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Effect of Solar Lighting Installation on Night-Time Healthcare Service Availability in Rural Nigerian Health Facilities

Abstract

Reliable electricity is essential for the delivery of safe, continuous, and effective healthcare services, particularly during nighttime when health facilities may receive emergency cases, conduct deliveries, provide inpatient care, administer medications, and perform essential clinical procedures. Rural health facilities in Nigeria may experience frequent power interruptions, limited access to the national electricity grid, high energy costs, and inadequate alternative power sources. These challenges may disrupt nighttime healthcare services, reduce staff capacity to respond to emergencies, limit the use of essential medical equipment, and discourage patients from seeking care after regular daytime hours. Solar lighting systems provide a potentially sustainable alternative for improving electricity availability in underserved healthcare facilities. Against this background, this study investigates the effect of solar lighting installation on nighttime healthcare service availability in rural Nigerian health facilities. The study will be anchored on the Health Systems Framework, Donabedian Model of Healthcare Quality, and Social Ecological Model. The Health Systems Framework emphasizes infrastructure, service delivery, health workforce, medical technologies, financing, and access as essential components of effective healthcare systems. The Donabedian Model provides a framework for examining healthcare quality through structure, process, and outcome, allowing solar lighting infrastructure to be assessed as a structural factor that may influence healthcare service delivery and availability. The Social Ecological Model emphasizes the interaction between healthcare facilities, healthcare workers, communities, infrastructure, and broader environmental factors in determining access to healthcare services. Collectively, these theoretical perspectives provide a suitable framework for explaining how improved electricity infrastructure may influence nighttime healthcare service availability in rural Nigerian health facilities. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise selected rural primary healthcare centres, health centres, cottage hospitals, and other appropriate rural health facilities across Nigeria, as well as healthcare workers providing services in these facilities. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, rural communities, and eligible health facilities. Solar lighting installation will be assessed using indicators such as availability of solar lighting systems, number and location of solar-powered lighting units, functionality, lighting coverage, battery capacity, duration of nighttime illumination, reliability, maintenance arrangements, frequency of system failure, and availability of backup lighting. Nighttime healthcare service availability will be assessed using indicators such as availability of healthcare workers during nighttime hours, provision of emergency care, availability of maternal and newborn services, nighttime consultations, overnight patient observation, medication administration, basic laboratory services where applicable, emergency referrals, availability of essential equipment requiring lighting or electricity, and the number or proportion of nights during which essential services remain operational. Data will be collected using structured questionnaires, facility assessment checklists, electricity and solar-system records, duty rosters, service registers, emergency records, equipment-use records, and relevant health facility documents. Descriptive statistics will be used to summarize facility characteristics, solar lighting availability, electricity reliability, and patterns of nighttime healthcare service provision. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of solar lighting installation on nighttime healthcare service availability. Where a quasi-experimental design is adopted, nighttime service availability before and after solar lighting installation may be compared with that of facilities without the intervention to determine changes associated with the programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that solar lighting installation has a significant positive effect on nighttime healthcare service availability in rural Nigerian health facilities. Facilities equipped with functional solar lighting systems are expected to demonstrate greater capacity to provide healthcare services during nighttime hours than facilities without reliable lighting. Improved lighting may facilitate emergency consultations, maternal and newborn care, overnight monitoring, medication administration, basic clinical procedures, patient observation, and timely referrals. Solar lighting may also improve healthcare workers' ability to work safely and efficiently during power outages while reducing dependence on unreliable grid electricity, kerosene lamps, generators, and other costly or inadequate lighting sources. Improved nighttime service availability may consequently increase community confidence in rural health facilities and reduce delays in accessing emergency healthcare. However, inadequate maintenance, battery deterioration, insufficient solar capacity, poor installation, equipment theft or damage, limited technical support, and inadequate funding for system replacement may reduce the effectiveness and sustainability of solar lighting interventions. The study therefore expects properly designed, adequately maintained, and sustainably supported solar lighting systems to contribute significantly to improved nighttime healthcare service availability in rural Nigerian health facilities. The study is expected to contribute to the literature on healthcare infrastructure, renewable energy in healthcare, solar energy, rural health services, nighttime healthcare delivery, primary healthcare, health systems strengthening, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, rural health authorities, primary healthcare facility managers, renewable-energy providers, development partners, healthcare workers, and policymakers regarding strategies for improving electricity access in rural healthcare facilities. The study will also provide evidence-based recommendations for expanding solar-powered lighting infrastructure, strengthening maintenance and technical-support systems, incorporating renewable energy into rural health facility planning, ensuring adequate system capacity, improving energy sustainability, and supporting continuous provision of essential healthcare services during nighttime hours across rural Nigeria.

Keywords: Solar lighting installation, nighttime healthcare service availability, rural health facilities, renewable energy, electricity access, primary healthcare, healthcare infrastructure, rural healthcare services, health systems strengthening, Nigeria, public health.