Use, cost-effectiveness, and end user perspectives of a home solar lighting intervention in rural Uganda

A mixed methods, randomized controlled trial

Bibliographic Data

ID15545388
AuthorsRadhika Sundararajan (0000-0002-8451-2243, Cornell University), Helen D’Couto (0000-0002-1389-8206, Massachusetts General Hospital), Joseph Mugerwa (Mbarara University of Science and Technology), Mellon Tayebwa (Mbarara University of Science and Technology), Nicholas L Lam (0000-0001-7480-0535, Cal Poly Humboldt), Eli Wallach (0000-0003-2458-2466, Cal Poly Humboldt), Matthew O Wiens (0000-0002-3287-5181, Mbarara University of Science and Technology), Matthew Ponticiello (0000-0002-8684-7047, Cornell University), Debbi Stanistreet (0000-0003-3738-1727, Royal College of Surgeons in Ireland), Alexander C Tsai (0000-0001-6397-7917, Harvard University), Jose Vallarino (Harvard University), Joseph G Allen (0009-0001-3041-3565, Harvard University), Daniel Muyanja (Mbarara University of Science and Technology), Mark G Shrime (0000-0002-3546-9867, Royal College of Surgeons in Ireland), Edwin Nuwagira (0000-0001-7526-9504, Mbarara University of Science and Technology), Peggy S Lai (0000-0001-9501-8606, Harvard University, corresponding author)
Year2021
Volume17
Issue1
Pages015002-015002
Publication date2021-12-01
Open AccessYes
TypeARTICLE
VenueEnvironmental Research Letters (JOURNAL)
Journal identifiersISSN: 1748-9326 • E-ISSN: 1748-9326
PublisherIOP Publishing (PUBLISHER • GB)
DOI10.1088/1748-9326/ac3f05
PMID35295194
OpenAlexW3216666073
LanguageEN
Citations received4
References cited38

Energy poverty is prevalent in resource-limited settings, leading households to use inefficient fuels and appliances that contribute to household air pollution. Randomized controlled trials of household energy interventions in low and middle income countries have largely focused on cooking services. Less is known about the adoption and impact of clean lighting interventions. We conducted an explanatory sequential mixed methods study as part of a randomized controlled trial of home solar lighting systems in rural Uganda in order to identify contextual factors determining the use and impact of the solar lighting intervention. We used sensors to track usage, longitudinally assessed household lighting expenditures and health-related quality of life, and performed cost-effectiveness analyses. Qualitative interviews were conducted with all 80 trial participants and coded using reflexive thematic analysis. Uptake of the intervention solar lighting system was high with daily use averaging 8.23 ± 5.30 hours per day. The intervention solar lighting system increased the EQ5D index by 0.025 [95% CI 0.002 - 0.048] and led to an average monthly reduction in household lighting costs by -1.28 [-2.52, -0.85] US dollars, with higher savings in users of fuel-based lighting. The incremental cost-effectiveness ratio for the solar lighting intervention was $2025.72 US dollars per quality adjusted life year (QALY) gained making the intervention cost-effective when benchmarked against the gross domestic product (GDP) per capita in Uganda. Thematic analysis of qualitative data from individual interviews showed that solar lighting was transformative and associated with numerous benefits that fit within a Social Determinants of Health (SDOH) framework. The benefits included improved household finances, improved educational performance of children, increased household safety, improved family and community cohesion, and improved perceived household health. Our findings suggest that household solar lighting interventions may be a cost-effective approach to improve health-related quality of life by addressing SDOH

Business · Cost effectiveness · Environmental health · Per capita · Population · Psychological intervention · Risk analysis (engineering · Energy and Environment Impacts · Energy, Environment, and Transportation Policies · Impact of Light on Environment and Health · Medicine · Nursing

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