Energy Efficiency in Healthcare Buildings: A Systematic Comparative Review of Building Performance, Regulatory Frameworks, and Retrofit Strategies in the United Kingdom and Selected Developing Economies

Abstract

Healthcare buildings are among the most energy-intensive facilities due to their continuous operation, stringent environmental requirements, and reliance on complex building services. Improving their energy efficiency is essential to achieving global decarbonisation goals. This study presents a comparative analysis of energy efficiency in healthcare buildings in the United Kingdom and Kenya, focusing on building performance, regulatory frameworks, and retrofit strategies. A systematic review of peer-reviewed literature, policy documents, technical reports, and case studies was undertaken to evaluate energy use, carbon emissions, regulatory approaches, and energy-efficiency interventions. The findings reveal that UK healthcare buildings generally achieve higher energy performance through stronger regulatory frameworks, greater investment, and wider adoption of advanced technologies. In contrast, healthcare facilities in Kenya face challenges including limited funding, ageing infrastructure, and constrained technical capacity. However, the study identifies several cost-effective measures, including LED lighting upgrades, HVAC optimisation, energy management systems, and solar photovoltaic installations, that can significantly improve energy performance in resource-constrained settings. The study contributes an integrated framework linking building performance, regulation, and retrofit strategies, providing practical recommendations for policymakers, facility managers, and building services engineers seeking to enhance healthcare building sustainability and support decarbonisation objectives.