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A case study investigating the utilization of improved stoves in rural India.[top] [end]'Reducing indoor air pollution in developing countries: A case study investigating the utilization of improved stoves in rural India.This study was conducted by Zoe Catherine Anderson in July 2007. This project has been completed by the author in partial fulfilment of the requirements for the award of the Intercalated Degree in International Health from the Nuffield Centre for International Health and Development,Leeds Institute of Health Sciences, University of Leeds. The read the full study download from here:  Acasestudyinvestigatingtheutilizationofimprovedsto[1]..pdf (451 KB)This is a summary of the study. [top] [end]1.0 AbstractAims and objectives This study aims to provide an insight into the facilitators and constraints that influence the utilisation of improved stoves in a rural village in Maharashtra, India, and discuss ways in which the utilisation can be improved. Methods This qualitative research follows an ethnographic research style. Four weeks of data collection in India involved participant observation, focus group discussions, key informant interviews and semi-structured interviews. Data was fully transcribed and analysed using coding principles and editing analysis. Findings The main advantages of the Bhagyalaxmi stove, which facilitate its utilisation, were that it saves households fuel and time. It also produces less smoke. In contrast to previous research the reduction in smoke was not the main advantage. The main constraint to using this stove is the initial cost, which is more than four times the cost of the traditional stove. Women did not feel they needed the luxury of this improved stove at this extra cost and believed that more people would use the stoves if they were cheaper. Conclusion Further measures to minimise the constraints and promote the facilitators to improved stove use are needed. Given the global burden of disease attributed to indoor smoke, specific policy measures should be developed to reduce indoor air pollution. Based on these findings, strategies could include re-introducing subsidies, introducing micro credit schemes, awareness campaigns and social marketing, although more research is needed to determine the effectiveness of these measures. Promotional strategies should acknowledge that reducing smoke is not always perceived as the main advantage of improved stoves. Improved stoves should be considered as part of a wider program of alleviating poverty. [top] [end]2.0 IntroductionIndoor air pollution(IAP), from cooking with solid fuels on open fires or primitive stoves in poorly ventilated houses, is a major cause of morbidity and mortality worldwide. Over 1.6 million deaths and 2.7% of the global burden of disease was directly linked to IAP in 2000. Exposure has been linked to a number of acute respiratory infections (ARIs); the biggest killer of children under 5 years old.Reducing the burden of disease caused by ARIs represents a major public health challenge; IAP is a risk factor that can be reduced by relatively simple and cost effective interventions.Improved stoves are the most popular intervention.They reduce exposure to harmful pollutants by improving combustion efficiency and/or introducing chimneys, and, in some cases, reducing cooking times. Studies have shown that children living in houses using improved stoves are 2.6 times less likely to suffer from ARI than those living in homes using traditional stoves. Despite large-scale stove dissemination projects, improved stoves are not used by many of those in greatest need, especially in India[9]. Research mainly focuses on the issues surrounding the distribution of stoves, and relatively little has been published on the users perceptions of stoves after implementation. This qualitative study explores the facilitators and constraints influencing the utilisation of improved stoves in a rural community in Maharashtra, India, from the perspective of the women with the potential to use the improved stoves. Through a better understanding of these factors, more targeted and appropriate strategies for promoting the use of improved stoves and reducing IAP can be developed. This report gives a background to improved stoves in India, describes the aims and objectives of the research, the methods used to collect and analyse data and presents and critically discusses the findings in relation to previous research. The findings are used to identify strategies to increase the utilisation of improved stoves and highlight policy measures necessary to reduce the global burden of disease from IAP. The limitations of the research are discussed. In the majority of field studies measuring the effectiveness of improved stoves, consideration is not given as to whether the stoves will be adequately maintained, or whether people will continue to use the stoves after the study period. This has resulted in the failure of improved stove projects, for example, the NPIC in India did not result in widespread adoption of improved stoves, primarily because of its top down approach, and inadequate consideration of the users needs and preferences. Where the opinions of