Household Energy Poverty in South Africa: Dimensions, Drivers, Disparities, and Implications for Health, Justice, and Sustainability

Although South Africa has achieved near-universal grid electrification, many connected households experience inadequate, unreliable, and unaffordable energy. This review asks why energy poverty persists despite improved access, a question at the intersection of social inequality, human health, and environmental sustainability, the core concerns of planetary health. Drawing on 143 sources (peer-reviewed studies, reports, and theses) from a structured search of Scopus and Google Scholar (1994–2026) and citation tracking, the review examines conceptual foundations, drivers, and disparities of household energy poverty by income, gender, location, and province; its associations with welfare, health, education, livelihoods, and the environment; and South Africa’s policy responses. Building on South African reviews that addressed measurement within the Just Energy Transition or focused on rural households, it makes three contributions: it covers urban, peri-urban, informal, and rural settings; it proposes a conceptual framework linking structural drivers, household energy conditions, well-being and environmental outcomes, and policy responses through multidimensional energy poverty, energy justice, and planetary health; and it appraises where the evidence is consistent, mixed, or limited. Evidence of the persistence and unequal distribution of energy poverty after connection is consistent, whereas evidence of its consequences is weaker. Energy transitions are not driven by electrification or decarbonization alone but by household energy well-being: whether households can obtain adequate, affordable, reliable, and safe energy that supports health and livelihoods while reducing environmental harm. Limitations include purposive source selection and mostly cross-sectional evidence; most reported relationships should therefore be read as associations rather than demonstrated causal effects.