{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:52:14Z","timestamp":1789710734378,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"P&G Children\u2019s Safe Drinking Water Program"},{"name":"Office for Undergraduate Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Many healthcare facilities (HCFs) in low-income countries experience unreliable connectivity to energy sources, which adversely impacts the quality of health service delivery and provision of adequate environmental health services. This assessment explores the status and consequences of energy access through interviews and surveys with administrators and healthcare workers from 44 HCFs (central hospitals, district hospitals, health centres and health posts) in Malawi. Most HCFs are connected to the electrical grid but experience weekly power interruptions averaging 10 h; less than one-third of facilities have a functional back-up source. Inadequate energy availability is associated with irregular water supply and poor medical equipment sterilization; it adversely affects provider safety and contributes to poor lighting and working conditions. Some challenges, such as poor availability and maintenance of back-up energy sources, disproportionately affect smaller HCFs. Policymakers, health system actors and third-party organizations seeking to improve energy access and quality of care in Malawi and similar settings should address these challenges in a way that prioritizes the specific needs of different facility types.<\/jats:p>","DOI":"10.1093\/heapol\/czz118","type":"journal-article","created":{"date-parts":[[2019,9,7]],"date-time":"2019-09-07T07:47:44Z","timestamp":1567842464000},"page":"142-152","source":"Crossref","is-referenced-by-count":21,"title":["Energy access in Malawian healthcare facilities: consequences for health service delivery and environmental health conditions"],"prefix":"10.1093","volume":"35","author":[{"given":"Frances","family":"Reuland","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Behnke","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"},{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-4447","authenticated-orcid":false,"given":"Ryan","family":"Cronk","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"},{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"McCord","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"},{"name":"Carolina Population Center at UNC-CH, Carolina Population Center, 123 West Franklin St., Chapel Hill, NC 27516, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fisher","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"},{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Abebe","sequence":"first","affiliation":[{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"},{"name":"USAID Bureau for Global Health, Office of Maternal and Child Health and Nutrition, 2100 Crystal Dr, Arlington, VA 22202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Suhlrie","sequence":"first","affiliation":[{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"},{"name":"Institute for Medical Information Processing, Biometry and Epidemiology at Pettenkofer School of Public Health, LMU Munich, Marchioninistr. 15, 81377 M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Joca","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, USA"},{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Mofolo","sequence":"first","affiliation":[{"name":"UNC Project-Malawi, Lilongwe, Malawi"},{"name":"The Department of Medicine at UNC-CH, 125 MacNider Hall, Campus Box #7005, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holystone","family":"Kafanikhale","sequence":"first","affiliation":[{"name":"Malawi Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Mmodzi Tseka","sequence":"first","affiliation":[{"name":"UNC Project-Malawi, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Rehfuess","sequence":"first","affiliation":[{"name":"The Department of Environmental Sciences and Engineering at UNC Gillings School of Public Health, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599, USA"},{"name":"Institute for Medical Information Processing, Biometry and Epidemiology at Pettenkofer School of Public Health, LMU Munich, Marchioninistr. 15, 81377 M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Tomaro","sequence":"first","affiliation":[{"name":"The Water Institute at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Public Health, 4114 McGavran-Greenberg Hall, CB#7431, USA, Chapel Hill, NC 27516, 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