Assessing the Feasibility of Solar-Powered Digital Health Infrastructure in Rural and Peri-Urban Kenya: A Mixed-Methods Study

Abstract

Background: Health systems in low-and middle-income countries (LMICs) face persistent infrastructure constraints, particularly unreliable electricity and limited digital connectivity, that hinder the effective implementation of digital health interventions. These challenges are especially pronounced in rural and peri-urban settings, where facilities rely on unstable power sources and fragmented information systems. Although digital health technologies can strengthen health systems and improve care delivery, their effectiveness depends on reliable infrastructure. Integrating renewable energy with digital health systems has emerged as a promising approach to address these challenges. Objective: This study assessed the technical, economic, and health system feasibility of deploying a solar-powered digital health infrastructure (Bright Health) in rural and peri-urban healthcare facilities in Kenya. Methods: A mixed-methods study was conducted across 12 public healthcare facilities. Quantitative data were collected using structured facility assessments to evaluate power reliability, connectivity, hardware availability, and system use, and analyzed using descriptive statistics. Qualitative data were obtained through key informant interviews with facility managers, administrators, and technical staff, as well as a multi-stakeholder validation workshop. Thematic analysis was applied to identify patterns across feasibility domains, and findings were integrated. Results: Frequent power outages were reported in 83% (10/12) of facilities, with 67% (8/12) experiencing disruptions to electronic medical record systems. Connectivity limitations were widespread; however, offline-first architecture enabled continuity of data capture and service delivery. Economically, 83% (10/12) of facilities perceived that solar-powered systems would reduce long-term operational costs by minimizing reliance on generators and reducing downtime, despite concerns about upfront investment. Health system readiness was high, with 92% (11/12) expressing willingness to adopt the solution, although gaps in staff training and technical support were identified. Overall, feasibility was shaped by interactions among energy reliability, connectivity, infrastructure, and organizational capacity. Conclusions: Solar-powered digital health infrastructure is a feasible and scalable approach to addressing energy and digital health gaps in low-resource settings. Integrating renewable energy with adaptive digital systems enhances service continuity and resilience. However, sustainable implementation requires a systems-based approach aligning infrastructure, financing, workforce capacity, and governance. These findings inform strategies to strengthen resilient and equitable health systems and advance universal health coverage in LMICs.