The NIH, in partnership with USAID, the CDC, the EPA and the Global Alliance for Clean Cookstoves (GACC), launched a
Clean Cooking Implementation Science Network (ISN) to advance the science of uptake and scale-up of clean cooking technology in the developing world. Sustained, near-exclusive use of clean cooking technology is understood to be key to improving multiple important health outcomes by reducing exposure to household air pollution.
About the Clean Cooking ISN
Hosted by the
Center for Global Health Studies (CGHS) at Fogarty, and supported by the
NIH Common Fund, the primary goal of the Clean Cooking ISN is to advance the scientific understanding of how to implement evidence-based clean cooking interventions to maximize their benefits to the health and longevity of populations in low- and middle-income countries (LMICs).
Significant implementation challenges exist in the clean cooking arena concerning the adoption and use of technologies that reduce pollutant exposures sufficiently to achieve health benefits. These challenges can multiply when the goal is scaling up these technologies. Successful scale-up will depend on understanding the complex interplay among multiple environmental, economic, behavioral and other setting-specific factors.
To meet its objectives, the Clean Cooking ISN aims to foster collaboration among researchers and implementers. Each year since 2016, the Network has supported projects designed to advance the science of clean cooking implementation at scale.
The Clean Cooking ISN supported the development of 11 case studies of large-scale clean fuel programs in regions across Africa, Latin America and Asia. They are published in
Scaling up Clean Fuel Cooking Programs, an open access special issue of
Energy for Sustainable Development (October 2018).
The Clean Cooking ISN has also contributed to scoping and policy papers.
Projects Supported by the Clean Cooking ISN
One-year Research Projects, Workshops and Analytical Tools
In 2018, the Clean Cooking ISN funding cycle focused on research projects, as well as workshops and analytical tools to extend the learning of the network to the broader HAP community. Nine projects are currently being supported.
Workshop on Household Energy Impact Evaluation (WHEIE)
Ellison Carter, Ph.D. (Colorado State University)
Katherine Dickinson, Ph.D. (Colorado School of Public Health)
The Workshop on Household Energy Impact Evaluation (WHEIE) aims to accelerate transitions toward cleaner household energy systems by providing targeted, specific training on policy-oriented impact evaluation research designs. This training will bridge a current gap in the clean cooking sector between small-scale, investigator-led intervention studies, and large-scale policies and programs in low- and middle- income countries (LMIC) that often lack strong monitoring and evaluation components. Quasi- experimental methods for impact evaluation provide an opportunity for researchers to learn about the real- world impacts of household energy transitions across a wider variety of settings, while simultaneously providing practitioners with actionable information on best practices to accelerate change in this sector.
System Science Training Workshop for Clean Cooking GEOHealth Researchers and Practitioners
Project PI: Gautam Yadama, Ph.D. (Boston College)
This project will convene a workshop to introduce two system science methods (community based system dynamics and network analysis) and their application in understanding complex adaptive systems and the role of social networks in the uptake and use of clean cooking technologies. The workshop will leverage ongoing research and capacity building efforts by the Global Environmental and Occupational Health (GEOHealth) Network to enhance efforts to understand and address these issues in low- and middle-income countries (LMIC). Each GEOHealth hub features a collaboration between one institution in the United States (US) to coordinate research training and one LMIC institution focused on conducting research.
Improving Stove Use Monitoring with Better Tools and Workshops
Project PI: Ajay Pillarisetti, Ph.D. (UC Berkeley)
Stove use monitors (SUMs), typically data-logging thermometers, revolutionized our understanding of how and when people use their cooking appliances. Two key challenges have arisen, however, in (1) analyzing SUMs data to provide rapid and actionable guidance to programs and program evaluators, a step that requires quickly translating raw temperature data into meaningful metrics of stove use, and (2) ensuring field partners follow best practices for the deployment of SUMS, especially physical installation of sensors (which involves many compromises) and the management of data collection & warehousing. This proposal addresses these challenges by a) upgrading SUMSarizer: a free, open-source (MIT license), state-of-the- art software tool built to facilitate analysis of stove use monitoring data; and b) Holding a SUMs workshop in Pune, India, focusing on SUMs best practices.