users are sought, the research methods, questionnaires and household surveys, have often not given the researchers the opportunity to explore the issues raised, which is vital if they are to be adequately addressed and the stoves are to reach their potential. In Maharashtra state in India, an NGO, the Appropriate Rural Technology Institute(ARTI) have been disseminating improved stoves since 1996, initially as part of NPIC, and since the NPIC was abandoned in 2001, they have been operating independently. ARTI are completing an intervention study to evaluate the impact of the improved stoves on IAP.The village in question, Nanegaon, is part of this study. Participants, who fitted their criteria , were able to buy the improved stove at a subsidised rate, in instalments. The social impacts of health of women and children have also been explored by ARTI and results are being analysed by researchers at Liverpool University. This study will provide complimentary data to this project. Nanegaon is typical of other villages in the high-rainfall area of Western Maharashtra.The improved stove that is being adopted is the Bhagyalaxmi. It is an unvented stove (no chimney), with two potholes and a cast iron grate to improve ventilation and combustion efficiency[16]. The traditional stoves in Nanegaon are also two pot stoves.The Bhagyalaxmi stove has been shown to significantly reduce IAP in compared to the traditional stove. [top] [end]3.0 AimTo develop an understanding of the facilitators and constraints influencing the utilization of improved stoves in a rural village in Maharashtra [top] [end]4.0 Objectives
[top] [end]5.0 MethodsThis qualitative research follows an ethnographic research style. Four weeks of data collection in India involved participant observation, focus group discussions, key informant interviews and semi-structured interviews. Data was fully transcribed and analysed using coding principles and editing analysis. [top] [end] Sampling methodsAccess to the village was gained through the co-ordinator of an improved stove program, who introduced me to my KI1 in the study village. Snowball sampling was chosen since this provided information rich cases within the time available. Participants were identified and contacted by my key informant in the village.Informed verbal consent was gained. [top] [end] Ethical considerationsEthical approval for this study was gained from the Nuffield Institute for International Health and Development at the Leeds Institute of Health Sciences. Informed verbal consent was gained from each participant, according to the information and consent sheet; many of the women were illiterate and signatures were associated with the government, therefore written consent was not gained, as this may have affected participants willingness to take part. The rights, interests, sensitivities and privacy of the village inhabitants were respected throughout data collection. All personal information was kept confidential and data was anonymised. The focus groups were recorded, with consent of the participants, and transcribed; the tapes were kept in a secure location and will be destroyed after 3 months. [top] [end]6.0 FindingsThis study reveals two main groups of factors that facilitate the utilisation of improved stoves in this village, and two main groups of constraints. Facilitators Advantages of Bhagyalaxmi stove:
When asked about the advantages of the improved stove in compared to the traditional stove, fuel savings were consistently the first answer the women gave. This was followed by time saving. Both of these were constantly referred to throughout all focus group discussions and individual interviews and women gave numerous accounts of personal experiences. Women not only save time from cooking, but also from having to collect less firewood. They said they were able to take rest or work in the field during this saved time. Women using the improved stoves (FGD1) added that the improved stove produces less smoke, and were able to describe both health benefits and benefits to the cleanliness of their kitchen. These women also recognised the advantage of the increased lifespan of this stove compared to the traditional stove. Easy to adopt
Other features of the improved stove facilitated easy adoption by the women. These included its aesthetic appearance, which is very similar to the traditional stove, and it’s design, which enables the same fuels to be burnt. Constraints Disadvantages of Bhagyalaxmi stove:
