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Equity by accident, or by design?

Solar powered healthcare in developing countries


July 2018 |

Overview

The lack of electrification in parts of the world leaves many healthcare facilities with inadequate power provision for even basic services. It is estimated that nearly 38 million people in India are dependent on Primary Health Centres (PHCs) without electricity supply. Pilot projects show that solar power has the potential to reliably electrify PHCs, bypassing unreliable centralised grids.

Following up on our independent evaluation of 147 PHCs across 15 districts in Chhattisgarh, this journal paper, published in Nature, reiterates the immense opportunity for solar energy to bridge the gaps in electricity access in rural healthcare facilities across the developing world.

Key Highlights

  • PHCs with solar power conducted 50 per cent higher institutional deliveries and provided round round-the-clock services.
  • Nearly 70 per cent of health centres with solar power provided emergency medical services 24 hours a day, seven days a week as compared to 48 per cent without solar.
  • Solar-powered PHCs reported a 59 per cent increase in outpatient services, 78 per cent increase in deliveries and 45 per cent improvements in laboratory services after installation.
  • Energy is a critical enabler in achieving several other sustainable development goals (SDGs). Research reveals that 113 SDG targets require actions pertaining to energy systems. There is evidence that access to clean energy (SDG 7) can positively reinforce attainment of health and well-being (SDG 3), sustainable cities and communities (SDG 11) and responsible consumption and production (SDG 13).
  • More and better designed trials are required to build the necessary policy and financial support for scaling solar for healthcare.
  • More holistic policy thinking across ministries and departments is needed to recognise funding opportunities with multiple benefits.

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Lessons from the World’s Largest Subsidy Benefit Transfer SchemeThe Case of Liquified Petroleum Gas Subsidy Reform in India

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August 2018 |

Citation: Jain, A., Agrawal, S., & Ganesan, K. (2018). Lessons from the World’s Largest Subsidy Benefit Transfer Scheme. In H. Van Asselt (Author) & J. Skovgaard (Ed.), The Politics of Fossil Fuel Subsidies and their Reform (pp. 212-228). Cambridge: Cambridge University Press. doi:10.1017/9781108241946.014

Overview

This book chapter, published in ‘The Politics of Fossil Fuel Subsidies and their Reform’, examines the performance of the Direct Benefit Transfer of LPG (DBTL) scheme. The chapter focuses on three key questions – (i) How successful was the implementation process of the scheme, and what were the gaps in implementation, if any? (ii) How successful was the scheme in achieving its stated objectives? (iii) Why did the DBTL scheme achieve this degree of success?

In the pursuit of answering these questions, the authors focused on key actors and stakeholder groups, and strategies used to design and administer the scheme while overcoming challenges during the scheme’s implementation. As part of the assessment process, authors used mixed-methods approach, comprising structured telephonic survey of 1,270 households and 92 LPG distributors, semi-structured telephonic interviews with implementation officers and bank managers, and unstructured in-person interviews with senior management of the oil marketing companies and government officials.

Key Lessons

The following lessons could be useful for designing fossil fuel subsidy reforms in other contexts and countries.

Political leadership and framing of the narrative is crucial: Strong leadership from the national government, timely recognition of the opportunity for reform, and smart framing of the narrative have been prime factors behind the successful and smooth implementation of the world’s largest cash transfer scheme, as it infused a momentum throughout the range of actors along the LPG supply chain involved in the implementation process.

Successful institutional coordination: The scheme’s implementation process involved multiple stakeholders, including several government ministries, the entire LPG retail supply chain, the banking sector and the district-level administration. An elaborate multi-tiered structure of project management teams was formed to facilitate coordination and to enable troubleshooting during the implementation.

Exploiting motivations at the individual level and supporting capacity building important: Giving individual ownership and responsibility to stakeholders is instrumental in the implementation of such large-scale public programmes. The senior and middle managers of the OMCs, along with the officials and Minister at the Ministry of Petroleum and Natural Gas, were the guardian officers for one district each. This created a sense of responsibility for effective implementation of the scheme in their respective districts.

Learning from past experience necessary to avoid failures: The modified DBTL scheme incorporated insights from a review of the scheme’s first round of implementation. The review included an alternative enrolment procedure which addressed the politically sensitive issue of exclusion of LPG consumers lacking an Aadhar number and also identified the difficulties faced by different stakeholders. Reviewing reform programmes and incorporating feedback of key stakeholders, particularly end-consumers, improved the scheme design and implementation process.