Proposal for model development of intensive exposure sampling sub-sample of the Household Air Pollution Intervention Network (HAPIN) Trial population
Project PI: Michael Johnson, Ph.D. (Berkeley Air)
This project is a validation sub-study of exposure measurement in the Household Air Pollution Intervention Network (HAPIN) trial, an ongoing multi-country intervention randomized controlled trial of an LPG stove and fuel intervention in Rwanda, Guatemala, India, and Peru. This exposure validation sub-study increases the exposure sampling frequency in a subset of the HAPIN population in order to enable analyses that will more accurately characterize the predictive performance of the exposure assessment strategy in the main study. It will also serve to develop a general model to predict personal PM2.5 exposures; such a model is needed for other studies in which no or minimal personal PM2.5 samples are collected.
Evaluating LPG Consumption Behavior: Identifying and testing conservation strategies to maximize affordability and sustainability of exclusive LPG use
Project PI: William Checkley, Ph.D. (Johns Hopkins University)
Although use of clean fuel such as liquefied petroleum gas (LPG) could alleviate the burden of household air pollution in many LMICs, the high cost of LPG makes it unaffordable for most rural populations. In this project, the researchers will conduct a series of observations, interviews, and systematic water boiling tests to identify strategies for gas conservation, and evaluate the impact of these strategies on gas consumption and emissions when implemented with rural households in Puno, Peru. The results will inform the development of a toolkit for promoting LPG conservation to increase the affordability of exclusive LPG use, which could be integrated into clean energy programs across LMIC settings.
Building capacity to evaluate clean cooking in Ecuador
Alfredo Valarezo, Ph.D. (Universidad San Francisco de Quito)
Darby Jack, Ph.D. (Columbia University)
This study will (i) Create and build capacity for a personal exposure to air pollution and stove monitoring research center at an Ecuadorian university, and supplement training with pilot evaluations of multiple fuel use and personal exposure to air pollution in selected contexts; and (ii) Use existing data to assess household-level induction stove use in all households participating in the Programa de coccion eficiente, a program promoting transition to induction (electric) cookstoves.
Understanding the HAP impacts of alternative stove, fuel and cooking practices stacking patterns
Project PI: Omar Masera, Ph.D. (Universidad Nacional Autónoma de México)
This study will examine air pollution exposure reductions (PM2.5 and CO) associated with different stacking patterns of stoves, fuels and cooking practices and other typical household uses of solid biofuels in rural Mexico. To achieve this objective, the researchers will integrate several databases covering primary data collected in previous years of field and laboratory work. They will also build on their experience with the single-zone Model developed by WHO to estimate the HAP kitchen concentrations from stove emissions data, which has been already parameterized and validated for Mexico. The activities will be carried out in two simulated kitchens, equipped specifically for HAP measurements.
Slicing the Exposure Pie: Modeling Personal HAP Exposure Attributable to Multiple Sources in Ghana
Project PI: Michael Hannigan, Ph.D. (Colorado School of Public Health)
In this project the researchers aim to develop, implement, and validate a tool that apportions CO and PM2.5 exposures to specific sources by fusing three types of continuous data: participant exposure, participant proximity to source, and source use. To enable the generalizability of the tool, they will undertake this effort at two study sites in Ghana (Navrongo and Kintampo). In each of these sites, ongoing interventions are examining LPG stove adoption and its associated health and economic impacts.
Integration of System Science Approaches to Enhance Understanding of Adoption and Sustained Use of Clean Cookstoves in Humanitarian Settings in Rwanda
Project PI: Anita Shankar, Ph.D. (Johns Hopkins University)
This study builds upon an on-going randomized control trial (RCT) supported by the Global Alliance for Clean Cookstoves (GACC) and the World Bank (WB)/Sexual Violence Research Initiative (SVRI) to examine the role of cleaner cooking systems in improving women’s health and well-being within a humanitarian context. The RCT is being undertaken in the Kigeme camp in Rwanda and is assessing the impacts of systematically introducing the Inyenyeri pellet distribution program and the Mini-Moto gasifier stove, a Tier 4 biomass stove, to all 3,900 refugee households. The overall objective of the present study is to incorporate system science approaches within this ongoing funded project to examine factors that impact adoption and use of cleaner cooking systems in a humanitarian setting in Rwanda.
