A pilot subsidized cook stove program for sub

A pilot subsidized cook stove program for sub. Saharan Africa Darby Jack Patrick Kinney Eleanne van Vliet Mailman School of Public Health March 12, 2009

The problem

Source: Disease Control Priorities Project (dcp 2. org)

From Kirk Smith Source: Kirk Smith

The project

Solutions • Switch to a cleaner fuel • Remove emissions from the home using a chimney • Switch to an improved stove (increased combustion efficiency)

Kintampo Health Research Centre

Enterprise. Works Gyapa Improved Woodstove

What we did We set out to answer two questions: • How much do stoves reduce exposure? • What factors lead people to permanently adopt stoves? What strategies might improve adoption?

Personal Monitoring (24 -hr) Filter-based and realtime collection of PM 2. 5

Personal Monitoring in the Field

Adoption: Focus groups and surveys • Ongoing activity – One round of stove distribution occurred last summer; second round will occur this summer, drawing on what we’ve learned • Generally, positive response – High percentage of households using stoves on follow-up visits – Continue to use 3 -stone fires, however – Some foods are harder to cook

What’s next

The big questions • How clean is clean enough? – Are there thresholds in the dose response relationship? • What interventions will get you there? – How much do stoves reduce exposure (by stove type, mode of diffusion, etc) • Does it matter when in the lifecycle exposure occurs?

Large-scale randomized trial Joint with Pat Kinney (air pollution epidemiologist), Robin Whyatt (toxicologist), and Seth Owusu (epidemiologist) • Hypothesis 1: maternal exposure during pregnancy is associated with low birth weight • Hypothesis 2: maternal exposure during pregnancy is associated with increased risk of Acute Lower Respiratory Infection (ALRI) Status: currently preparing revised proposal for NIH grant; first round was well-received, but ultimately unsuccessful.