Leveraging existing systems and schemes: The DBTL scheme rested on the effective use of several other government schemes and efforts. While there was a clear convergence of past and ongoing schemes, sustained efforts continued to improve banking infrastructure and services for all households, particularly as rural and/or economically poor households constitute majority of future LPG adopters in India.

Strong emphasis on awareness generation: The DBTL scheme was well-publicised through an intensive information education campaign comprising advertising through different media and direct outreach to consumers through text messages, calls and public announcements.

The scheme’s implementation has been largely successful indicated by very low proportion of households facing difficulties during enrolment and also in limiting the diversion of subsidised commodity to unintended uses. However, there remain gaps in cash transfer efficiency, as well as associated information flow. Improvements pertaining to human resource management, standardisation of protocols and consumer awareness are required. There must be emphasis on financial inclusion and access to banking services to ensure that DBTL would not pose additional barriers to LPG adoption, particularly in rural India.

The Cambridge University Press book is the first of its kind academic collection of analyses delving deep into the politics and political economy of the fossil fuel subsidies. The book understands the conceptual aspects of fossil fuel subsidies, offers valuable insights for international community to enable fossil fuel subsidies reforms and explores the role of various intergovernmental and non-governmental institutions in promoting fossil fuel subsidy reform at the international level.

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Clean Energy Can boost Rural Economy

Can states meet Centre’s village electrification targets?

Access to Clean Cooking Energy in IndiaState of the Sector

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October 2017 |

Citation: Sasmita Patnaik, Sara Dethier, Saurabh Tripathi, and Abhishek Jain (2017) 'Access to Clean Cooking Energy in India: Beyond Connections, Towards Sustained Use' October

Overview

Over 800 million Indians use traditional biomass cookstoves for their cooking needs. This widespread use of traditional cookstoves poses serious risks to health and women’s empowerment. It also is a global warming threat, as they emit black carbon, a highly potent short-lived climate pollutant. Access to clean cooking energy has the transformative potential to curb the health risks posed by traditional cookstoves while also reducing the time spent by women on unpaid domestic work.

This report provides an overview of the clean cooking energy sector in India, including policy and market developments over the last few years. It outlines the key ecosystem-level challenges in creating sustained demand for clean cooking energy products and in building capacity for manufacturers and suppliers of such solutions. It also details critical avenues for intervention in policy and through investments to eliminate the inefficient use of traditional biomass by households in India.

Access to Clean Cooking Energy and Electricity: Survey of States, 2015 (Source: CEEW)

Key Findings

  • Less than one per cent of households in India use biogas for cooking.
  • Eighty-eight per cent of households not using LPG report high recurring costs as one of the bottlenecks to adoption of LPG.
  • More than 70 percent of rural households in the lowest seven percentile classes use firewood and chips for cooking, indicating a higher use of traditional biomass among low-income households.
  • Access to reliable electricity supply in rural areas remains a major barrier to the penetration of electricity-based cooking. Just over one per cent of rural households used an electric or induction stove in 2015, with only 0.01 per cent of households using it as primary cooking energy.
  • As of 2013, only three per cent of urban households in India had PNG connections.
  • Almost half of the households in India having LPG were not using it as their primary cooking fuel, indicating that affordability concerns lead to stacking of cooking fuels. 29 per cent of the rural households and 34 per cent of the urban households in India were stacking traditional fuels with LPG.

Households in rural India predominantly use biomass for cooking, while urban India uses LPG

Source: 2011 Census of India

  • Building awareness and addressing affordability concerns for improved biomass cookstoves (ICS) and biogas will be necessary to increase adoption.
  • Feasible business models to enable availability are critical for better access to clean cooking energy solutions. The existing infrastructure struggles to provide last mile connectivity at affordable prices.
  • Operations and maintenance (O&M) of systems in rural areas is a strong determinant of the sustainability of a fuel or technology.
  • Significant investments are required in R&D to improve efficiency of both ICS and induction cookstoves.
  • Many challenges remain in the implementation of standards and testing for ICS.
  • Lack of market intelligence, strong data management systems, and limited ability to evaluate the impact of their products are leading challenges for enterprises operating in rural areas. Access to commercial finance is limited for last mile energy enterprises.

