Using longitudinal survey and sensor data to understand the social and ecological determinants of clean fuels use and discontinuance in rural Ghana

Abstract

Efforts to reduce the health and ecological burdens of household biomass combustion are underway in Ghana, principally by promoting clean cookstoves and fuels. Recent studies have focused on the sustained use of clean cookstoves, but sometimes household adopt a new cookstove and then end use of that stove. In this study, we introduce a novel framework for understanding and encouraging household transitions to cleaner cooking: clean fuel discontinuance. We leveraged data from the Ghana Randomized Air Pollution and Health Study (GRAPHS) (N = 1412) where pregnant women received either improved biomass (BioLite) or dual burner LPG stoves for free. LPG users were given free LPG refills during GRAPHS. Weekly questionnaires were administered. Stove use monitors tracked a sub-cohort (n = 220) 6 months before and after the fuel subsidy. We examined social and ecological determinants of stove use and discontinuance. Overall intervention stove use adherence was high throughout GRAPHS, with self-reported use at 69% and 86% of participant-weeks for BioLite and LPG arms respectively. Participants used intervention stoves less for meals requiring vigorous stirring. Burns from intervention stoves decreased use among BioLite (RR: 0.96, p = 0.009), but not LPG users. Device breakage was mentioned as an impediment in 18% of free-text responses for LPG users and 1% for BioLite. Tree canopy within a spatial buffer—a plausible proxy for biomass fuels access—was the only variable explaining LPG discontinued stove use in adjusted Cox time-to-event analyses (HR = −0.56, p < 0.001). Future studies should consider the stove use discontinuance framework.

Enhancing LPG Adoption in Ghana (ELAG): A Trial Testing Policy-Relevant Interventions to Increase Sustained Use of Clean Fuels

“…It has long been observed that receiving or purchasing a new cookstove (adoption) does not mean recipients will sustain use of the stove over time [ 11 – 13 ], which we have also observed in Ghana [ 9 , 10 , 14 ]. Research has found that there are many determinants of cookstove adoption and sustained use, broadly categorized into: (1) household/community characteristics, (2) access issues, and (3) knowledge, perceptions, and attitudes [ 12 , 15 – 18 ].…”

“…Energy access research underscores the importance of the “last mile” (or, more realistically in rural Ghana, last 30 km) of LPG delivery/accessibility [ 14 ]. Few studies have tested how much these logistical barriers impact user demand [ 47 ].…”

The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS)

“…A limitation of GRAPHS is that there was not comprehensive stove use monitoring during all personal air pollution monitoring sessions or throughout the longer study period. Use of non-intervention stoves was reported during GRAPHS based on weekly household surveys, as reported in the Supporting Information and published elsewhere 63 . However, given the lack of complete stove use monitoring we are unable to undertake a full analysis of the contributions of stove use to observed personal exposure.…”

A comprehensive review of the production, adoption and sustained use of biomass pellets in Ghana

“…Another major bottleneck to pellet production and use is the lack of public awareness [ 120 ]. While most Ghanaians still lack clean fuel awareness, others perceive it to be costly [ 138 ]. In Indonesia, the lack of public education has caused biomass pellets to not become common in rural communities [ 139 ].…”