-5

2. KULANG

6-9

-Information

7-8

-Acknowledgement letter

9

3. MAHESHKOLA

10-13

-Information

11-12

-Acknowledgement letter

13

4. MAWPUD

14-17

-Information

15-16

-Acknowledgement letter

17

5. NONGKYNBAH

18-21

-Information

19-20

-Acknowledgement letter

21

6. NONGRYNIANG -Information -Acknowledgement letter

7. PHLANGDILOIN -Information -Acknowledgement letter

8. PHOTJAUD -Information -Acknowledgement letter

9. SHNGI MAWLEIN -Information -Acknowledgement letter

10. ABOUT -SELCO Foundation

22-25 23-24 25

26-29 27-28 29

30-33 31-32 33

34-37 35-36 37

38-39

1

Approval u/s 80G(5)(vi) of the I.T Act 1961: AAKTSO145GF 20214 From AY 2022-23 to AY 2026-27

2

Background and Need Stronger primary health care systems are essential to achieving Sustainable Development Goal 3 (SDG3) which aims to ensure healthy lives and promote well-being for all, of all ages, including through universal health coverage. This in turn affects the attainment of other SDGs. Primary healthcare systems in rural, remote and vulnerable contexts often lack the resources integral to provide affordable, accessible, quality healthcare.

Reliable and affordable electricity access, alongside efficient medical and electrical appliances contribute to increased efficacy and impact of healthcare provision. The need for energy is critical when it comes to storing vaccines; using medical equipment such as baby warmers, suction apparatus and lighting especially during deliveries; powering diagnostic services and accessing basic lighting and communication for regular operations. With the onset of the COVID 19 pandemic, it has become extremely important to strengthen the primary healthcare system and equip health facilities with independent, reliable energy access. Strengthening cold chains for vaccines in the last mile, for example, is critical to curbing the spread of COVID 19 and containing the pandemic.

Meghalaya in North East India, given its difficult terrain and hilly geography, faces a combination of energy poverty, resource constraints and climate and disaster risks that adversely affect the population’s access to healthcare in the last mile. 80% of the 2.9 million population in Meghalaya reside in rural, hilly areas and depend on public health centres. Meghalaya has close to 86% tribal population (https://meghealth.gov.in/statistics/Handbook_2019.pdf) (https://ruralindiaonline.org/en/library/resource/rural-health-statistics-2019-20/) Besides facing regular power cuts, health systems are often dependent on diesel with implications on costs. The state is particularly prone to landslides, heavy rains and floods, disrupting access to the main hospitals or larger health facilities in the district.

Given the Meghalaya context, the role of independent, decentralized and reliable energy systems becomes increasingly significant.

Decentralized solar energy systems, powering energy efficient appliances can contribute significantly to creating more resilient health systems in an efficient manner, enabling health staff to better deliver services to last mile communities.

3

SELCO Foundation Established in 2010, SELCO Foundation’s mission is to develop holistic solutions that use sustainable energy as a catalyst to address poverty alleviation alongside ensuring environmental sustainability. SELCO's interventions enable the delivery of essential services such as healthcare and education, and enable improvements in livelihoods productivity, impacting more than 5 million people across 12 states in India. It also works with key stakeholders to build the ecosystem for long term sustainability of these solutions and to enable their adoption and scale.

SELCO Foundation's efforts broadly include: 1. Inclusive innovation and implementation of holistic technology- finance- ownership models based on a clear understanding of end-user needs 2. Ecosystem building on aspects of financing, skills, policy and entrepreneurship for interventions to be sustainable in the long run 3. Incubation of grassroots level clean energy enterprises and local technology enterprises to enable decentralization of services at the last mile 4. Replication of learnings and sharing of knowledge across regions and contexts.

Specifically on healthcare, the Foundation has worked across levels within the health system, with sustainable energy and efficiency interventions at around 800 sites in the Health Value chain including Anganwadis (child care centres), Primary Health Centres, Sub centres, NGO-run hospitals and mobile health units, reaching more than 3 million end-users across 12 Indian states.

