Household air pollution (HAP) is a top-priority public health problem in developing countries. According to the most recent comparative risk assessment, 3.5 million people die prematurely each year as a result of HAP exposures. While uncertainties remain regarding causal links between HAP exposures and health, the time is ripe for focused research into effective interventions. Limited past research has shown that the demand for clean cookstoves is low, and that households continue to use traditional hearths even when they have clean stoves. These behaviors threaten to undermine cookstove intervention programs, such as those promoted by the Global Alliance for Clean Cookstoves. We propose to harness an existing cohort in Ghana to study factors that increase the adoption of clean cookstoves, and to test strategies to promote adoption and continued use. Our work draws heavily on the availability of reliable low cost stove use monitors (SUMS), which record stove temperature and other key parameters to provide an objective measure of daily use over long periods of time. Additionally, our work examines the adoption both of efficient biomass cookstoves and liquefied petroleum gas (LPG). Our study is structured around four main activities. First, we will measure stove use in our current intervention (n=1415) and test a series of hypotheses about household characteristics that predict increased use of clean stoves. Second, we will assess the effects of stove type and usage on household time allocation using time activity diaries, to test the hypothesis that clean cookstoves free up substantial time for household members, particularly women. Third, we will carry out a small-randomized trial to test the effects of health education delivered by community health workers and by local opinion leaders. Finally, we will use a simple bidding procedure to elicit willingness-to-pay (WTP) for high efficiency cookstoves, and will examine how WTP varies in function of the way in which the stove is marketed. Collectively, these activities will substantially enhance the knowledge base for effective household energy interventions that reduce air pollution exposures and prevent disease.

Public Health Relevance

Exposure to household air pollution from open cooking fires is a top global health risk that causes 3.5 million premature deaths per year, mostly in the developing world. We aim to determine how to best encourage people to adopt clean cookstoves, which prior research has shown to be an effective strategy for reducing these exposures. We will harness an existing cohort in Ghana to study factors that predict the adoption of clean cookstoves, and to test strategies to promote adoption and continued use.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Research Project (R01)
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Social Sciences and Population Studies B Study Section (SSPB)
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Thompson, Claudia L
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Columbia University (N.Y.)
Public Health & Prev Medicine
Schools of Public Health
New York
United States
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Carrión, Daniel; Dwommoh, Rebecca; Tawiah, Theresa et al. (2018) Enhancing LPG adoption in Ghana (ELAG): a factorial cluster-randomized controlled trial to Enhance LPG Adoption & Sustained use. BMC Public Health 18:689
Gould, Carlos F; Schlesinger, Samuel; Toasa, Andres Ochoa et al. (2018) Government Policy, Clean Fuel Access, and Persistent Fuel Stacking in Ecuador. Energy Sustain Dev 46:111-122