By PPH Foundation

In many parts of Kenya, heavy rainfall is often followed by sudden electricity interruptions. While this is widely seen as a normal inconvenience, evidence shows that these disruptions reflect deeper infrastructure vulnerabilities with serious implications for health services, especially maternity care. In facilities where electricity fails during childbirth, the risk of complications such as Postpartum haemorrhage increases significantly, as care is delayed at a critical moment.

According to the World Bank (2021), many health facilities in low- and middle-income countries still experience unreliable electricity supply, with frequent outages affecting essential services. This means that during storms, when the national grid is already under pressure, hospitals are more likely to lose power exactly when emergency obstetric care is needed most.

Rainfall contributes to these disruptions through wind damage, lightning strikes, flooding of transformers, and water infiltration into power lines. These climate-related shocks weaken already fragile infrastructure, particularly in rural and peri-urban areas. The World Health Organization (Adair-Rohani et al., 2013) notes that reliable electricity is a core requirement for safe health service delivery, yet many facilities still rely on unstable grid power or inconsistent backup generators.

In maternity wards, electricity is not a convenience. It is part of the clinical system.

Theatre lighting, oxygen delivery, suction machines, sterilization units, and blood transfusion services all depend on uninterrupted power. When electricity fails during an obstetric emergency, clinicians are forced to improvise, often in unsafe conditions. This becomes particularly dangerous in cases of PPH, where rapid bleeding requires immediate intervention and continuous monitoring.

According to WHO estimates on maternal mortality (2023), postpartum haemorrhage remains one of the leading causes of maternal deaths globally. Delays in treatment are a key driver of these deaths, a pattern also described in the “three delays model” by Thaddeus and Maine (1994), which highlights delays in receiving appropriate care as a major contributor to maternal mortality.

In practice, a power cut during a PPH emergency can delay surgical intervention, interrupt oxygen supply, and halt blood transfusions. Even short interruptions can shift outcomes from manageable to fatal.

Prof Julius Ogeng’o, a Co-Lead of the End PPH Initiative, emphasizes that electricity instability should be treated as a clinical risk factor, not just an infrastructure problem.

“Electricity is not separate from clinical care in obstetrics. When power fails during a haemorrhage, surgery slows down, transfusion is interrupted, and monitoring becomes unreliable. In maternal health, time is life,” he explains.

The link between climate change and maternal outcomes is therefore becoming more direct. Climate-driven extreme weather events are exposing long-standing weaknesses in health system infrastructure, turning seasonal rainfall into a trigger for emergency risk in maternity wards.

Research on health system resilience in sub-Saharan Africa (Bennett et al., 2021) shows that infrastructure gaps, including unreliable electricity, significantly reduce the quality and safety of emergency care. This means that strengthening maternal survival is not only about improving clinical skills, but also ensuring uninterrupted power supply in delivery rooms and theatres.

Building resilience requires investment in stable grid systems, protected hospital wiring, and reliable backup power solutions such as solar and hybrid systems designed specifically for maternity care.

Because when the lights go out during a storm in a maternity ward, what follows is not just darkness. It is a narrowing of the window between life and death for mothers experiencing PPH.

Sources

Adair-Rohani, H., Zayas, J., Darton, T. C., et al. 2013. Energizing health: Accelerating electricity access in health-care facilities. World Health Organization and World Bank.

Bennett, S., et al. 2021. “Health system resilience in sub-Saharan Africa: Infrastructure and service delivery challenges.” BMJ Global Health, 6(Suppl 5).

Thaddeus, S., and Maine, D. 1994. “Too far to walk: Maternal mortality in context.” Social Science & Medicine, 38(8), 1091–1111.

World Bank. 2021. Reliable electricity supply in health facilities: A critical component of quality health services in low- and middle-income countries. Washington, DC: World Bank Group.

World Health Organization. 2012. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: WHO.

World Health Organization. 2023. Trends in maternal mortality 2000 to 2023. Geneva: WHO.

Image by Freepik