The provision of electricity is a key component in the development of a country's health care facilities. This study was performed to estimate the cost of powering a rural primary health centre, in India with a decentralised renewable energy system. The costs were also compared between a decentralised renewable energy system and providing electricity from a grid source. The critical or break-even distance that makes electricity from a decentralised renewable energy system cost effective over that from a grid source was determined. The decentralised renewable energy system considered was a hydrogen-based fuel cell for the generation of electricity with hydrogen extracted from biogas obtained from biomass. The software program HOMER was used for the simulation analysis. The cost of a decentralised renewable energy system was found to be between seven times and less than half that of conventional energy, and the break-even distance was between 43.8 km to a negative distance for varying ranges of input component costs. The results of this study indicated that the use of a decentralised renewable energy system to power a rural primary health centre is both feasible and cost effective, and may even be cheaper than using electricity from a grid source. (C) 2011 Elsevier Ltd. All rights reserved.