Women's empowerment and household fuel use in 31 African countries: a cross-sectional analysis of households in the Demographic and Health Survey

Access to clean and affordable energy is vital for health, well-being, and socio-economic development. This critical service remains unrealised in many African countries. Women's empowerment is known to promote healthcare service use, child nutrition and agricultural productivity. In Africa, however, little is known about the relationship between women's empowerment and household fuel use, and if it varies between countries. Therefore, we assessed the cross-sectional associations between women's empowerment and cooking fuel use in 31 African countries. We analysed individual-level data from the Demographic and Health Surveys, conducted between 2003 and 2018 (n = 264 269 [women-household pairs]). We used a novel, Africa-specific index (survey-based women's empowerment index), including three domains of empowerment: decision-making, attitude to violence, and social independence. Hierarchical logistic regression models assessed the associations between women's empowerment domains and the type of fuel used in the household ('clean': electricity, liquefied petroleum gas (LPG), biogas or natural gas; 'polluting': solid fuels or kerosene). Results were adjusted for household- and area-level covariates, and expressed as odds ratios (OR). The 31 country-specific estimates were combined using meta-analysis. Approximately 43 778 (14.5%) of households used clean fuels. Overall, between 12/31 and 22/31 country-level estimates showed a significant association between a one standard deviation increase in empowerment domains (higher scores indicate greater empowerment), and higher odds of using clean fuel as primary energy source for cooking. The random-effect meta-analytic estimates showed that increased empowerment was associated with higher odds of using clean fuel for attitude to violence (OR = 1.22; 95% CI: 1.12-1.33), social independence (OR = 1.34; 95% CI: 1.28-1.42), and decision-making (OR = 1.10; 95% CI: 1.05-1.15). These findings suggest that empowering women, in addition to being crucial in its own right, has potential to accelerate transitions to clean fuel in Africa, although these associations vary between countries.