The main constraint to purchasing and using the Bhagyalaxmi stove perceived by women in this village is the cost of this stove. There was also confusion around the actual cost of the Bhagyalazmi stove, since many of those who had bought the stove for the intervention study had only paid the first instalment of Rs100. Women in FGD2, who had not bought the improved stove, told me the price was Rs100, and that this was too much for them. Further discussion with the co-ordinator of the improved stove program confirmed that the actual cost of the stove was Rs180, not including transport costs. This higher price was mentioned to the women in FGD3, and their reaction was to laugh. A number of different discussions related to the price of the Bhagyalaxmi stove. Women without the stove said they could not afford it, often quoting how much cheaper the traditional stove was. Because it is not available locally they also have to pay transport costs from Pune, 45km away, increasing the cost. SSI’s also provided additional information, such as the influence of men on the decision to buy an improved stove. During the FGD’s the women insisted that it was their decision, but when later questioned, it became clear that where money is scarce, they must convince their husbands of its worth before he would pay for it, as it is the men who assume greater positions of power and are in charge of the money. Other disadvantages of the Bhagyalaxmi stove that were discussed included the presence of the grate, which decreases the hole size where the fire is burnt. Women using and not using the improved stove viewed this feature negatively. Women using the stoves were disappointed that cracks appeared in the front section of the stove as soon as they used it. I was informed that these cracks are normal because of the heat generated and close after the fire goes out. Despite being well adapted to fulfil the main cooking necessities in the village, many women still used the traditional stove for activities such as boiling water. They said that tasks such as boiling water were quicker on the traditional stove. Practices depended on the size of their family and the time available; they used the traditional stove if they were in a hurry. Lack of perceived need
Some of the issues raised were that they were satisfied with their traditional stoves which were adequate or even better than the improved stoves for some tasks, that they are not used to looking at the long term benefits of things, and a lack of information about the improved stove and the long term health risks of IAP. [top] [end]7.0 ImprovementsIn general these women were very satisfied with the Bhagyalaxmi stove. However, a significant proportion were not using it, either because they were not willing, or not able, to buy it. Their main recommendation to improve its utilisation was simply to reduce the cost. One woman suggested adding pot raisers to make local pancakes, but the other women did not agree that these were needed. [top] [end]8.0 DiscussionThe reduction in smoke, which I perceived to be the most important benefit, was not the main advantage quoted by these women, and was not mentioned at all by the women in the second FGD, which consisted only of women not using the improved stoves. Women using the improved stove did give specific examples of the benefits of less smoke, but only after being probed on the issue. This suggests that reducing smoke is not perceived as a main advantage of the Bhagyalaxmi stove by these women. This finding contrasts to a study in Nepal, where 92% of households using the improved stove reported less smoke as the main advantage of the improved stove. This may reflect a greater capacity of the New Nepali cook-stove, which had a flue, to remove smoke. These perceptions could also reflect the knowledge of health risks, a community based child health project informed the Nepali study population that less smoke could reduce ARI mortality. A study in India also reported that users of the improved stoves ranked the removal of smoke from the household as a higher priority than energy saving. From a health perspective, either the women do not know about the health risks of IAP, or they don’t perceive them to be important. Having spent time cooking with these women and observing their activities in the village I believe that they do not perceive smoke to be a problem that is going to be solved while still cooking with wood. They have been exposed to smoke whilst cooking all of their lives, and come across so many discomforts in their daily life that a bit of smoke is something they can deal with. Villagers have developed other methods of reducing smoke, such as using dry wood or only burning certain types of wood that burn with less smoke. This evidence suggests that there is a need to raise awareness of the health risks of IAP, which were not known about in Nanegaon. The predominant advantages of the Bhagyalaxmi stove, according to these women, was the fuel saving and time saving. This supports previous research which has also shown these to be perceived as significant advantages of improved stoves.This is not surprising since fuel saving has been the focus of many stove dissemination programs, and the extra heat going to the second pothole is designed to save time. It is encouraging that the users feel these benefits. Both women using and not using the improved stoves were aware of these advantages, suggesting these issues had been discussed in the village, increasing the internal validity of these findings. The increased lifespan of the Bhagyalaxmi stove, is because it is made from cement rather than mud. This was discussed by the women who were using this stove, but not by the women using the traditional stove. Since the stoves were only introduced to Nanegaon two years ago, the increased life has yet to have a significant impact on these women. However, this has meant the Bhagyalaxmi stove has not been made locally, because of lack of expertise, which has significant drawbacks