Women, Energy and Economic EmpowermentBoiling Point, Issue 66, 2015.

This issue’s theme on Women, Energy and Economic Empowerment shines light on the role of women in reaching energy products and services to the poor and ‘difficult to reach’ consumers. The issue also explores the impact that women led micro and small enterprises (MSEs) selling energy services can have, with respect to household spending, poverty, gender equality and local markets and economies. Because of their role as household energy managers and through their formal and informal networks, women are in a unique position to connect with their peers, increase awareness and deliver energy products and services.

As users, they know what features energy products should have. At the same time, when women who are home-based micro and small scale business owners or workers get energy access, they stand to benefit tremendously through increased productivity and lowered costs, resulting in increased incomes benefitting families, societies and local markets. ENERGIA taps into this huge potential of women-led MSEs in scaling up energy access with its recently launched Women’s Economic Empowerment Programme (WE).

Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic reviewBMC Public Health, July 2015.

Authors: Emma Thomas, Kremlin Wickramasinghe, et al.

Background: Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.

Methods: We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.

Results: The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.

Conclusions: Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators


USAID and Global Alliance for Clean Cookstoves Jointly Fund Research on Clean Cooking Adoption

July 2015 – The USAID Translating Research into Action Project (TRAction) and the Global Alliance for Clean Cookstoves (the Alliance) are funding three research projects to study the adoption of clean cooking technology to reduce household air pollution.

TRAction and the Alliance aim to better understand the barriers and motivators for using clean cooking technology through these research awards, which will be implemented by teams from the University of North Carolina (UNC), University of California-San Francisco (UCSF), and the Kintampo Health Research Center. All research studies will commence in June 2015.

Read more on the Alliance website.

Targeting Household Air Pollution for Curbing the Cardiovascular Disease Burden: A Health Priority in Sub-Saharan AfricaThe Journal of Clinical Hypertension, July 2015.

Authors: Jean Jacques N. Noubiap, Mickael Essouma and Jean Joel R. Bigna

Household air pollution (HAP) is a major public health problem, particularly in sub-Saharan Africa where most of the populations still rely on solid fuels for cooking, heating, and lighting. This narrative review highlights the direct and indirect evidence of the important role of HAP in cardiovascular disease, especially in sub-Saharan African countries where highest rates of major cardiovascular disease and death are observed, and thus provides ample reason for promotion of preventive interventions to reduce HAP exposures in the region. There is an urgent need for efficient strategies to educate populations on the health issues associated with this health hazard, to provide affordable clean cooking energy for poor people and to promote improved household ventilation. High-quality data on household energy practices and patterns of HAP and related health issues are still needed for efficient policy making in this region.

Cluster-randomized controlled trial to evaluate the Rwanda Ministryof Health and DelAgua Health “Tubeho Neza” large-scale distribution of cookstoves and water filters in Western Province, Rwanda, 2015. DelAgua.

Authors: Thomas Clasen, Corey Nagel, Evan Thomas

Preliminary results suggest that after 2 years, the Phase 1 program achieved a 46% reduction in diarrhoea in children under 5, a 73% reduction in household air pollution for families cooking outdoors, and a 27.7% reduction in cookstove emission exposure among children. If similar reductions are sustained throughout Phase 2, this program may save more than 30 children’s lives a year, and avert over 2,500 disability-adjusted life-years (DALYs) annually.


Household and community poverty, biomass use, and air pollution in Accra, Ghana. Proc Natl Acad Sci U S A. 2011 Jul 5.

Authors: Zheng Zhou, Kathie L. Dionisio, et al.

Many urban households in developing countries use biomass fuels for cooking. The proportion of household biomass use varies among neighborhoods, and is generally higher in low socioeconomic status (SES) communities. Little is known of how household air pollution varies by SES and how it is affected by biomass fuels and traffic sources in developing country cities. In four neighborhoods in Accra, Ghana, we collected and analyzed geo-referenced data on household and community particulate matter (PM) pollution, SES, fuel use for domestic and small-commercial cooking, housing characteristics, and distance to major roads.

Cooking area PM was lowest in the high-SES neighborhood, with geometric means of 25 (95% confidence interval, 21–29) and 28 (23–33) μg/m3 for fine and coarse PM (PM2.5 and PM2.5–10), respectively; it was highest in two low-SES slums, with geometric means reaching 71 (62–80) and 131 (114–150) μg/m3 for fine and coarse PM. After adjustment for other factors, living in a community where all households use biomass fuels would be associated with 1.5- to 2.7-times PM levels in models with and without adjustment for ambient PM.

Community biomass use had a stronger association with household PM than household’s own fuel choice in crude and adjusted estimates. Lack of regular physical access to clean fuels is an obstacle to fuel switching in low-income neighborhoods and should be addressed through equitable energy infrastructure.

Lessons From Rural Madagascar on Improving Air Quality in the Kitchen. Jnl Environ Dev, June 2015.

Authors: Susmita Dasgupta, Paul Martin. Hussain A. Samad

The World Bank, Washington, DC, USASusmita Dasgupta, The World Bank, 1818 H Street, Washington, DC 20433, USA. Email: sdasgupta@worldbank.org

Household air pollution is the second leading cause of disease in Madagascar, where more than 99% of households rely on solid biomass for cooking. This article presents findings and conclusions from an initiative to monitor household air pollution in rural Madagascar. The average concentrations of fine particulate matter and carbon monoxide in kitchens significantly exceeded World Health Organization guidelines for indoor exposure. A fixed-effect panel regression analysis was conducted to investigate the effects of fuel (charcoal, wood, and ethanol), stove (traditional, improved charcoal and wood, and ethanol), kitchen size, ventilation, building materials, and ambient environment.

