In 1998, the South African government developed an energy policy that focused on a pro-poor agenda. Its objectives included addressing the health impacts of solid fuel use in households. Fourteen years later, and with household electrification at over 80%, millions still use solid fuels and yet ambitious policy objectives to address this situation are not being met. Using three theoretical frameworks; institutional capacity, policy inheritance and the symbolic use of policy, this paper analyses the reasons why household energy policy objectives related to solid fuels and health, as stated in the 1998 South African energy policy, have not been implemented. The results of the analysis show that the symbolic use of policy, including meanings of objects used for meeting policy objectives is the most critical explanation. The paper illustrates that political and historical contexts are critical to understanding policy outcomes in developing and transition countries which often experience tensions between implementing what may seem as objective policies, and that matches their political and historical experiences and aspirations. We recommend that policy analysts in the energy sector complement currently common methods to include political contexts of policy development and implementation in order to better understand why policy makers chose to implement certain policies over others