Researchers Examining the Impacts of Clean Cooking on Children’s Health

Child Survival Workshop in Nepal Provides Preview of Studies’ Preliminary Results

How much can clean cookstoves and fuels reduce the incidence of pneumonia in children? Does using clean cooking technologies and fuels during pregnancy boost birth weights?

These were two of the many questions under discussion by 30 leading global public health researchers during a three-day meeting to discuss how clean cooking impacts children’s health. The Child Survival Workshop, co-hosted by the Alliance and Johns Hopkins University, provided experts with an opportunity to exchange lessons from the field and to take a first look at early results of ongoing research evaluating the child health benefits of clean cookstoves and fuels.

“When you get this many committed researchers together working on the same topic, there’s an incredible amount of learning taking place,” said Dr. Sola Olopade, Professor of Medicine at the University of Chicago and Principal Investigator of the Nigeria research trial. “After seeing the preliminary results of the many ongoing studies, I think we’re making significant progress on how much changing to a clean cookstove or fuel can improve a child’s health.”

Dr. Darby Jack, Assistant Professor at Columbia University’s Mailman School of Public Health, is working on another of the Alliance-supported studies that seek to better understand the potential impacts of clean cookstoves and fuels on birth outcomes and child survival in Ghana.  “By measuring the impact of adopting clean cooking during pregnancy on birth weight and childhood pneumonia, we’re hoping to determine how large-scale interventions that target pregnancy can improve health,” said Jack. “We hypothesize that birth weight will increase with the clean cooking interventions and that the incidence of pneumonia will decrease in the first year of life.” Results of the study are expected by the end of the year.

The child survival studies, underway in Ghana, Nepal, and Nigeria, are some of the first in which truly clean technologies are being evaluated, and they expect to measure the magnitude of health impacts that can be attributed to higher particulate matter reductions due to clean cookstove and fuel interventions.

After seeing the preliminary results of the many ongoing studies, I think we’re making significant progress on how much changing to a clean cookstove or fuel can improve a child’s health. – Dr. Sola Olopade
Dr. Olopade presented early results from a randomized controlled trial in Nigeria assessing the impact of replacing either traditional biomass or kerosene stoves with ethanol on birth outcomes. The study is being conducted in an urban population where the majority of women use kerosene as their primary cooking fuel.
Because the study will have data from biomass, kerosene, and ethanol, it is expected to help establish a dose-response relationship between measured pollutants and birth outcomes.”What’s been most surprising so far, is how much the study participants like their new ethanol cookstoves,” said Amanda Northcross, Assistant Professor at George Washington University, who’s working with Olopade on the Nigeria study. “I’m hopeful we will see significant reductions in exposure, and ultimately improved health.”

A study underway in Nepal is examining the incidence of acute lower respiratory infections and adverse reproductive outcomes in a rural setting. The research, being led by Dr. James Tielsch, Chair of the Department of Global Health at George Washington University, seeks to measure the health impacts of replacing traditional open-burning biomass stoves with an “improved” biomass stove or LPG stove.

“The issue of household air pollution came up as a result of previous studies as an important cause of child mortality,” said Dr. Tielsch. “We are now seeking to measure the reduction in indoor air pollution as a result of replacing biomass stoves with cleaner-burning LPG stoves.”In addition to discussing preliminary findings, a highlight of the child survival workshop included a site visit to a biogas and child health study being conducted by the Partnership for Enhanced Engagement in Research (PEER) Health Program. Attendees visited households using traditional cooking fires and improved biogas stoves and observed health workers monitoring children for exposure levels.

The meetings also included an evening interaction program in Kathmandu organized by Nepal’s LEADERS program that provided an overview of clean cooking solutions and child survival in South Asia. Speakers included Dr. Mrigendra Pandey, Founder of the Mrigendra Samjhana Health Foundation, Dr. Sanjay Nath Khanal, President, Indoor Air Pollution and Health Forum, Nepal (IAPHF-N), Dr. Sharat Verma, PEER Health Study, Dr. Amod Pokhrel, University of California, Berkeley, and Dr. Sumi Mehta, Director of Research and Evaluation for the Alliance.

In addition to discussing preliminary findings from their work in countries including Bangladesh, Ghana, Guatemala, India, Kenya, Malawi, Nepal, Nigeria, and Rwanda, workshop attendees exchanged some of the key lessons learned in their field research and discussed influencing advocacy during a presentation led by Nuzhrat Rafique, Regional and Newborn Health Specialist with UNICEF Nepal.

Researchers also discussed some of the current issues impacting the sector, such as best practices for measuring exposure, the need for improved ambient air pollution measurement, and the need for more community-level implementations. A more detailed report from the workshop will be on the Alliance website once it is finalized.