Access to Clean Cooking Energy and Electricity: Survey of States, 2015 (Source: CEEW)

Key Recommendations

  • Build awareness through communication and behaviour change campaigns to influence adoption of clean cooking energy solutions, and include ministries responsible for health, rural development, environment and women and child development.
  • Enhance affordability of solutions by reducing the cost of the fuel and cooking devices, providing consumer finance, and through interventions that strengthen livelihoods.
  • Reduce the upfront cost for households through innovative payment mechanisms such as pay-as-you-go and rental models.
  • Leverage local institutions and groups for efficient and faster delivery mechanisms.
  • Set-up local manufacturing and servicing facilities to sustain prolonged use of clean cooking energy solutions, through improved accessibility and affordability.
  • Evaluate adoption and use of clean fuels and technologies to provide the much-needed evidence to inform future interventions.
Including access to clean cooking energy for all in the broader development narrative can deliver 10 of the SDGs and bring about a paradigm shift in the cooking energy space.
  • Encourage field-based tests to demonstrate performance of ICS with local cooks, foods, practices, and fuels.
  • Modify norms for rural LPG distributorships to accommodate the higher transaction cost of operating in rural areas will be crucial to improving availability of LPG.
  • Encourage new business models for biogas operated by entrepreneurs at local and regional levels tol enable greater adoption of the fuel.
  • Encourage local manufacturing of ICS fuels – pellets and briquettes, for economic viability and local availability.
  • Raise patient capital support for early stage clean cooking energy enterprises for R&D and large-scale pilots.

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Access to Clean Cooking Energy in IndiaBeyond Connections, Towards Sustained Use

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October 2017 |

Citation: Sasmita Patnaik and Saurabh Tripathi (2017) 'Access to Clean Cooking Energy in India: State of The Sector' October

Overview

As of 2011, while 53 per cent of households in India had an LPG connection, only 28 per cent used it as a primary source of cooking (Census, 2011). The latest, and the largest, effort by the government to improve access to clean cooking energy in the country is the Pradhan Mantri Ujjawala Yojana (PMUY), which provides free LPG connections to all BPL households as per the Socio-Economic Caste Census (SECC). Despite significant success in addressing the challenge of affordability of connections, and some improvements in the reliable availability of the fuel, the scheme falls short of addressing the challenges posed by affordability of the recurring cost of fuel and generating consumer awareness of the health impacts.

Comparison of uptake of LPG connections among SECC BPL vs SECC non-BPL households

Source: Petroleum Planning and Analysis Cell (PPAC) 2017b

This policy brief reviews the existing policies pertaining to clean cooking energy, analyses a broad range of demand- and supply-side challenges that hinder the penetration and sustained use of clean cooking energy solutions, and proposes an interdisciplinary and multidimensional national approach for addressing these issues.

Sustained use of clean cooking energy is influenced by multiple factors like affordability of a connection, affordability of the recurring cost of the fuel, accessibility of the fuel, consumer awareness of the adverse health impacts of using traditional biomass, and success in overcoming behavioural challenges.

Comparison of willingness to pay for LPG connections between SECC BPL and SECC non-BPL households

Source: PPAC 2017 and ACCESS 2015

The challenges presented by affordability and accessibility of clean cooking fuel leads to the stacking of clean cooking energy with traditional biomass.

Key Highlights

  • To eliminate exposure to pollution from the burning of traditional biomass, it is important to facilitate stacking between a mix of clean cooking fuels (which might be LPG, biogas, improved cookstoves, PNG or electricity), rather than one clean cooking energy option with the traditional chulha.
  • A collaborative effort by various ministries (beyond only the energy-related ministries) is required to enhance clean cooking energy access. This brief provides an overview of the potential roles and relevance of concerned ministries.
  • Traditional cooking methods disproportionately affect women in terms of the drudgery involved, adverse health outcomes, and lost opportunity cost of time. It is imperative to include them in the design and execution of solutions for clean cooking energy access.
  • PMUY in its current form targets SECC BPL households, leaving out all SECC non- BPL households, many of which may not have access to clean cooking energy. SECC non-BPL households exhibit greater willingness to adopt LPG, as well as express greater readiness to pay for its regular consumption.
  • The increasing dependence on direct and indirect imports of LPG is a cause for concern, since it will increase India’s existing dependence on imports, expose a basic household need to market fluctuations and vulnerabilities, and take away from investments in alternatives for clean cooking energy that might be sustainable for households in the long run.

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24x7 Power for All in Uttar PradeshStrategies for on-ground action based on ACCESS 2015

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October 2017 |

Citation: Saurabh Tripathi and Abhishek Jain (2017) '24x7 Power for All in Uttar Pradesh: Strategies for On-ground Action Based on ACCESS 2015', October

Overview

Data from the Ministry of Power shows that all villages of Uttar Pradesh (except two) are electrified, but around 50 per cent of rural households in the state are still unelectrified. The recent transition from village electrification targets to household electrification, reinforced by the Saubhagya scheme, is a necessary one given that the end-user of the electricity is the household. However, that may not be enough, as merely being connected to the grid does not guarantee access to electricity.

