A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi.
A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi.
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DOI：
10.1016/j.socscimed.2017.04.017
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Conteh L
中科院分区：
文献类型：
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作者：
Cundale K;Thomas R;Malava JK;Havens D;Mortimer K;Conteh L
肺炎是撒哈拉以南非洲五岁以下儿童死亡的主要原因。已发现家庭空气污染会增加患肺炎的风险，特别是由于暴露于肮脏燃烧的生物质燃料。有人建议，更有效地燃烧燃料和减少烟雾排放的先进炉灶可能有助于减少贫困农村地区的家庭空气污染。这项定性研究的目的是深入了解马拉维家庭使用炉子的成本和预期收益。该研究与“烹饪与肺炎研究”（CAPS）同时进行，CAPS是迄今为止最大规模的村群水平随机对照试验，旨在采用先进燃烧炉灶干预措施预防5岁以下儿童肺炎。2015年，本研究通过100次半结构化访谈，评估了参加Chilumba CAPS试验的对照组和干预组参与者的家庭使用时间和对炉子的看法。计算了与干预相关的家庭直接和间接成本。绝大多数用户都喜欢使用这个炉子。报告的主要好处是减少了烹饪时间和减少了燃料消耗。在大多数访谈中，最初并没有将健康益处确定为炉子的优点，尽管在提示时，答复者表示，减少烟雾排放有助于减少呼吸道症状。炉子的价格比大多数受访者愿意支付的价格要高得多。这些炉灶最初并不被视为保健产品。对健康影响有限的看法随后得到CAPS试验数据的支持，该数据显示对肺炎没有显著影响。虽然从可接受性的角度来看，调查结果令人鼓舞，但如果没有创新的融资机制，在这种情况下可能无法普遍接受和持续使用炉子。研究结果还提出了一个问题，即是否应该将这种炉灶作为“健康干预措施”进行营销和宣传。首次评估马拉维家庭对先进炉灶试验的看法。我们研究密集边际，即如何使用和感知技术。据报道，减少烹饪和燃料收集时间带来了显著的好处。除非得到提示，否则受访者很少将炉灶与健康益处联系起来。需要解决先进炉灶的高成本问题，以确保未来的普及。
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’. The first evaluation of household perceptions of an advanced cookstove trial in Malawi. We investigate the intensive margin, i.e. how the technology is used and perceived. Significant benefits from reduced cooking and fuel collection times were reported. Unless prompted, respondents rarely associated the stoves with health benefits. The high cost of the advanced cookstove will need addressing to ensure future uptake.