DISCUSSION
In this qualitative study embedded within a randomized trial of a lighting intervention in rural Uganda, we identified multiple ways in which improving the quantity and quality of household lighting influenced study participants’ social network formation and social interactions, and thus improved social integration and subsequently psycho-social health. Our data revealed that access to lighting improved social status for participants and ameliorated the stigma of poverty. Improved lighting services facilitated more interpersonal interactions between community members, strengthened perceived community safety, and improved household relationships. Lastly, participants reported that lighting improved their self-esteem, sense of well-being, and reduced psychological stress. There is little in the household energy and lighting literature focused on social health impacts thus highlighting a gap in how these programs are evaluated. Were these social outcomes to be accounted for in intervention trials, it is likely that the resulting cost-benefit ratios would be even more favourable than current estimates indicate [Currently, there is a major gap in the household energy literature related to the impact of lighting and illumination on social integration and health. In the study site of rural southwestern Uganda, we found that improved lighting services promoted social integration across scales and, as a result, improved psycho-social health. At the macro-level, lighting improved participants’ social status; at the mezzo-level lighting improved social cohesion and engagement; and at the individual level lighting directly improved self-reported psychological well-being. While other studies note the profound health benefits of social integration [Outside of health research and the clinical consequences of light and lighting sources, social scientists have begun to examine the political-economic and socio-cultural dimensions of access to and development of lighting technologies [Our study’s findings are also resonant with the literature on the social meaning of energy poverty. A previous study in Afghanistan found that lack of access to electric light was interpreted by marginalized communities as a reminder of perceived exclusion and discrimination, as well as the feeling that they have been left behind by the international community [Our study has a few limitations. First, all trial participants were women, and our findings may not apply to men. In this particular study setting of rural Uganda, the household division of labour is such that women are responsible for food preparation, child rearing, and household management – so the burden of food insecurity, water insecurity, and energy insecurity (and their disparate impacts on health and well-being) is highly gendered [Our work begins to fill a gap in the scientific literature and attempts to bridge social science and clinical research perspectives in household energy intervention trials, particularly in resource-limited settings. Access to lighting has far-reaching psycho-social health implications and should be considered a priority in global health and development efforts. The potential for light to improve social integration may lead to downstream effects on other health outcomes like mortality and should be further studied.