Ethanol is significantly cleaner than biomass fuels, and a larger kitchen significantly improves the quality of household air. Although improved wood stoves with a chimney were effective in reducing concentrations of carbon monoxide in the kitchen, improved charcoal stoves were found to have no significant impact on air quality compared with traditional charcoal stoves. The findings reinforce the need for initiatives that foster fuel switching and improved ventilation as critical first steps to fight unhealthy household air pollution in developing countries.


Indoor Particulate Matter Concentration, Water Boiling Time, and Fuel Use of Selected Alternative Cookstoves in a Home-Like Setting in Rural Nepal.

Authors: Kristen D. Ojo, Sutyajeet I. Soneja, et al.

Alternative cookstoves are designed to improve biomass fuel combustion efficiency to reduce the amount of fuel used and lower emission of air pollutants. The Nepal Cookstove Trial (NCT) studies effects of alternative cookstoves on family health. Our study measured indoor particulate matter concentration (PM2.5), boiling time, and fuel use of cookstoves during a water-boiling test in a house-like setting in rural Nepal. Study I was designed to select a stove to be used in the NCT; Study II evaluated stoves used in the NCT. In Study I, mean indoor PM2.5 using wood fuel was 4584 μg/m3, 1657 μg/m3, and 2414 μg/m3 for the traditional, alternative mud brick stove (AMBS-I) and Envirofit G-series, respectively. The AMBS-I reduced PM2.5 concentration but increased boiling time compared to the traditional stove (p-values < 0.001). Unlike AMBS-I, Envirofit G-series did not significantly increase overall fuel consumption.

In Phase II, the manufacturer altered Envirofit stove (MAES) and Nepal Nutrition Intervention Project Sarlahi (NNIPS) altered Envirofit stove (NAES), produced lower mean PM2.5, 1573 μg/m3 and 1341 μg/m3, respectively, relative to AMBS-II 3488 μg/m3 for wood tests. The liquid propane gas stove had the lowest mean PM2.5 concentrations, with measurements indistinguishable from background levels. Results from Study I and II showed significant reduction in PM2.5 for all alternative stoves in a controlled setting. In study I, the AMBS-I stove required more fuel than the traditional stove. In contrast, in study II, the MAES and NAES stoves required statistically less fuel than the AMBS-II.

Reductions and increases in fuel use should be interpreted with caution because the composition of fuels was not standardized—an issue which may have implications for generalizability of other findings as well. Boiling times for alternative stoves in Study I were significantly longer than the traditional stove—a trade-off that may have implications for acceptability of the stoves among end users. These extended cooking times may increase cumulative exposure during cooking events where emission rates are lower; these differences must be carefully considered in the evaluation of alternative stove designs.

The Economics of Household Air Pollution. Annual Review of Resource Economics, July 2015.

Authors: Marc Jeuland, Sanford School of Public Policy and Duke Global Health Institute, Duke University, Durham, NC 27517; email: marc.jeuland@duke.edu ; Subhrendu K. Pattanayak Sanford School of Public Policy, Duke Global Health Institute, Nicholas School of the Environment, and Department of Economics, Duke University, Durham, North Carolina 27517; email: subhrendu.pattanayak@duke.edu; Randall Bluffstone, Department of Economics, Portland State University, Portland, OR 97207; email: bluffsto@pdx.edu

Traditional energy technologies and consumer products contribute to household well-being in diverse ways but also often harm household air quality. We review the problem of household air pollution at a global scale, focusing particularly on the harmful effects of traditional cooking and heating. Drawing on the theory of household production of health, we illustrate the ambiguous relationship between household well-being and adoption of behaviors and technologies that reduce air pollution. We then review how the theory relates to the seemingly contradictory findings emerging from the literature on household demand for clean fuels and stoves. In conclusion, we describe an economics research agenda to close the knowledge gaps so that policies and programs can be designed and evaluated to solve this critical global problem.

Expected final online publication date for the Annual Review of Resource Economics Volume 7 is October 05, 2015. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.

Association between wood cooking fuel and maternal hypertension at delivery in central East IndiaHypertension in Pregnancy, July 2015.

Authors: Blair J. Wylie, Mrigendra P. Singh, Brent A. Coull, Ashlinn Quinn, Kojo Yeboah-Antwi, Lora Sabin, Davidson H. Hamer, Neeru Singh, and William B. MacLeod

Objective: Smoke from burning of biomass fuels has been linked with adverse pregnancy outcomes and hypertension among nonpregnant subjects; association with hypertension during pregnancy has not been well studied. We evaluated whether the use of wood cooking fuel increases the risk of maternal hypertension at delivery compared to gas which burns with less smoke. Methods: Information on fuel use and blood pressure was available for analysis from a cross-sectional survey of 1369 pregnant women recruited at delivery in India.

Results: Compared to gas users, women using wood as fuel had on average lower mean arterial pressure (adjusted effect size − 2.0 mmHg; 95% CI: −3.77, −0.31) and diastolic blood pressure (adjusted effect size −1.96 mmHg; 95% CI: −3.60, −0.30) at delivery. Risk of hypertension (systolic >139 mmHg or diastolic >89 mmHg) was 14.6% for wood users compared to 19.6% for gas users although this did not reach significance after adjustment, using propensity score techniques, for factors that make wood and gas users distinct (adjusted prevalence ratio 0.76; 95% CI: 0.49, 1.17).

Conclusions: Combustion products from the burning of biomass fuels are similar to those released with tobacco smoking, which has been linked with a reduced risk for preeclampsia. The direction of our findings suggests the possibility of a similar effect for biomass cook smoke. Whether clean cooking interventions being promoted by international advocacy organizations will impact hypertension in pregnancy warrants further analysis as hypertension remains a leading cause of maternal death worldwide and cooking with biomass fuels is widespread.