Light Every Birth

Each year, pregnancy and childbirth complications claim the lives of 300,000 women and over 1 million newborns worldwide, primarily in sub-Saharan Africa and Southeast Asia (afro.who.int). The majority of obstetric deaths—caused by hemorrhage, infection, eclampsia, obstructed labor, and unsafe abortion—could be prevented with access to timely emergency obstetric care. Light and electricity are critically important for maternal-newborn care. A recent study in 78 low-to-middle-income Countries (LMICs) revealed 59% of health facilities lacked reliable electricity (Cronk, 2018). Causes include utility grid power outages, generators prone to fuel shortages or breakdown, and lack of access to modern electricity, despite the fact that electricity is “a critical enabler of universal access to healthcare and universal health coverage”—essential for medical lighting, electronic equipment and ICT devices (WHO, 2015).

Without continuous electricity, health workers cannot ensure the provision of timely, high quality maternal-newborn healthcare. It is well documented that midwives struggle by candlelight or kerosene lanterns, hospitals postpone or cancel c-sections and other critical procedures, and patients can be turned away from darkened health facilities at night. Health workers describe their inability to monitor or treat complications and hazards of working without good visibility, including contamination and injury (Stachel, 2020). Patients in these settings fear nighttime care and are further deterred by requests to purchase candles, kerosene, or batteries. As a result, many impoverished women deliver at home, unattended, increasing their risk of complication, morbidity and mortality.

To respond to the critical need for light and power in last mile health facilities, We Care Solar designed the Solar Suitcase and leads robust programs to build local capacity in solar installation, operation, and maintenance. The We Care Solar Suitcase is a compact, rugged institutional-grade solar electric system for health workers. This complete, easy to install and maintain solar electric system includes power generation and storage, bright procedure lights, medical appliances, and installation hardware. It is the only renewable power source designed specifically to provide the first 100 watts of electricity to last mile maternal health centers.

The Solar Suitcase incorporates years of human-centered design field research; the newest model features improved functionality, durability and ease of use. It is equipped with customized 70,000-hour medical lights, rechargeable headlamps, phone chargers, a fetal heart-rate monitor, and an infra-red thermometer. It is durable in harsh environments and easy to install, operate, and maintain. 100-watt solar panels recharge the system fully each day, ensuring light throughout the night. The lithium ferrous phosphate battery is maintenance-free and lasts for five years before needing a simple replacement.

We Care Solar works with a range of local partners to identify health centers in need of electricity and to provide programmatic oversight. We launched the Light Every Birth initiative to address energy poverty at the systems level, working with governments and NGOs to equip every energy-poor public health center with our technology and to create an ecosystem of support. Our technical trainings build local capacity in solar installation, operation, and servicing. We work closely with governments to foster local ownership and ensure long-term sustainability of our programs.

Our target population includes (1) expectant mothers and their newborns, (2) rural healthcare workers, and (3) families in need of frontline health services. These beneficiaries typically live in impoverished rural communities in Africa and Southeast Asia. 

The Solar Suitcase is typically mounted to the wall and used as a primary source of light and power for smaller health facilities. It is used as a back-up source of power for hospital delivery rooms and operating theaters with sporadic power. The quality of medical care significantly improves after Solar Suitcase installation. With improved lighting, health workers can assess patients, promptly conduct routine and emergency procedures (including c/sections), maintain good hygiene, institute infection control protocols, and monitor patients throughout the night. The fetal Doppler allows health workers to assess fetal well-being during labor and detect distress. Improved phone charging ensures that emergency consultations and referrals happen when needed. The no-touch thermometer aids COVID-19 assessments.

Our regional headquarters are based in Uganda; we have additional team members in Zimbabwe, Liberia, and Sierra Leone. Many team members have been raised in communities similar to those we serve and are all too familiar with the challenges of living with energy poverty. For example, our Africa Regional Director is a doctor who was raised in a home without electricity and later worked in hospitals that experienced regular power outages. He describes the stress of conducting surgeries in operating theaters that experience blackouts. Our country managers and program leads are all women; they are African mothers who have relied upon the health systems we are serving. They are sensitive to the challenges facing health workers and the importance of providing safe childbirth services to mothers and newborns.

The Solar Suitcase was originally designed for rural communities based on fieldwork conducted in Nigerian hospitals by our co-founder (an obstetrician). She worked side-by-side with health workers conducting obstetric and neonatal care in hospitals with sporadic power. Later modifications of the Solar Suitcase were the result of an iterative design process, incorporating feedback from dozens of healthcare workers in multiple countries. More recently, we conducted user-centered design workshops with health workers and solar installers in Uganda to refine our product design and training materials. These workshops informed the development of the user-interface, the selection of high-quality electrical components, the inclusion of medical devices, and the preparation of culturally-relevant training manuals and videos. 

Our team works closely with district and federal government officials to design our processes for program implementation. Together we craft a memorandum of understanding that outlines roles and expectations, including assessment of health facilities, installation of Solar Suitcases, and plans for eventual program handover.

We need help with evaluating the performance and impact of the Solar Suitcase and in developing a business model that will allow us to scale our programs to new geographies. 