Two-year Adoption and Sustained Use Studies
In 2016, the network invited proposals for research support linked to existing funded and active clean cooking research or implementation programs that advance generalizable learning. The first cycle supported four research projects.
Enhancing adoption and use of liquefied petroleum gas (LPG): an implementation science approach to understanding key determinants and impacts of local interventions to address financial constraints
The LPG Adoption in Cameroon Evaluation-2 Study (LACE-2)
Daniel Pope, Ph.D. (University of Liverpool)
Bertrand Mbatchou, M.D. (Douala General Hospital)
Building on the ongoing "LPG Adoption in Cameroon Evaluation" (LACE) study in Cameroon, the LACE-2 project will implement two interventions aimed at increasing adoption of liquefied petroleum gas (LPG) as a cooking fuel in peri-urban and rural regions of Cameroon. The first is a loan/credit intervention that will be studied via a community-level matched treatment-control study. The managed loan, which will cover the cost of the LPG start-up kit and periodic LPG refills, will be paid back in a maximum of 12 monthly installments. The second intervention is a pressure cooker intervention that aims to shorten the cooking time for preparing certain common foods. For both intervention studies, surveys, stove use and air pollution monitoring will be conducted in intervention and control households to determine the proportion of cooking carried out using LPG over the year. The project will also implement Photovoice, a qualitative participatory methodology, with the aim of understanding the societal and cultural factors that influence initial adoption and sustained use of LPG as a fuel. Lastly, the project researchers will conduct a mixed-methods evaluation of enablers and barriers to the adoption and sustained use of LPG.
Enhancing liquefied petroleum gas (LPG) use during pregnancy
Kalpana Balakrishnan, Ph.D. (Sri Ramachandra University)
Sanjay Juvekar, Ph.D. (KEM Hospital Research Centre)
Kirk Smith, Ph.D. (University of California, Berkeley)
A major transition in the life of many Indian women occurs at the time of their marriage, which for 60-80% of women is also followed by pregnancy within a year. "Enhancing LPG Use during Pregnancy" targets this important life transition as a potential moment for implementation of behavior change. Borrowing from successes in other global health areas, the project will implement a conditional cash transfer (CCT) program focusing on newly married and newly pregnant women in the northern Pune district of Maharashtra, India. A specially modified stove use monitor (SUM) called the "Pink Key" will be installed on LPG stoves, tracking stove use. When a pregnant woman brings the Pink Key to her antenatal health visits, she will receive a small cash payment for each meal prepared using the stove, thus encouraging exclusive use of the LPG technology during pregnancy. The effect of the program on stove use will be evaluated using SUMs tracking on LPG and traditional stoves, air pollution monitoring, and time-activity tracking.
Prices, peers and perceptions: opportunities for scaling up liquefied petroleum gas (LPG) adoption in Northern Ghana
Abraham Oduro, M.D., Ph.D. (Navrongo Health Research Centre)
Maxwell Dalaba, Ph.D. (Navrongo Health Research Centre)
Katie Dickinson, Ph.D. (University of Colorado-Boulder and National Center for Atmospheric Research)
The government of Ghana has set the ambitious goal of expanding LPG access to 50% of the country by 2020, but currently LPG access varies widely, with the northern reaches of the country having some of the lowest LPG adoption rates. The "Prices, Peers, and Perceptions" project is located in the Kassena-Nankana Districts of northern Ghana, where only 7% of households were using LPG as their main cooking fuel as of 2013. This collaborative implementation science project begins, first, with supply- and demand-side analyses. On the supply side, the project team will analyze barriers to LPG distribution and how they might be overcome; while on the demand side they will explore the role of PRICES (upfront fixed cost of stoves and variable cost of fuel, as well as credit and savings constraints), PEERS (information and encouragement from social contacts), and PERCEPTIONS (safety, health benefits, suitability for cooking local dishes) on LPG adoption decisions. The team will also conduct a series of experiments to evaluate willingness-to-pay (WTP) for different LPG intervention packages. In these experiments, intervention packages comprised of different combinations of cylinder refilling options (status quo vs. cylinder recirculation with home delivery); refill vouchers; and financing options (lump sum vs. payment plan) will be presented to participants. Follow-up work to measure stove use, fuel stacking, and perceptions of LPG will be used to determine the effectiveness of the interventions toward the goal of expanding LPG adoption and sustained use in the region.
