ELECTRICITY TARIFF INCREASE AND ITS EFFECT ON THE HEALTHCARE SECTOR OF NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the study 

Electricity consumption is often associated with indicators of economic growth, productivity, and poverty alleviation (Ouedraogo et al., 2021). The seventh target of the Sustainable Development Goals (SDGs) is to ensure universal access to dependable, cost-effective, and environmentally-friendly energy for all. This objective has received unanimous endorsement from all 193 member nations of the United Nations (Irwin et al., 2020). In 2019, a total of 770 million individuals worldwide lacked access to electricity, with 75% of them living in sub-Saharan Africa (Apenteng et al., 2018). Moreover, this issue is typically limited to a specific sector, which prevents policymakers from fully understanding its impact on broader government services such as education, food provision, and healthcare.

The correlation between energy and health is robust and essential for the efficient provision of high-quality healthcare. The World Health Organisation (WHO, 2018) states that hospitals often follow standard operating procedures that involve energy consumption for various purposes such as water supply, temperature regulation, lighting, ventilation, and clinical procedures. Although modern health facilities in high- and middle-income countries consume a significant amount of energy and have negative effects on climate and the environment, many small rural and public facilities in resource-limited areas face challenges due to unreliable energy networks, which hinder the provision of health services (Ibrahim et al., 2021).

There are a total of 34,173 health institutions distributed among the 36 States and the Federal Capital Territory (FCT) Abuja. There are a total of 30,098 primary healthcare (PHC) institutions, accounting for 88% of the total. Additionally, there are 3,992 secondary facilities, making up 12% of the total, and 83 tertiary facilities, which represent 1% of the total. The capacity of these facilities to deliver specific services to address the health requirements of the population is compromised by the rise in electricity tariffs (Josephine et al., 2019). More than 80% of the Nigerian population is either unserved, meaning they have no access to grid energy, or underserved, meaning they have irregular electrical delivery. Many primary healthcare centres (PHCs) in Nigeria are compelled to close before dark due to a lack of adequate lighting for night shifts. In cases of urgent nighttime situations, they resort to using torchlights or kerosene lanterns. (Rasheed, Christian & Effiong, 2010; Tijani et al., 2021)

Drugs and vaccinations are frequently unable to be stored in most Primary Health Centres (PHCs) due to the inadequate or nonexistent provision of grid electricity. This has an impact on the level of immunisation coverage and has the potential to undermine the quality of medications and vaccines that are provided (Usman, 2012; WHO, 2018). Due to the absence of inexpensive energy in many primary healthcare centres (PHCs), the availability of safe water supply is compromised. As a result, most PHC facilities are compelled to collect water from unreliable and unsanitary sources.

As to the National minimum standard for Primary Health Centres (PHCs) in Nigeria, the provision of high-quality healthcare services relies on three key elements. The first element is Health Infrastructure, which encompasses essential facilities, structures, furnishings, water supply, sanitation, staff housing, and equipment. The second pillar encompasses the domain of Human Resources: The minimum recommended number of people and their positions for each type of health facility are outlined, along with the last aspect which is Service Provision. This includes the recommended minimum primary healthcare services for each facility type, as well as the minimum requirement for medical equipment and critical pharmaceuticals. These pillars should be supported by a base of cost-effective, environmentally-friendly, reliable, and continuous electricity provision. Due to the ongoing and consistent increase in electricity prices, the three main components of health service provision are unable to operate efficiently. Therefore, this study is necessary.  

1.2 Statement of the problem

Significant increases in electricity tariffs, as well as intermittent or complete power outages, have a severe impact on healthcare facilities, healthcare professionals, patients, and companies involved in medical technology and supply chains (Kushner et al., 2010; WHO, 2019). Healthcare institutions consume a significant amount of energy. The majority of energy consumption in healthcare is attributed to operating rooms, especially their supporting equipment. This energy usage is equivalent to 4.8% of the overall energy consumption of commercial buildings. In addition to surgical procedures, the use of lighting, air-conditioning, and biomedical instruments can result in an energy intensity of 234 kWh/m (Adair-Rohani et al., 2023). 

Research conducted in sub-Saharan Africa indicates that power outages lasting more than 2 hours result in a significant increase of up to 43% in the death rate of hospitalised patients (Mbonye et al., 2023). An increase in power hazards jeopardises the lives and welfare of hospitalised patients, causing interruptions in the provision of in-hospital treatment and affecting the capabilities of outpatient and emergency departments. According to Stang (2021), an increase in electricity prices might cause power outages that can harm biomedical equipment and cause the deterioration of temperature-sensitive commodities including vaccinations, insulin, and blood transfusion items. 