We have conducted evaluations with older models of the Solar Suitcase and identified some areas where the Solar Suitcase could be improved. We also work in health facilities where data can be hard to obtain. We are seeking help in designing cost-effective studies that will both assess the performance of the newest model of the Solar Suitcase, conduct a cost-analysis, and also re-assess health impact.  

In addition to evaluation support, we are seeking partners to help us develop sustainable business models. To date, we have largely relied on grant funding to support our efforts to equip underserved public health facilities with our technology. As we grow, we are exploring new business models that can help us achieve financial sustainability.

The Solar Suitcase is the ONLY complete, all-in-one, prewired institutional-grade solar electric system designed by health providers and engineers for health facilities in harsh environments. The patented solar controller was designed to maximize harvest of the solar power, optimize use of lithium-ferrous-phosphate battery, and work with a range of solar panels. The customized 70,000-hour LED lights provide appropriate illumination for medical and surgical procedures (the color rendition index enables surgeons to visualize arteries and veins). These water and break-resistant medical lights can be washed, re-positioned, and even dropped without damage. The cables and connectors can withstand thousands of connections. The power switch is a circuit breaker that provides over-current protection.  The technology is safe, durable, and effective, designed to work day after day without failure. 

The system went through years of user-centered design testing with African health workers.The interface is designed to be user-friendly and easily understood.  The cable lengths for the lights and solar panels can accommodate a range of health facilities in multiple countries. Common prewired solar homes systems cannot compare in terms of light quality, durability, and medical facility customization.

Our work extends to social innovation. We are addressing energy poverty at the systems level, working with governments and NGOs to create an ecosystem of support. We provide technical trainings build local capacity, support livelihoods, and strengthen supply chains. We created a Women's Solar Ambassador program to promote women's leadership and have conducted women installer trainings in Liberia and Sierra Leone. Finally, we engage policy makers and key stakeholders to strengthen the nexus of energy and healthcare.

In the next year, we will complete our Light Every Birth Solar Suitcase installation program in Uganda, Zimbabwe and Sierra Leone, working with a coalition of partners to uplift obstetric care at public facilities throughout the country. With the Solar Suitcase, health workers will no longer fear night duty and will be able to perform medical procedures throughout the night. Patients will be able to access immediate obstetric and newborn care – any time of day.

Over the next five years, we will expand our Light Every Birth program to new geographies reaching thousands of health facilities in West and East Africa. We aim to reach 8,000 health facilities, serving 1.6 million mothers and their newborns each year.

We will expand our coalition of certified solar partners and solar trainers to build our technical support network. We will recruit more women for our African Women’s Solar Ambassador Program, advancing gender-equity and women’s leadership.

We will work with our government partners to implement a Sustainability Plan in each country, training government technicians in each of these countries to follow maintenance and service protocols, such as changing the system battery after five years of system operation. They will utilize an electronic data collection and online incident report tracker recently developed. 

We will expand our vaccine refrigeration program that is currently being piloted in Ethiopia. We will conduct a health impact evaluation of version 3.0 of the Solar Suitcase.  We will share our findings and learnings externally, and continue to advocate for the need of light and electricity for healthcare.

These are a few specific measurable indicators we use to measure our progress:

• #Health centers equipped with Solar Suitcases
• #Mothers utilizing the health centers
• #Mothers and Newborns served by our programs each year
• #Partner agencies
• #Health workers (e.g. midwives) trained to use the Solar Suitcase and medical devices included (e.g. fetal Doppler)
• #Technicians Trained in Solar Installation and Maintenance
• Tons of CO2 averted by our renewable energy systems

When energy-poor health facilities receive clean solar electricity...they have better lighting for extended hours of operation and power for medical devices. This leads to improvements in the quality of emergency obstetric care and primary care improved air quality from the displacement of fossil fuels, and more timely services. As a result, there is reduction of preventable maternal deaths, improvements in newborn survival and ultimately healthier families and communities.

Here is an Outline of our Logic Model: Using the following Inputs:

• Solar Equipment and Medical Appliances
• Rural Health Centers
• Partner agencies: Ministries of Health, UN Agencies, International NGOs, local NGOS
• Health Workers
• Expectant Mothers and their newborns
• Key Staff: Engineers, Program Managers,Trainers, Logisticians, Support Staff

We Care Solar engages in these Activities:

• Design and Manufacture Solar Suitcases
• Transport Solar Suitcase to rural communities
• Cultivation of partnerships with governments, UN agencies and NGOs
• Training of local health technicians on how to install and maintain Solar Suitcases
• Training of health workers on how to optimally use the Solar Suitcase and its medical devices

Outputs include:

• # Solar Suitcases produced
• # Health centers equipped
• # Partner agencies
• # Health Technicians Trained in Installation
• # Health workers (i.e. midwives) trained to use Solar Suitcase and its accessories
• # Expectant mothers utilizing health centers
• # Hours of medical light provided
• # Tons of CO2 averted by renewable energy

To achieve the following Outcomes:

• Improved lighting at health facilities
• Increased utilization of health centers; i.e. more facility-based deliveries each month
• Health workers with greater confidence and less fear of night duty
• Improved detection of fetal well-being or distress (Doppler)
• Improved ability to call for emergency help (charged cell phones)
• Greater safety during obstetric care and improved quality of care
• Cleaner air, less pollution

To create Impact in:

• Improved MCH care with reductions in maternal and newborn complications, morbidity and mortality
• Better retention and morale of rural health workers
• Improvements in planetary health

The Solar Suitcase offers distributed renewable energy to remote communities in need. Grid power extension is slow, expensive, and often fails to reach clinics in harsh geographies.  Health facilities with grid connection are subject to daily load-shedding, plunging many centers into darkness. We Care Solar bypasses the daunting complexities of infrastructure build-out in Africa. Our portable, immediately-operational, reliable, stand-alone units match power generation and loads. They are not prone to siphoning, wire theft, or battery damage caused by overuse. 

Environmentally-friendly Solar Suitcases replace polluting and dangerous sources of light and energy such as candles, oil lamps, kerosene lanterns, and diesel-fueled generators. They use the highest quality solar panels and components. Our lighting was specifically designed for medical and surgical procedures in harsh environments.  These lights enhance obstetric care, illuminate surgical procedures, and facilitate patient assessment; screening for medical conditions; administration of routine medical care; healthcare workers’ safety; and overall management of complications. They feature a customized heat-sink to maximize LED longevity. The 12VDC and 5VDC charging ports and AA/AAA battery charger eliminate travel to charge mobile phones and medical devices. The current version 3.0 of the Solar Suitcase (version 3.0) features dimmable LED lights, a simpler user interface, storage pockets, a longer-lasting battery, additional lights for additional treatment rooms, a trouble-shooting interface for technicians, and greater functionality. It is water-and-dust tight and enabled for remote monitoring. We customized our own charge controller to accommodate lithium battery technology. We have equipped the Solar Suitcases with the capacity for remote monitoring. We also include all installation hardware and a range of educational videos and manuals.

As a female-led organization, we are committed to diversity, equity, and inclusivity in our team in board. We value a range of perspectives and promote a working environment where many opinions are solicited and all voices are heard. We actively create a welcoming environment of mutual respect, support, and cooperation. The pandemic allowed us to accommodate greater geographic diversity, with team members from four states and six countries. Many of our team members became parents during the pandemic, and we offered a generous maternity and paternity leave to allow all parents to have quality time with their newborns. We feel strongly that our leadership and board should represent our beneficiaries. Our board includes directors from Uganda, Angola, Benin, Ghana, Zimbabwe, the Netherlands, and United States. Our team has members from Uganda, Zimbabwe, Sierra Leone, and Liberia. We also have diversity in terms of gender and sexual orientation.

We Care Solar has vertical integration of our value chain from product design to manufacturing to distribution to international logistics to distribution and installation, to after-sales service and finally, program evaluation. We have expertise in product design, engineering, public health, education, solar electricity, international development, and research. We outsource manufacturing to a contract manufacturer in Colorado and outsource shipping to a 3rd-party logistics firm.

Our key beneficiaries are health workers, expectant mothers, and newborn babies.

We bring value to our beneficiary population through our key activities of creating a compact, scalable solar-electric system for health facilities in underserved communities to enable health workers to have reliable lighting, and 12VDC electricity for charging phones and small medical devices and provide around-the-clock OB emergency care. We design educational programs to build local capacity. We stimulate systems change by advocating for energy access for health care.

Our key resources are solar technology, our staff of engineers, designers, program managers, fundraisers, researchers, and advocators.

Our key business partners are NGOs, Ministries of Health, and international agencies who provide access to health centers, linkages to district health organizations, and monitoring and evaluation capabilities. Individual funders and philanthropic organizations provide revenue streams to cover costs for Solar Suitcase hardware, product development, shipping/logistics, trainings, research/evaluation, marketing, and advocacy.

We Care Solar has cultivated a diverse funding stream to support health facility electrification in rural communities, including (1) philanthropic support from institutional funders, family foundations, individual donors, (2) awards, and (3) earned income from purchases by UN agencies and iNGOs.

Financial sustainability has been the result of:

• In-kind support from government partners for our Light Every Birth initiative, such as assessment of health facilities, clearance and storage of Solar Suitcases and spare parts, and training of government technicians as installers and service technicians.
• Direct purchases of Solar Suitcases by various UN and international agencies.
• Grant funding for the capital expenditures for Solar Suitcase manufacturing, shipping, and installation.
• Pledged support of operational expenditures by government partners when we conduct program handover.

Over time, we wish to expand our percentage of direct purchases and increase in-kind and financial support from government partners.

Key supporters of our Light Every Birth initiative include: UBS Optimus Foundation, the Meadow Fund, Gilead Foundation, Wells Fargo Foundation. Direct Purchases of Solar Suitcases have been made by Pathfinder International, UNWomen, UNFPA, and others. Government agencies that have provided in-kind support include the Ministry of Health and Social Welfare in Liberia, the Ministry of Health in Uganda, and the Ministry of Health and Child Care in Zimbabwe.