This policy brief presents findings and recommendations, based on the ‘Access to Clean Cooking Energy and Electricity: Survey of States’ (ACCESS) 2015, for improving the household electrification rate and improving the satisfaction derived from electricity for households in Uttar Pradesh.

Seventy-two per cent of households in Uttar Pradesh use kerosene for their primary lighting needs

Source: ACCESS 2015

ACCESS 2015 shows that a majority of unelectrified households in Uttar Pradesh live in electrified habitations, presenting a unique opportunity to pace up the rate of electrification.

Key Findings

  • Seventy-one per cent of unelectrified rural households in Uttar Pradesh live in habitations with grid electricity. For them the main barriers to adopting connections were the steep upfront cost, high recurring payments and unreliable supply of electricity.
  • Over 53 per cent of the households were unable to use appliances that they would like to use, only because of limited supply or poor quality of electricity.
  • One-fifth of the electrified households were not receiving any electricity supply between sunset and midnight on a typical day.
  • Less than 15 per cent of electrified households had a meter installed, and at least 20 per cent of electrified households were not paying for the electricity they were consuming.
  • Unelectrified households in the state perceive grid electricity to be too expensive for daily use, even though they spent as much, if not more, on kerosene as their primary source of lighting. However, many unelectrified households in Uttar Pradesh were willing to pay more for grid electricity than their existing expenditure on kerosene.

In half of the districts, over 80 per cent of unelectrified households reside in electrified habitations

Source: ACCESS 2015

Almost 50 per cent of households in Uttar Pradesh were dissatisfied with their electricity situation

Source: ACCESS 2015

Key Recommendations

  • Prioritise the electrification of households in habitations that are already connected to the grid to rapidly increase the rate of household electrification, as this is likely to require limited deployment of heavy onground infrastructure. Target grid-connected districts like Azamgarh, Bijnour, Gorakhpur, Jhansi and Sultanpur, where over 90 per cent of households do not receive electricity.
  • Organise awareness camps in unelectrified habitations of Banda, Bulandshahar and Kannauj, to educate households of the prevailing tariff of grid electricity, given that people perceive the recurring cost of electricity to be too high, even when they spend more on kerosene for lighting.
  • Enable households to use electricity during hours when they need it the most. Increase hours of supply to districts like Aligarh, Bijnour and Mirzapur that receive less than one hour of electricity in the evening.
  • Improve maintenance services to reduce occurrence of 24-hour black-out days, particularly in districts like Siddharthnagar and Sitapur in the north of the state, which report seven days of black-outs in a typical month.
  • Improve the penetration of meters and the efficiency of bill generation and collections across all districts. Regular and correct bills would help in reducing the public perception around high recurring bills. The possibility of distribution franchisees could be explored to improve the billing and collection efficiency and to reduce the losses of the state distribution companies.

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24x7 Power for All in OdishaStrategies for on-ground action based on ACCESS 2015

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September 2017 |

Citation: Saurabh Tripathi and Abhishek Jain (2017) '24x7 Power for All in Odisha: Strategies for On-ground Action Based on ACCESS 2015', September

Overview

Data from the Government of India’s GARV2 dashboard shows that 37 per cent of households in Odisha are unelectrified, even as over 98 per cent of villages in the state have been electrified. While the difference between proportion of households having grid and using it as primary source of lighting is much lower in Odisha than it is in neighbouring states, there is room to improve household satisfaction from electrification, and the management of grid electricity as a service. To achieve 24x7 power for all, it is essential to go beyond connections and provide adequate, sufficient and affordable electricity supply to all.

This policy brief presents findings and recommendations, based on the ‘Access to Clean Cooking Energy and Electricity: Survey of States’ (ACCESS) 2015, for improving the household electrification rate and improving the satisfaction derived from electricity for households in Odisha.

Over a third of households continue to use kerosene as their fuel of choice for basic lighting needs

Source: ACCESS 2015

ACCESS 2015 shows that a majority of unelectrified households in Uttar Pradesh live in electrified habitations, presenting a unique opportunity to pace up the rate of electrification.

Key Findings

  • Seventy per cent of households are connected to the grid and 63 per cent use grid electricity as their primary source of lighting. However, over one-third of households still rely on kerosene lamps or lanterns for their primary lighting needs.
  • Ninety per cent of unelectrified households viewed high monthly cost as a barrier to their adoption of grid electricity. However, while such households in Odisha spend INR 128 on kerosene every month, they are willing to pay only INR 122 for the monthly costs of grid electricity.
  • Almost 64 per cent of households experience 2 or more 24-hour black-out days in a month, while 31 per cent experience 3 or more days of low voltage supply.

