Nearly half the world?s population, mostly in the developing world, cooks over open flames on a daily basis. This releases greenhouse gas and exposes people to toxic emissions that contribute to respiratory disease. In Ghana and other countries in the "meningitis belt," emissions from cooking have been linked to meningitis. We hypothesize that widespread use of efficient, or "clean", cookstoves - which produce less smoke than open fires even while burning the same available materials - will reduce people's exposure to toxic emissions, improve health outcomes, and improve regional air quality. To test this hypothesis, we will introduce cookstoves into households in northern Ghana. In addition to determining whether they do, in fact, improve air quality and health outcomes, we will explore the social and economic factors that encourage or discourage cook stove use, and consider the impacts of climate change. Our methods combine 1) a randomized experiment intended to increase use of efficient cookstoves; 2) social surveys to measure effects on cooking behavior and self-reported health outcomes; 3) collection of physical data to measure the impacts on emissions and air quality; 4) integrated modeling of the relationships among cooking practices, air quality, climate variability, respiratory illness and bacterial meningitis; and 5) simulations of emissions and climate change scenarios and their potential impacts on regional air quality and health outcomes over time.
Our results will enhance understanding of the social and physical systems that shape air quality in the African Sahel and particularly in northern Ghana, contribute valuable observations in a part of the world where observations are sparse, and empower communities in Africa. The work will provide quantitative knowledge that can be used to develop novel strategies to control the spread of meningitis in the face of future threats. Our results will also shed light on the interactions among human behavior, air quality, climate variability, exposure, and health outcomes, and how future changes in these factors may combine in Africa and other areas. Affordable and effective instrumentation developed and applied as part of this project will be tested and available for use in areas around the globe. Further, we will develop novel university curricula and train African and American university students in data collection. Finally, our participatory epidemiology approach, in which community members help measure air quality and report disease, will empower local communities that do not have access to vaccines. Ultimately, we will work with communities to generate scenarios in which realistic changes in cooking practices interact with climatic processes to produce improvements in air quality that reduce the burden of respiratory illness and bacterial meningitis in the African Sahel.