Integrating sustainable energy for improved healthcare delivery: SDG7 for SDG3 The National Health Mission of Meghalaya and SELCO Foundation, along with key health and energy partners have embarked on a mission to strengthen 100 Sub Centres in the state with improved energy access. The goal of the program is to make the delivery of health services reliable and sustainable through climate resilient, energy efficient and clean-energy driven solutions for public health infrastructure. The objectives include:

4

• To prove a model for the State on SDG7 and SDG3 integration by showcasing DRE solutions with efficient appliances in 100 Sub centres across 11 districts of Meghalaya district.

The first phase is to inform the design of the next phase which would include DRE interventions across 342 health-centres in Meghalaya • To develop templates, processes for procurement, training on ownership and management, which would equip SELCO Foundation and NHM-Meghalaya to scale the solutions across health facilities in the State The program covered the following components: 1. Health-Energy Assessments: These are employed to better understand health-energy gaps at the health facility through consultations with staff and patients.

2. Appropriate design, implementation (efficient equipment + decentralized solar systems): Based on service needs identified, the intervention is designed as a combination of efficient medical, electrical equipment, powered by decentralized solar energy. The services and relevant energy systems include: • Medical-care and basic diagnostics: lighting for operations, energy for microscopes, instrument sterilizers, Non-Communicable Diseases kits.

• Maternal and Child-care: Suction machines, baby warmers; Refrigerators and deep freezers for vaccines.

• COVID-19 preventive and therapeutic care: Energy and built environment for space heating, cooling; basic energy for testing, quarantine facilities; Cold chains for vaccine storage and delivery.

• Basic administrative services: General needs including lights, fans, computers, mobile charging etc.

As part of the program, we work closely with health partners to identify, procure appropriate, efficient equipment from technology suppliers.

3. Ownership, maintenance and capacity building, includes engagement with a. health partners, facility staff to ensure ownership, proper equipment utilization b. local energy enterprises for regular maintenance and servicing c. health officials of local, state government for strong ownership of assets, leverage of funds towards capex and committing fund allocation towards system upkeep.

The following pages showcase the completion of the first phase of the program, which includes implementation of DRE and Energy Efficient interventions across 11 health centers.

5

Kulang Sub Centre

Population: 1329 (as per feedback form) 1974

Eligible Couples: 188 7

Power cut Hrs/Day 5

Average OPD/Month: 180

No of Villages: 5

8

Acknowledgement letter

9

Maheshkola Sub Centre

Population: 1982 (as per feedback form) 2115

Eligible Couples: 354 11

Power cut Hrs/Day No Grid Connection

Average OPD/Month: 20

No of Villages: 6

12

Acknowledgement letter

13

Mawpud Sub Centre

Population: 5646 (as per feedback form) 4614

Eligible Couples: 500 15

Power cut Hrs/Day 7

Average OPD/Month: 70

No of Villages: 12

16

Acknowledgement letter

17

Nongkynbah Sub Centre

Population: 1560 (as per feedback form) 1555

Eligible Couples: 247 19

Power cut Hrs/Day No Grid Connection

Average OPD/Month: 50

No of Villages: 3

20

Acknowledgement letter

21

Nongryniang Sub Centre

Population: 1229 (as per feedback form) 1369

Eligible Couples: 172 23

Power cut Hrs/Day 5

Average OPD/Month: 90

No of Villages: 5

24

Acknowledgement letter

25

Phlangdiloin Sub Centre

Population: 3029

Eligible Couples: 0 27

Power cut Hrs/Day 7

Average OPD/Month: 550

No of Villages: 12

28

Acknowledgement letter

29

Photjaud Sub Centre

Population: 6140 (as per feedback form) 6306

Eligible Couples: 673 31

Power cut Hrs/Day No Grid Connection

Average OPD/Month: 30

No of Villages: 16

32

Acknowledgement letter

33

Shngi Mawlein Sub Centre

Population: 5990 (as per feedback form) 6233

Eligible Couples: 697 35

Power cut Hrs/Day 1

Average OPD/Month: 350

No of Villages: 6

36

Acknowledgement letter

37

SELCO Foundation, SDG7 and More

SELCO Foundation interventions are premised on an understanding that uplifting millions out of poverty is possible using decentralized renewable energy (DRE) and energy efficiency as a catalyst. This linkage between energy and several of the development indicators are now well understood and accepted under the United Nation’s Sustainable Development Goals (SDG). It was registered as a Not for Profit Trust on 5th October, 2010, and registered under FCRA on 2nd December 2014.