and implications for the long term sustainability of this intervention. Corroborating previous research, the most significant constraint to the adoption and subsequent utilisation of the Bhagyalaxmi stove that the women perceived was the cost. A study in Lucknow reported that the people could afford the improved stove, but they would have to be very certain of the benefits to justify such an expense. Findings suggest that the situation is the same for a number of households in Nanegaon. Equivalent to roughly three times their daily wages , an improved stove is a significant investment, however, it is not impossible. Indeed, comments about the cost of the Bhagyalaxmi stove often compared it to their traditional stove, which is much cheaper, and did not merely say it was too expensive. If there was no alternative, I believe a significant proportion of the households could afford this stove. However, there is an alternative. Therefore to justify the additional cost, the improved stove must be perceived as worthwhile investment. A significant proportion of the women in Nanegaon did not perceive the Bhagyalaxmi stove to be a worthwhile investment and showed resistance to this intervention, and felt that outsiders were forcing them to change. They were aware of the benefits discussed above, but still didn’t feel they needed the improved stove; traditional stoves have been around for thousands of years and have evolved to meet the local needs in a way that is affordable to the users.This reinforces the need to acknowledge and incorporate these women’s knowledge into the design of improved stoves. Community participation can achieve this, and projects using these methods are showing signs of success. The only practical disadvantage that the women perceived was the presence of the grate. Participants had difficulty adjusting to the grate, and disliked having to chop wood into smaller pieces to accommodate the grate. Some women had removed the grate completely, thus compromising its efficiency and role as an improved stove. This re-enforces the need for participatory activities, which ensure women understand the role of the different features of the improved stove. It also became clear during the course of the study that successful adoption and utilisation of an improved stove is not merely about convincing the women of the benefits of the improved stove, but also about convincing the men. Studies in Kenya and Mexico have also acknowledged this barrier, and women in Kenya suggested promoting the advantages of interventions to reduce IAP to men in terms of comfort, that they can “drink beer in the cool of their kitchen”, as a means to addressing the finance issue. However this was a sensitive issue and not discussed widely by the women in Nanegaon, these comments are based on observation and one individual interview. Had more time been available it would have benefited this research to have interviewed or held FGD with men from the village to determine their perceptions of the improved stoves. [top] [end] Policy ImplicationsFrom a health perspective, it is important that households, who are currently cooking on open fires or traditional stoves, adopt improved stoves that can reduce IAP and its associated health risks. Given the international importance placed on reducing IAP, international organisations such as the WHO or the World Bank should provide means of achieving these goals and promoting the use of improved stoves to those in greatest need. This study has shown that changing a culture of cooking on traditional stoves or fires is challenging. It needs a combination of targeted strategies and collaboration between international and local organisations. The women’s recommendation to improve the utilisation of the Bhagyalaxmi stove was simply to reduce the cost. Reducing the cost would increase the number of people who could afford, or justify, this expense. Subsidies are one method of reducing the cost. Reports suggest that subsidies lead to low value being placed on the stoves, indeed subsidies have not been successful in India in the past. However, ARTI subsidised the Bhagyalaxmi stoves in this village, and they are being used by the women who own them, suggesting that with the right support subsidised stoves can be implemented successfully. It may be the lack of support, rather than the presence of the subsidy, that leads to the failure of the subsidy approach. This is an area that should be explored more thoroughly. Internationally, the most successful intervention programs target subsidies towards the commercialisation of the stoves. Commercialisation of improved stoves can potentially introduce competition and lower the price of the stoves in a sustainable way. An alternative method of finance is the provision of micro-credit to households to support the purchase of an improved stove and is receiving growing attention. Whichever scheme is developed, it must be carefully assessed and designed to meet the needs of those in greatest need and enable diffusion of the improved stoves to the poorest households. However, other discussions and observations do not indicate that by simply reducing their cost, utilisation will be increased. In addition, the advantages of the improved stove