Challenges — Journal of Planetary Health

Climate usually brings to mind air, temperature, and precipitation [...]

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.

Malnutrition in Nepal’s Eastern Terai is shaped by food access, caregiving, water and sanitation, agricultural livelihoods, and local institutions. This mixed-methods evaluation describes the implementation patterns and endline nutrition, WASH, and food-system practices of an integrated Nutrition Education and Rehabilitation Program (NERP) and Linking Agriculture and Natural Resource Management towards Nutrition (LANN+) programme implemented in Karjanha, Kalyanpur, and Siraha municipalities from 2021 to 2024. The final evaluation included a household survey of 365 participating households, six focus group discussions with 69 participants, 19 key informant interviews, document review, and a partner reflection workshop. Because endline households were selected sequentially from accessible participating households until municipality/community quotas were met, municipality comparisons are presented descriptively rather than as population-level statistical inference. Project-supported community screening conducted by health-facility staff used MUAC and weight-for-height criteria for children aged 6–59 months. The Phase II evaluation source records reported a GAM prevalence of 20.0% at the initial project screening and 8.38% (1038/12,392 screening records) at the final screening; because the initial numerator/denominator, individual anthropometric records, exact screening coverage, and seasonal comparability were not available for secondary verification, these values are not interpreted as a verified longitudinal reduction. At endline, MDD-W was 79.3% (242/305), and the project-defined SIFS criterion was met by 92.7% (294/317) and the project-defined hygiene criterion by 95.6% (349/365). After correcting age-inconsistent breastfeeding records, a breastfeeding-related project criterion was met by 84.5% (125/148) of households with children aged 0–59 months; a corrected complementary-feeding criterion was met by 73.8% (104/141) of households with children aged 6–59 months. The qualitative findings indicated that nutrition gardens, diversified production, nutrition learning, women’s economic participation, and municipal planning were perceived as mutually reinforcing, while COVID-19 disruptions, procurement delays, seasonal water constraints, and weak routine water treatment constrained implementation. This study provides descriptive implementation evidence; climate resilience and planetary-health benefits remain plausible pathways rather than directly measured outcomes.