Climate change and poverty alleviation are the biggest challenges of our generation.

Breaking down cycles of poverty requires effective education and healthcare systems, combined with steady livelihood sources to increase incomes. The role of reliable electricity in enabling these systems is often underestimated. A combination of efficient technologies and decentralized clean energy has the power of taking these services closer to the doorsteps of the underserved.

SELCO Foundation sees the pressing need to develop a fertile environment to enhance sustainable energy access solutions for the poor. This includes an inclusive design process, affordable end-user financing and conducive policies, as well as training and nurturing local talent as skilled workers, entrepreneurs, and innovators.

SELCO Foundation is an open-source innovation research lab for replicable social innovations across focus sectors for development. The organization sees sustainable energy as a means to deliver developmental goals- ie SDG 7 as a driver for all other SDGs of health, livelihood, education, poverty, gender etc. SELCO has worked actively in proving solutions at the grassroot level and scaling them across the country.

SELCO Foundation’s work showcasing effectiveness of using sustainable energy to last mile public health systems has also been accepted and adopted by the State Health Missions, Government of Meghalaya and Government of Manipur, State Health Department, Government of Madhya Pradesh and District Administration in Manipur, Jharkhand, Odisha, Karnataka and Nagaland. SELCO has also worked with Ministry of Rural Development in the State of Madhya Pradesh and Karnataka, as well as State Livelihood Missions under Government of Jharkhand, Assam and Meghalaya to improve livelihoods of farmers, and vulnerable communities engaging with crafts and non-farm livelihood activities. Its efforts have also been recognised internationally by International Renewable Energy Agency, World Health Organization and United Nations Development Program.

38

SELCO Foundation’s incubation program also aims at boosting local entrepreneurship, while ensuring delivery of sustainable energy services to the remotest and most vulnerable communities in the country. Started in 2015, the Incubation programs has been nurturing and catalyzing clean energy enterprises that deploy and maintain sustainable solutions for underserved communities. In 2019, the incubation program also expanded to boost local energy efficient technology enterprises focused on needs of the low income communities.

The efforts of the program have also been recognised by the Niti Aayog, Government of India under the Atal Innovation Mission. Its incubation efforts in North Eastern Region have been awarded the Atal Incubation Centre status.

In 2020, during the COVID-19 Pandemic, SELCO Foundation also innovated on solutions across health and livelihood in order to complement the country’s efforts to fight the pandemic. In partnership with District and State administrations in Karnataka, Meghalaya, Manipur, Odisha and Jharkhand specifically, it solar powered hospitals, government recognised COVID care centres, isolation centres, quarantine centres and testing kiosks.

Because of its efforts 600,000 individuals across the country had access to improved COVID Care Facilities and 3.5 million individuals could access improved COVID testing facilities.

SELCO Foundation has also piloted and incubated a portable cold storage technology for vaccine carriers which is currently being considered by the Government of India for distribution of vaccines to the last mile communities. Recognising the livelihood challenges during COVID, SELCO Foundation also launched a special COVID relief program focused on building resilience of local micro and small businesses.

SELCO Foundation is headquartered in Bangalore, and has impacted over 5.6 million individuals across vulnerable populations in Karnataka, Odisha, Jharkhand, Assam, Meghalaya and Manipur. It also provides its technical expertise and knowledge with its partner networks- including community based organizations, government institutions and departments, and research organizations.

39

info@selcofoundation.org www.selcofoundation.org

@selcoofficial

@SELCOFoundation @SELCOFoundation