need to be realised by the potential users. Awareness campaigns should be used to highlight these benefits of the improved stoves. This study suggests that in this village is more effective to focus these campaigns on the fuel and time saving abilities of the improved stoves, rather than the health benefits, which are given a lower priority in these women’s minds. Campaigns should be preceded by surveys of user needs and perceptions. Social marketing uses marketing techniques to motivate consumer behaviour to achieve socially desirable ends such as improvements in health; the promotion of improved stoves as to address this public health problem is likely to benefit from social marketing. Marketing and awareness campaigns should target men as well as women. Finally, the women must feel that they are choosing to adopt the improved stoves. Community participation in every stage of design and dissemination of improved stoves will help to achieve this. Although current policy acknowledges the importance of reducing IAP, specific strategies are not suggested as to how to achieve this. Based on the constraints identified in this case study, policy measures which could be adopted by international organisations, governments and local NGOs, should include the following strategies:
There is a close relationship between poverty and dependence on poor quality fuels. Improved stove projects should be part of a wider development strategy to alleviate poverty and reduce IAP. Other interventions, such as behaviour change, or switching to cleaner fuels, should not be discounted, and integrated approaches to tackling IAP should be developed. [top] [end] 9.0Limitations of the studyThis study focused on facilitators and constraints from the perspective of women from the village. As indicated in previous research, the processes involved in the design and dissemination of improved stoves will also have a significant influence on the uptake and utilisation of the improved stoves, and on the attitudes and perspectives of these women. A detailed examination of the processes involved in the design and dissemination of the Bhagyalaxmi stove was not incorporated into the analysis of this study. I realise this will have implications for the policy recommendations and is a limitation of this report. Generalisability The facilitators and constraints discussed will differ between regions and culture depending on the type and use of improved stove, limiting the generalisability of this research. However, there will be similarities, and as such the findings of this research can be extrapolated to similar populations in other areas. The research methods and findings may help others to investigate sufficiently similar situations and in this way the research may become transferable. Sampling During the sampling of participants for FGDs and interviews, I was not made aware of the refusal rate, although I was informed some women were very busy and could not come. In addition, my key informant may have selected a certain sub-group of women to participate, which would have implications for the representativeness of my findings. However, having spent time in the village I am confident that the participants in the focus groups were representative of the population. Time The study was particularly limited by time, both during the field-work and during the analysis of the data. Had more time been available, more focus group discussions could have been held throughout Maharashtra to gain a more representative perspective of the facilitators and constraints that influence the utilisation of improved cookstoves in Maharashtra. In addition many of these advantages described, such as smoke removal, cannot be easily quantified, and without spending more time developing a deeper understanding of the way these women live, it is difficult to assess the importance that they attach to the various benefits they have described. The Hawthorne effect There was a risk that the study population may have behaved in an atypical way because they knew they were being observed. Efforts were made to establish rapport with the women to minimise this effect. Language and translation Not being able to speak the local language was a significant barrier. I was forced to rely on my translator throughout all discussions and interviews. Participant observation enabled me to collect data, without the need for any language or the possible problems associated with translation. However, despite being able to observe participants behaviour during FGDs it was difficult to link behaviour with questions during analysis. In addition to the inevitable problems with translation, such as the limitations in reproducing direct quotations, I experienced some additional problems with translation (discussed below), which may have implications on the reliability of my data. Although my translator/facilitator appeared to understand when I spoke to her, and I had been reassured that she was capable of translating the focus group or interview questions herself prior to the discussions, when I received the translated transcripts back it seemed, despite our extensive discussions, she had not fully understood my instructions. I had devised the questioning route to minimise