When the COVID-19 pandemic hit, Nigeria’s health systems were already debilitated and in need of wholesale reform and investment after decades of neglect. Among the health system improvements triggered by the COVID-19 crisis, the electrification of health facilities by renewable energy (RE) has emerged as a rapid and affordable solution for health access, particularly in remote areas.

The article investigates the business models for sustainably powering primary health care facilities (PHCs) in Nigeria through mixed-method design, comprising interviews, financial modelling and legal/regulatory analysis. The bankable options for PHCs using Luminous or lithium batteries require careful allocation of costs among the government, financial institutions and donors. As PHCs have a limited budget, it is unlikely that they can pay for operation and maintenance costs and battery replacement in the long term. Involving teaching hospitals and small and medium-sized businesses in the surrounding areas with a better source of subvention or revenue can be an option to keep the system working. The Nigerian Rural Electrification Agency (REA) is strategically positioned to coordinate initiatives in the electrification of health facilities with a leading role in integrating the health and energy sectors.