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Table 2 Localized solutions to rising petroleum prices in the health sector in LMICs

From: Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices

  Examples of localized solutions to rising petroleum prices
1. Health infrastructure, supplies, & equipment • Build infrastructure using locally available materials
• Reduce reliance on disposable materials and move toward sterilizing reusable ones on-site
• Substitute local goods when possible, including those made from traditional materials (bandages, etc.) of known safety and efficacy
2. Transportation and referral system • Create a strategic fuel reserve to power emergency vehicles
• Identify alternative means of transport for referral systems (local ambulance schemes, animal-powered referrals, etc.)
• Use distance technology e.g. cell phone-based monitoring systems when feasible and appropriate
3. Energy for health services • Identify and utilize local energy resources (solar roof panels, hydropower, wind power)
• Utilize architectural design allowing for natural lighting, heating & cooling
• Adopt energy efficient technologies & reserve fuel supplies to ensure supply chains for goods whose production cannot be localized
4. Human resources policy • Scale up task-shifting to CHWs and increase roles for local health workers
• Provide incentives for health workers to stay in rural communities
• Scale-up training activities and training of trainers at the lowest levels of the health system
• Localize supervisory structures and/or provide non-petroleum based forms of transportation for supervisory visits
5. Health systems organization • Create satellite health facilities or health posts in rural or peripheral areas
• Clarify and improve upon decentralization policies using evidence-based practices
  • Empower local governance by creating village health committees, health facility oversight boards, and financing and procurement systems that can support and monitor implementation of health services