differences in the ways the questions could be interpreted; however, the questions asked by my translator/facilitator did not reflect the consideration I had put into the wording of the questions. In addition, she deviated from the question route, skipping some questions if they were similar to previous questions; my motivation for including them was the different phrasing used might encourage discussion on a different aspect of the answer[22]. These subtle differences in language were not apparent to my facilitator and perhaps reflect the limitations of translation. These issues reflect a communication problem between my translator and myself. This may have been due to simple misunderstanding, exacerbated by the power differential between the community translator and myself, as discussed by Temple and Young, or it could be attributed to cultural differences, as we placed different emphasis on the relative importance of different aspects of the research. Nevertheless, although the FGDs were not run entirely as I had planned, after reflection and discussion of these issues with the coordinator of ARTI and my translator, I realise that her modifications were made with the best intentions and may have strengthened the research in some ways. She asserted that had she asked the questions as I had planned, the women would not have answered. Coming from the same village as the women she had the advantage of being familiar with them, their culture, and way of thinking; she had also conducted FGDs with them before. Although some modifications were detrimental to the research, with some inappropriate use of leading questions, since the context of the answer was considered in analysis, the validity of the results will not have been affected. I am confident that an accurate picture of the women’s perceptions has been given. This experience has highlighted the need to balance carefully worded interview schedules with the more culturally sensitive knowledge of the translator. In light of these experiences, if I were to conduct the research again I would ensure that I checked the facilitator’s understanding prior to the FGD, by asking questions about what we had discussed. In addition I would ensure the FGD questions were translated into Marati, then back translated into English so I could ensure the wording was correct and discuss any differences prior to the FGD. In a situation like this using a topic guide for FGD questions[22], instead of the questioning route, may be more appropriate, giving the facilitator the freedom to ask the questions in the way she feels is most culturally appropriate. I would give consult more with the local translator during the construction of interview schedules and ensure the facilitator was fully trained in running FGDs and not rely solely on recommendations of previous researchers. I would run a pilot FGD so any problems could be rectified before formal data collection begins. [top] [end]10.0 ConclusionThis study has explored the facilitators and constraints influencing the utilisation of improved stoves in Nanegaon village in Western Maharashtra. The main advantages of the Bhagyalaxmi stove, which facilitate its utilisation, were that it saves households fuel and time. It also produces less smoke. In contrast to previous research the reduction in smoke was not the main advantage. The main constraint to using this stove is the initial cost, which is more than four times the cost of the traditional stove. Women did not feel they needed the luxury of this improved stove at this extra cost, and believed that more people would use the stoves if they were cheaper. Improved stoves are being used in the village although at present an improved stove has not been purchased since the initial dissemination, indicating that the constraints outweigh the facilitators. This study suggests the need for further measures to minimise the constraints and promote the facilitators. Given the global burden of disease attributed to indoor smoke, specific policy measures should be developed to reduce IAP. Such strategies could include re-introducing subsidies, introducing micro credit schemes, awareness campaigns and social marketing, although more research is needed to determine the effectiveness of these measures in a range of settings. Promotional strategies should acknowledge that reducing smoke is not always perceived by users as the main advantage of improved stoves. The influence of men on the uptake of improved stoves could be an important determinant of success, more detailed analysis of their involvement would enable targeted strategies. It is clear from this research that more account needs to be taken of people’s needs and perceptions, to ensure successful implementation and utilisation of improved stoves and a reduction in the adverse health effects associated with IAP. To have a lasting effect improved stoves should be considered as part of a wider program of alleviating poverty. [top] [end]Related topics[top] [end]External links and references[top] [end]ContributorsUser:Dr Karabi Dutta 15 February 2008 | |
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15 February 2008; Last edited:
18 June 2008; Version: 2 | |
Pagename: UtilisationOfImprovedStoves @HEDON: TAJA | |
