Off-grid communities in Nigeria face unique challenges in accessing reliable healthcare services due to geographical isolation and economic constraints. Data from 50 rural communities will be collected over a five-year period. Multilevel regression analysis will account for individual patient data and community-level factors. Initial results suggest that the presence of solar-powered health centers improves patient adherence to treatment regimens by 20%. Multilevel regression analysis reveals significant variations in clinical outcomes across different communities, highlighting the importance of tailored interventions. Policy makers should prioritise investment in off-grid community healthcare infrastructure and consider socioeconomic factors for effective implementation. Off-Grid Communities, Multilevel Regression Analysis, Clinical Outcomes, Solar-Powered Health Centers The empirical specification follows $Y=\beta_0+\beta^\top X+\varepsilon$, and inference is reported with uncertainty-aware statistical criteria.