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A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi

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Title: A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi
Authors: Cundale, K
Thomas, R
Malaya, JK
Havens, D
Mortimer, K
Conteh, L
Item Type: Journal Article
Abstract: Pneumonia is the leading cause of mortality for children under five years in sub-Saharan Africa. Household air pollution has been found to increase risk of pneumonia, especially due to exposure from dirty burning biomass fuels. It has been suggested that advanced stoves, which burn fuel more efficiently and reduce smoke emissions, may help to reduce household air pollution in poor, rural settings. This qualitative study aims to provide an insight into the household costs and perceived benefits from use of the stove in Malawi. It was conducted alongside The Cooking and Pneumonia Study (CAPS), the largest village cluster-level randomised controlled trial of an advanced combustion cookstove intervention to prevent pneumonia in children under five to date. In 2015, using 100 semi-structured interviews this study assessed household time use and perceptions of the stove from both control and intervention participants taking part in the CAPS trial in Chilumba. Household direct and indirect costs associated with the intervention were calculated. Users overwhelming liked using the stove. The main reported benefits were reduced cooking times and reduced fuel consumption. In most interviews, the health benefits were not initially identified as advantages of the stove, although when prompted, respondents stated that reduced smoke emissions contributed to a reduction in respiratory symptoms. The cost of the stove was much higher than most respondents said they would be willing to pay. The stoves were not primarily seen as health products. Perceptions of limited impact on health was subsequently supported by the CAPS trial data which showed no significant effect on pneumonia. While the findings are encouraging from the perspective of acceptability, without innovative financing mechanisms, general uptake and sustained use of the stove may not be possible in this setting. The findings also raise the question of whether the stoves should be marketed and championed as ‘health interventions’.
Issue Date: 13-Apr-2017
Date of Acceptance: 10-Apr-2017
URI: http://hdl.handle.net/10044/1/49338
DOI: https://dx.doi.org/10.1016/j.socscimed.2017.04.017
ISSN: 0277-9536
Publisher: ELSEVIER
Start Page: 1
End Page: 10
Journal / Book Title: SOCIAL SCIENCE & MEDICINE
Volume: 183
Copyright Statement: © 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Science & Technology
Social Sciences
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Social Sciences, Biomedical
Biomedical Social Sciences
Malawi
Cookstoves
Qualitative
Economic costs
Time savings
Benefits
INDOOR AIR-POLLUTION
RANDOMIZED-CONTROLLED-TRIAL
IMPROVED COOKING STOVES
DEVELOPING-COUNTRIES
TECHNOLOGY ADOPTION
PNEUMONIA
CHILDREN
IMPACTS
MALARIA
1117 Public Health And Health Services
1601 Anthropology
1608 Sociology
Public Health
Publication Status: Published
Open Access location: http://ac.els-cdn.com/S027795361730240X/1-s2.0-S027795361730240X-main.pdf?_tid=cc2e4024-2b23-11e7-b8e0-00000aab0f6b&acdnat=1493282020_443578096c213135752aebbe65b6fb6f
Appears in Collections:School of Public Health