Interconnections Between Water, Energy, Food Security, and Health in South Africa: A Comprehensive Review

By
Eli Dearden
Kei Otsuki
Willem J. J. Assendelft
Joost Hopman
Floor van der Hilst
July 16, 2026

Jama Network Open

Objective:

To develop a conceptual framework describing associations between water-energy-food (WEF) insecurities and health outcomes in South Africa.

Approach:

Study Design: A scoping review combined with expert consultations was conducted to inform framework development.
Framework Development: The framework was designed to connect resource systems and human well-being, identifying integrated, cross-sectoral interventions.

Key Findings:

Approximately 2.11 million people in South Africa lack access to safe water.
3.5 million households rely on biomass for cooking or heating.
An estimated 14 million people experience food insecurity.

Interpretation:

The study highlights the need for systematic mapping of how WEF insecurities interact to produce health effects, emphasizing the complexity of these interconnections.

Limitations:

Limited systematic mapping of WEF insecurities and health interactions in existing literature.
Health is often only partially integrated in studies focusing on single WEF components.