Almost one-third of grid-electrified households were dissatisfied with their electricity situation

Source: ACCESS 2015

Unreliable supply and voltage fluctuations were the major reasons for dissatisfaction with grid electricity

Source: ACCESS 2015

Key Recommendations

  • Prioritise the electrification of households in habitations that are already connected to the grid to rapidly increase the rate of household electrification, as this is likely to require limited deployment of heavy onground infrastructure. Target grid-connected districts like Azamgarh, Bijnour, Gorakhpur, Jhansi and Sultanpur, where over 90 per cent of households do not receive electricity.
  • Organise awareness camps in unelectrified habitations to educate households of the prevailing tariff of grid electricity, especially since the fixed tariff of 30 units under Kutir Jyoti (INR 80) is much lower than their monthly willingness to pay for electricity.
  • Reduce the number of 24-hour black-out days experienced by households, by focusing on the improvement of maintenance services.
  • Attempt to match estimated demand with the power procured by distribution companies to allay voltage issues.
  • Analyse habitation-level scenarios and needs, even in grid-identified villages, since many habitations could be more effectively served through decentralised energy solutions.

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24x7 Power for All in BiharStrategies for on-ground action based on ACCESS 2015

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November 2017 |

Citation: Saurabh Tripathi and Abhishek Jain (2017) '24x7 Power for All in Bihar: Strategies for On-ground Action Based on ACCESS 2015', November

Overview

Data from the Ministry of Power shows that despite making progress towards achieving 100 per cent village electrification, Bihar lags considerably in household electrification, with 52 per cent of households still unelectrified. While the state government’s Har Ghar Bijli Yojana is ambitious and encouraging, focusing only on household electrification may not be enough, as merely being connected to the grid does not guarantee access to electricity.

This policy brief presents findings and recommendations, based on the ‘Access to Clean Cooking Energy and Electricity: Survey of States’ (ACCESS) 2015, for improving the household electrification rate and improving the satisfaction derived from electricity for households in Bihar.

A field picture from the CEEW Access to Clean Cooking Energy and Electricity: Survey of States (Source: ACCESS 2015)

Being connected to the grid does not guarantee access to grid electricity

Source: ACCESS 2015

Key Findings

  • Over 50 per cent of unelectrified rural households in Bihar live in habitations with grid electricity. For them, steep upfront cost and recurring monthly cost were the biggest barriers to get an electricity connection.
  • Sixty-two per cent of unelectrified households found the monthly cost of grid electricity to be a barrier to electrification, and yet most such households spent much more on kerosene for lighting than they were willing to pay for grid electricity, highlighting the prevalence of a perception that recurring expenditure of electricity is too high to afford.
A few key interventions in Bihar could help electrify more households rapidly and improve reliability and quality of power in the state.
  • Only seven per cent of electrified households were satisfied with grid supply. Unreliable supply and voltage fluctuations were the main reasons for the dissatisfaction of households. Poor supply situation is also reflected in the fact that while 41 per cent of households were connected to the grid, only 21 per cent used it as their primary source of lighting.
  • Supply duration in Purba Champaran and Siwan was much worse than other districts, with around 90 per cent of households receiving supply for eight hours or less in a day.
  • Fifty-four per cent of electrified households reported experiencing four or more days of 24-hour blackouts in a typical month.

Households in districts like Bhagalpur and Samastipur could be prioritised to rapidly increase the rate of electrification

Source: ACCESS 2015

Unreliable supply and voltage fluctuations were the major reasons for dissatisfaction with grid electricity

Source: ACCESS 2015

Key Recommendations

  • Prioritise the electrification of households in habitations that are already connected to the grid, particularly in Bhagalpur and Samastipur, to rapidly increase the rate of household electrification, as this is likely to require limited deployment of heavy onground infrastructure.
  • Organise awareness camps in unelectrified habitations to educate households of the prevailing tariff of grid electricity, as an attempt to amend the general perception of people about the high recurring cost, even when they spend as much if not more on kerosene for lighting.
  • Improve the satisfaction that households derive from electrification, and the management of grid electricity as a service.
  • Improve maintenance services to reduce occurrence of 24-hour black-out days, and particularly increase the hours of supply, particularly in districts like Siwan and Purba Champaran, where satisfaction with grid electricity was reported very low.
  • Improve billing and collection efficiency, particularly in Nawada, Patna and Samastipur, where a large proportion of households with meters were either not paying anything for the grid, or paying a fixed amount instead of receiving variable bills.

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