Multidimensional energy poverty and childhood respiratory health across 26 low and lower middle income countries

Energy poverty is a critical global challenge, with profound implications for health, climate, and sustainable development. Energy poverty is generally examined within the framework of indoor air pollution, considering acute respiratory infection (ARI) among young children in low- and lower-middle-income countries (LLMICs) acknowledged as one of its most significant health consequences. The present study employs a multidimensional perspective to comprehensively measure the association between ARI and energy poverty. A sample of 344,160 children in the under-five age group (mean age 2.05 years; 50.3% female) across 26 LLMICs, obtained from the Multiple Indicator Cluster Surveys, was analyzed. The Multidimensional Energy Poverty Index, composed of five fundamental dimensions of energy essential, was used to compute energy poverty. The results from binary logit models showed that the odds of ARI increased by 53% (aOR 1.53; 95% CI 1.46-1.60) with every unit increase in MEPI. Electricity deprivation, lack or absence of entertainment/education and household appliances, and reliance on biomass fuels for cooking were also independently associated with a greater ARI risk. These findings demonstrate that multidimensional energy poverty is a major contributor to child respiratory health. Therefore, to design result-oriented policies and interventions to minimize ARI among children in LLMICs, it is essential to address energy accessibility and affordability.