About 100 to 150 people walk the Sekelela Health Post walls every week seeking care. The facility serves four surrounding communities, a blend of peri-urban households and rural farming families, with most of its patients being women and young children. It offers the communities outpatient services, anti-retroviral treatments, and maternal and child healthcare services. Since working there, Shiela Kayata, a registered nurse, and Tikho Mwali, a psycho-social counsellor, have grown familiar with many patients who lean on them and the rest of the Sekelela team for care. But at the Health Post, the power does not always stay on, limiting their ability to meet the required standards of care.

With recurring electricity cuts and poor network, the team struggles to deliver quality care consistently. Tests for haemoglobin levels at the facility depend on power and medicines that need on cold-chain storage cannot be kept on site. Compounded with poor network that leaves the team dependent on manual processes and forms, the modest but incredibly busy health post is left at a significant disadvantage.

Since it opened in 2018, the health post has been the largest health structure in the immediate area, yet small by national standards. And until recently , it operated in the familiar rhythm of rural clinics, providing care to patients amidst constant outages and weak/unstable connectivity. While the care does not stop, it does become slower and riskier.

Across Zambia, 66% of women and girls aged 15–49 report facing at least one serious barrier when trying to access healthcare (Zamstats, 2024). The most common concern is that there may not be any medicine available (43%). Others also worry about long waiting times (32%) or the distance to facilities (29%). In Sekelela, providers like Shiela and Tikho are confronted with this reality daily. When they cannot deal with routine cases not from a lack of care, but because of the power and connectivity issues, they send patients to health care facilities further out of reach. Vaccine storage is also difficult, as power outages affect the potency of the medicines.

When healthcare systems feel unreliable, persons with disabilities and women, particularly pregnant women and mothers of young children, delay seeking care even when these seemingly “small” delays can turn into larger risks.