Household energy insecurity: dimensions and consequences for women, infants and children in low- and middle-income countries.

Energy insecurity, the lack of access to adequate, affordable, reliable, acceptable, and clean sources of energy for a healthy and sustainable livelihood, poses a challenge to several households. However, the conceptualization of its dimensions and role in the health outcomes of women, infants, and children in most sub-Saharan African countries have rarely been investigated systematically. We assessed the dimensions and adverse consequences of household energy insecurity (HEINS) in a sample of 347 Ghanaians and 420 Nigerians, with over 80% participation of women. The majority of respondents from Ghana (57%) and Nigeria (80%) had experienced of energy insecurity, at least once in the last four weeks. Following the energy insecurity framework, the experiences of participants were classified into physical, behavioral, and economic dimensions of energy insecurity. The consequences of energy insecurity grouped into psychosocial, nutritional, and disease domains. The development of a national as well as a cross-culturally validated scale that embodies these dimensions and domains will facilitate the assessment of the prevalence, causes, and consequences of HEINS. This will eventually enable the development of interventions and policies to mitigate energy insecurity and unearth modifiable factors that influence deleterious maternal, infant and child health outcomes in low-and middle-income countries.