Conceptualising the effect of access to electricity on health in low- and middle-income countries: A systematic review

ABSTRACT

Access to electricity is an important issue in low- and middle-income countries (LMICs) however its health implications are poorly understood. This paper systematically reviews the health effects of access to electricity and develops a conceptual model to summarise the pathways through which these effects may occur. The databases CINAHL, Embase, and MEDLINE were searched for studies examining the effects of access to electricity on health in LMICs. Thirty-three studies met the inclusion criteria: 23 focusing on electrification and 10 focusing on electricity reliability. Using a modified socio-ecological model, 4 main levels of influence were identified: (1) individual, (2) household, (3) community, and (4) institutional. Electrification was generally associated with positive health outcomes, such as reduced mortality, lower rates of disease, and improved quality of and access to care, while poor electricity reliability was associated with negative health outcomes, including increased morbidity and mortality, lower quality of care, and reduced utilisation of health services. Although the overall quality of the evidence was weak, given the many potential pathways through which electricity may affect health, efforts should be made not only to increase the number of connected households globally, but to improve the reliability of the electricity supply as well.

KEYWORDS:

• Electrification
• electricity
• power outages
• health systems
• socio-ecological model of health

Acknowledgements

We would like to thank Jilan Yang for her early contributions to this project, including an initial scoping review which informed much of the search strategy and inclusion and exclusion criteria. We acknowledge that this work was conducted on the Haldimand Tract, traditional territory of the Neutral, Anishnaabe and Haudenosaunee peoples. We are grateful to the AXA Research Foundation for financial support for this project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Availability of data and materials

This study analysed secondary data obtained from published studies or publicly available grey literature. All sources are cited here, and their respective authors should be contacted for raw data.

ORCID

Karen A. Grépin http://orcid.org/0000-0003-4368-0045

Additional information

Funding

This study received financial support from the AXA Research Foundation.