Investigating Cooking Activity Patterns and Perceptions of Air Quality Interventions among Women in Urban Rwanda

Cooking fuel frequency use in urban Uganda: addressing household air pollution

This study examines the frequency use of cooking fuels by residents of four urban areas in Uganda (Kampala, Lira, Soroti, and M'bale). The specific objective is to identify urban dweller characteristics influencing the frequency of use of fuelwood, charcoal, kerosene, gas, or electricity in daily cooking. An ordered probit regression uses the survey data to estimate five relationships of cooking fuel use frequency generating measures of probability use in response to socio-demographic, income, and location characteristics. Charcoal and firewood remain the key cooking fuels and their use exposes families to excessive levels of toxic emissions. The probability of frequent firewood use increases among elderly, those with children or lower incomes, and residing outside Kampala. Frequency of cooking with charcoal decreases with higher age, having children, or residing in Kampala, but increases if married, with high income, or if college educated. The frequent use of liquid gas or electricity increases with income and among the college educated, but there is no detectable effect of residing in Kampala, likely due to hindered progress of expanding supply infrastructure. Targeting meal preparers with public education campaigns offers a path of changing cooking fuels use to those less polluting.

Health risk perceptions of household air pollution and perceived benefits of improved stoves among pregnant women in rural Ethiopia: a mixed method study

OBJECTIVE

Since community perceptions of the risk of biomass smoke and the benefits of improved stoves play a critical role in behaviour change to the uptake and sustainable utilisation of improved stoves, we aimed to assess the level of health risk perception on kitchen smoke and benefits of using improved stoves among pregnant women.

DESIGN

A community-based cross-sectional mixed method study.

SETTING

In six kebeles of a low-income rural community of South Gondar Zone, Northwestern Ethiopia.

PARTICIPANTS

All 455 households with pregnant women aged 18-38 years, in their first-trimester or second-trimester gestation, exclusively use traditional biomass-fuelled or locally modified mud stoves, and the primary cook in her household were included. But completed data were obtained only from 422 households.

RESULT

From 422 completed data, more than half, 63% (95% CI 58% to 68%) had high-level health risk perception of household air pollution, and nearly three-fourths, 74% (95% CI 70% to 79%) of the respondents perceived that using improved stove had benefits for their families. Participants in the 32-38 years age group, rich in asset index, presence of under-five children, being a member of any women group and large family size were positively associated with high-level health risk perception. Whereas respondents in the 18-24 years age group, presence of under-five children, husbands of primary or higher education, high health risk perception and not happy with the current stove were positively associated with perceived benefits of using an improved stove.

CONCLUSION

The observed level of health risk perception of biomass smoke and the benefits of using improved stoves may help to adopt effective intervention measures. This study also suggests that for successful intervention, clean cooking programmes and policies must consider many local factors influencing health risk perception and benefits of using improved stoves.

TRIAL REGISTRATION NUMBER

ACTR202111534227089.

Impact of Stove Renovation on PM2.5 Exposure, Risk Perception, Self-Protective Willingness of Rural Residents

To improve household air quality, the Chinese government has launched a number of pilot stove renovation projects, but few studies have explored the impact of the project on people's perception of and willingness to participate in these renovations; moreover, factors affecting willingness to pay for the project in rural China are not yet clear. We conducted a field measurement and a corresponding door-to-door questionnaire survey using the renovated group and the unrenovated group. The results showed that (1) the stove renovation project could not only reduce PM_2.5 exposure and the excess mortality risk of rural residents, but also (2) improve residents' risk perception and self-protective willingness. (3) Specifically, the project had a deeper impact on female and low-income residents. (4) Meanwhile, the higher the income and the larger family size, the higher the risk perception and self-protective willingness. (5) Furthermore, willingness to pay for the project was related with residents' support for the project, benefit from renovation, income, and family size. Our results recommended that stove renovation policies should pay more attention to families with lower income and smaller size.

Women’s Perceptions and Attitudes to Household Air Pollution Exposure and Capability to Change Cooking Behaviours in Urban Rwanda

Household air pollution (HAP) from cooking on biomass fuel presents significant health, environmental and socioeconomic consequences worldwide. However, there is a lack of understanding of the factors influencing cooking behaviours that affect HAP exposure in Rwanda (e.g., cooking location, removing children from the cooking area). Sixteen qualitative in-depth interviews were undertaken with women living in an underprivileged neighbourhood in Kigali, Rwanda. Deductive thematic analysis was carried out using the Behaviour Change Wheel (Capability—ability to engage with chosen activity, Opportunity—factors which are beyond the individual’s control and Motivation—brain processes which direct behaviour: COM-B) to determine the thoughts and perceptions around cooking location and removing children from the cooking area. Facilitators and barriers were subsequently identified within the COM-B framework for the following HAP mitigation interventions: outdoor cooking, removing children from the cooking area and Liquid Petroleum Gas (LPG) use. Of the 16 interviewed, 12 cooked outdoors (75%), two (12.5%) cooked indoors (in the main home) and two (12.5%) in a separate kitchen. Despite the majority cooking outdoors, this was reported not to be a favourable cooking location. Levels of awareness of HAP sources and knowledge of the health effects of air pollution were observed to be limited, reducing women’s capability to change, along with stated barriers of cost, housing constraints and safety. Factors out of the individuals’ control (opportunities) included weather, socio-economic and educational factors. Preconceived beliefs, experiencing smoke reduction and the briefly described short-term health effects, directed motivation. Furthermore, participants identified a need for community-based education as a facilitator to changing their behaviour. Despite a high level of observed motivation towards reducing HAP exposure, many women lacked the capability and opportunity to change their behaviour. There are research and policy implications concerning development of community-based interventions which involved end-users and relevant stakeholders in the development process.