Understanding household, network and organizational drivers of adoption, sustained use and maintenance of clean cooking fuels in rural India
Gautam Yadama, Ph.D. (Washington University in St. Louis)
William Checkley, M.D., Ph.D. (Johns Hopkins University)
In rural India, 80% of households continue to use biomass fuels for cooking. Despite the fact that the Government of India has committed to redesigning their LPG policy and distribution to penetrate rural communities using a combination of direct cash transfer programs, campaigns encouraging non-poor to give up LPG subsidies (GiveItUp), and smaller LPG cylinders, empirical evidence on determinants of adoption and sustained use of LPG among energy poor communities is weak and anecdotal. Located in the Chitoor district of Anhra Pradesh, this project examines factors that influence the adoption, sustained use, and maintenance of LPG cooking in below poverty line (BPL) households in rural India. Using a combination of closed-ended questionnaires, stove use monitoring, and gendered social network analysis, the project aims to a) determine the factors that distinguish LPG-adopter BPL households from non-adopters; b) among adopter households, examine how the "3 A's" - affordability, accessibility and awareness - influence use of LPG versus traditional fuels (fuel stacking behavior); and c) evaluate the influence of social networks on LPG adoption and sustained use, following the hypothesis that adopter households will have more open and less kin-based social networks that facilitate fuel switching. The project will apply the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to explore LPG use and distribution at household, community, and block levels.
Ashlinn Quinn, Ph.D. (NIH/Fogarty)
Joshua P. Rosenthal, Ph.D. (NIH/Fogarty)
Clean Cooking Implementation Science Network Steering Committee
- Donee Alexander (Global Alliance for Clean Cookstoves)
- David Chambers (NIH/NCI)
- Kimberly Gray (NIH/NIEHS)
- Marion Koso-Thomas (NIH/NICHD)
- Sumi Mehta (Vital Strategies)
- John Mitchell (EPA)
- Gila Neta (NIH/NCI)
- Concepcion (Marie) Nierras (NIH/OD)
- Helen Petach (USAID)
- Antonello Punturieri (NIH/NHLBI)
- Mike Sage (CDC)
- Rachel Sturke (NIH/Fogarty)
- Claudia Thompson (NIH/NIEHS)
Clean Cooking Implementation Science Network Members
- Kwaku Poku Asante (Kintampo Health Research Center, Ghana)
- Kalpana Balakrishnan (Sri Ramachandra University, India)
- Kiros Berhane (University of Southern California, USA)
- Nigel G. Bruce (University of Liverpool, England)
- William Checkley (Johns Hopkins University, USA)
- Katherine (Katie) Dickinson (Colorado School of Public Health, USA)
- Jay Graham (Public Health Institute, USA)
- Sudhanshu (Ashu) Handa (University of North Carolina, USA)
- Darby Jack (Columbia University, USA)
- Pamela Jagger (University of North Carolina at Chapel Hill, USA)
- S M Munjurul Hannan Khan (Ministry of Environment and Forests, Bangladesh)
- Omar Masera (Universidad Nacional Autónoma de México, Mexico)
- Ilse Ruiz Mercado (Universidad Nacional Autónoma de México, Mexico)
- Subhrendu K. Pattanayak (Duke University, USA)
- Elisa Puzzolo (The Global LPG Partnership, USA)
- Anita Shankar (Johns Hopkins Bloomberg School of Public Health, USA)
- Kenneth Sherr (University of Washington, USA)
- Kirk R. Smith (University of California at Berkeley, USA)
- Lisa Thompson (Emory University, USA)
- James M. Tielsch (George Washington Milken Institute of Public Health, USA)
- Gautam N. Yadama (Boston College School of Social Work, USA)
Updated September 4, 2018