Using longitudinal survey and sensor data to understand the social and ecological determinants of clean fuels use and discontinuance in rural Ghana

• Type of Material: Article
• Authors: D Carrión, Icahn School of Medicine at Mount Sinai; R Prah, Kintampo Health Research Centre; CF Gould, Columbia University; F Agbokey, Kintampo Health Research Centre; M Mujtaba, Kintampo Health Research Centre; Ajay Pillarisetti, Emory University; M Tumasi, Kintampo Health Research Centre; O Agyei, Kintampo Health Research Centre; S Chillrud, Columbia University; T Tawiah, Kintampo Health Research Centre; D Jack, Columbia University; KP Asante, Kintampo Health Research Centre
• Language: English
• Date: 2020-09-01
• Publisher: IOP Publishing Ltd
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 The Author(s). Published by IOP Publishing Ltd
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1088/2515-7620/abb831
• Title of Journal or Parent Work: ENVIRONMENTAL RESEARCH COMMUNICATIONS
• Volume: 2
• Issue: 9
• Grant/Funding Information: This work was supported by the National Institute of Environmental Health Sciences, NIH R01ES019547, R01ES024489, and P30ES009089.; CFG was supported by T32ES007322. AP is supported by P30ES019776.
• Keywords: energy transitions; COOKING; sustained use; BARRIERS; Science & Technology; Environmental Sciences & Ecology; HEALTH; COLLECTION; Environmental Sciences; Life Sciences & Biomedicine; COOKSTOVES; clean cookstoves; HOUSEHOLDS; energy access; INTERVENTIONS; biomass combustion; TRANSTHEORETICAL MODEL; discontinued use; ADOPTION; STOVES

Abstract

Efforts to reduce the health and ecological burdens of household biomass combustion are underway in Ghana, principally by promoting clean cookstoves and fuels. Recent studies have focused on the sustained use of clean cookstoves, but sometimes household adopt a new cookstove and then end use of that stove. In this study, we introduce a novel framework for understanding and encouraging household transitions to cleaner cooking: clean fuel discontinuance. We leveraged data from the Ghana Randomized Air Pollution and Health Study (GRAPHS)(N = 1412) where pregnant women received either improved biomass (BioLite) or dual burner LPG stoves for free. LPG users were given free LPG refills during GRAPHS. Weekly questionnaires were administered. Stove use monitors tracked a sub-cohort (n = 220) 6 months before and after the fuel subsidy. We examined social and ecological determinants of stove use and discontinuance. Overall intervention stove use adherence was high throughout GRAPHS, with self-reported use at 69% and 86% of participant-weeks for BioLite and LPG arms respectively. Participants used intervention stoves less for meals requiring vigorous stirring. Burns from intervention stoves decreased use among BioLite (RR: 0.96, p = 0.009), but not LPG users. Device breakage was mentioned as an impediment in 18% of free-text responses for LPG users and 1% for BioLite. Tree canopy within a spatial buffer—a plausible proxy for biomass fuels access—was the only variable explaining LPG discontinued stove use in adjusted Cox time-to-event analyses (HR = −0.56, p < 0.001). Future studies should consider the stove use discontinuance framework.