While hospitals have backup power sources, patients who live at home are exposed to two potential risks: power outages and cutoff of energy supply due to unpaid debts to energy providers. Whether they are biomedical or ambient living equipment, such as respirators or freezers, both can experience temporary malfunction or mechanical harm. Patients may lack the ability to monitor essential health indicators, get medication or nourishment, ambulate, or seek assistance. These pose a threat to the physical health of patients, result in considerable mental anguish, and can potentially overwhelm emergency departments if patients are unable to obtain therapy that relies on medical devices at home. According to Haque and Pant (2020), the absence of power can result in unpleasant situations and risky behaviours. For instance, low temperatures can exacerbate cardiovascular, pulmonary, and mental health issues in individuals of all age groups. Individuals with limited access to heating resources may turn to self-made heaters that generate carbon monoxide, which has been associated with a significant number of deaths (Haque & Pant, 2020). 

Healthcare personnel are highly susceptible to power interruptions. During their working hours, healthcare professionals may encounter psychological stress and physical fatigue if they are required to care for severely ill patients without the essential electrical equipment. Turnbull, Conroy, and Ogbeka (2019) argue that having power outages or facing financial constraints in accessing electricity can undermine the ability of healthcare personnel to find the necessary tranquilly for recovery following a demanding day at work. This is especially true for residents, trainees, or support staff, whose relatively modest incomes have already made it difficult for them to deal with the increasing inflation affecting a wide range of products. Similarly, healthcare professionals that utilise computers and other electronic devices to stay updated on the most recent protocols in their industry or engage in research during their own time would be unable to accomplish their responsibilities. This study will analyse the impact of electricity rate rise on the healthcare sector of Nigeria, considering the current circumstances. 

1.3 Objectives of the Study 

The primary objective of this study is to critically analyze electricity tariff and its effect on the healthcare sector in Nigeria. Specifically the study seeks:

To determine the extent increase in electricity tariff affects the healthcare sector in Nigeria.

To examine extent in which increase in electricity tariff affects cost of healthcare services in Nigeria.

To assess the effect of the increase in electricity tariff on the availability of healthcare services in Nigeria.

To assess the effect of the increase in electricity tariff on the quality of healthcare services in Nigeria.

1.4 Research Questions

The following research questions will be answered in this study:

What is the extent increase in electricity tariff affects the healthcare sector in Nigeria?

What is the extent in which increase in electricity tariff affects cost of healthcare services in Nigeria?

What is the effect of the increase in electricity tariff on the availability of healthcare services in Nigeria?

What is the effect of the increase in electricity tariff on the quality of healthcare services in Nigeria?

1.5 Research Hypothesis

The following null hypothesis will validate this study:

Ho: The  increase in electricity tariff has no negative effect on the healthcare sector in Nigeria.

Ha: The  increase in electricity tariff has a negative effect on the healthcare sector in Nigeria.

1.6 Significance of the study

This study will be of interest to scholars, medical practitioners, and government. As a scholar, this study will contribute to the existing body of knowledge in this area, while also serving as a valuable source of empirical reference and literature review. It will also provide a foundation for further research to the scholar.

This study will be of importance to medical practitioners as it will expand their scope of knowledge, which serves as the foundation for decision making, particularly in relation to managing electricity. 

1.7 Scope of the study

The study aims to carry out a critical analysis on electricity tariff increase and its effect on the healthcare sector of Nigeria. Empirically, this study will explore the overall effect of hike in tariff on the healthcare sectors. This study will be carried out in Kwuba, General Hospital.

1.8 Limitation of the study

The researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing that there are little or no research on increase in electricity tariff; thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size covering only residents of Nigeria. Thus findings of this study cannot be used for generalization for other regions outside Nigeria.

 Additionally, the researcher will simultaneously engage in this study with other academic work which will impede maximum devotion to the research. Howbeit, despite the constraint encountered during the research, all factors were downplayed in other to give the best and make the research successful.

1.9 Definition of terms

Electricity: Electricity is the set of physical phenomena associated with the presence and motion of matter possessing an electric charge. Electricity is related to magnetism, both being part of the phenomenon of electromagnetism, as described by Maxwell's equations. Common phenomena are related to electricity, including lightning, static electricity, electric heating, electric discharges and many others.

Tariff: Tariff is a means of generating revenue for the government for the improvement of the welfare of her citizenry or serves as a protection for infant industries. Tariff reduces import by raising prices.

Healthcare: Healthcare efforts made to maintain, restore, or promote someone's physical, mental, or emotional well-being especially when performed by trained and licensed professionals. 

Healthcare sector: Healthcare sector consists of businesses that provide medical services, manufacture medical equipment or drugs, provide medical insurance, or otherwise facilitate the provision of healthcare to patients.