Low-smoke chulha in Indian slums: study protocol for a randomised controlled trial

Abstract

BackgroundBiomass fuel is used as a primary cooking source by more than half of the world’s population, contributing to a high burden of disease. Although cleaner fuels are available, some households continue using solid fuels because of financial constraints and absence of infrastructure, especially in non-notified slums. The present study documents a randomised controlled study investigating the efficacy of improved cookstove on the personal exposure to air pollution and the respiratory health of women and children in an Indian slum. The improved cookstove was based on co-creation of a low-smoke chulha with local communities in order to support adaption and sustained uptake.MethodsThe study will be conducted in a non-notified slum called Ashrayanagar in Bangalore, India. The study design will be a 1:1 randomised controlled intervention trial, including 250 households. The intervention group will receive an improved cookstove (low-smoke chulha) and the control group will continue using either the traditional cookstove (chulha) or a combination of the traditional stove and the kerosene/diesel stove. Follow-up time is 1 year. Outcomes include change in lung function (FEV1/FVC), incidence of pneumonia, change in personal PM2.5 and CO exposure, incidence of respiratory symptoms (cough, phlegm, wheeze and shortness of breath), prevalence of other related symptoms (headache and burning eyes), change in behaviour and adoption of the stove. Ethical clearance was obtained from the Institutional Ethics Committee of the Indian Institute of Public Health Hyderabad- Bengaluru Campus.DiscussionThe findings from this study aim to provide insight into the effects of improved cookstoves in urban slums. Results can give evidence for the decrease of indoor air pollution and the improvement of respiratory health for children and women.Trial registrationThe trial was registered with clinicaltrials.gov on 21 June 2016 with the identifier NCT02821650; A Study to Test the Impact of an Improved Chulha on the Respiratory Health of Women and Children in Indian Slums.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4369-6) contains supplementary material, which is available to authorized users.

Do we need better behaved cooks? Reviewing behavioural change strategies for improving the sustainability and effectiveness of cookstove programs

“…It should be noted that there is no standard duration or intensity of use that defines "adoption" of improved cookstoves. In this sense, we agree with Brakema et al, [26] when they refer to Thakur's et al, work [27] and claim that "generating new evidence on implementation is useful, but only provided that implementation strategies and processes are reported in detail, adoption rates and stove-stacking are systematically and objectively assessed, and follow-up time is 4 years or more... Although this can be challenging, this should be the norm for future implementation studies [26]".…”

Cooking Microenvironment and Health: A Cross-Sectional Study of Solid Fuels Users in Urban Slums in India

“…In the current study, we focus on the crosssectional analysis of the baseline data of a randomised controlled trial, [32] which was conducted in four slums in Bangalore, India (Supplementary Figure S1). Bangalore as a rapidly urbanising city attracts migrants from all over India, and because of a lack of proper infrastructure to accommodate this population; slums continue to crop up across the city.…”

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

“…Non-specific studies were mentioned 106 times, with most of the studies also being conducted on the city level (50%). These are, for example, studies on aging and the related effects or questions [76,77], studies on the influence of community centers [78], noise exposure [79], the impact of climate change on health [80], the influence of smoke from cooking stations [81], and general studies on sanitation that do not investigate its influence on a specific infectious disease.…”