A global response to solid fuel use, a local impact on children’s developmental status

Abstract

TPS 901: Indoor air pollution, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM Background: Household air pollution from solid fuel burning is a contributor to delay early child development (ECD). A global effort to decrease solid fuel use (SFU) by promoting cleaner burning stoves, cleaner fuels, and/or providing chimneys or other ventilation changes, has been introduced since 2010. This program, called the ‘Clean Cooking Alliance’ (CCA), has targeted 100 countries, eight of which have received a more in-depth treatment. Thus, countries are not randomly exposed to global efforts to tackle SFU, and thus SFU variation may be dependent on their relative position to this program, and in turn affecting differently ECD. Objective: To investigate the effect of SFU on ECD and explore the possible influence of CCA’s global efforts on SFU and ECD. Methods: A cross-sectional analysis of 30 countries with data on their relative position to CCA efforts--used as a proxy for CCA’s differentiated efforts--linked to socio-demographics and early development of 76576 3-4 years children from the Multiple Indicator Cluster Surveys. A standardized global ECD index (ECDI) was calculated. Two-stage least squares regression models were conducted, using countries’ relative position to CCA’s efforts as an instrumental variable, to study the effect of SFU on ECDI. Results: After adjustment for covariates, absence of SFU was associated with an increase of 0.16 in ECDI (95% confidence interval, CI: 0.10-0.20). Countries relative position to CCA’s efforts was an independent predictor of SFU (beta: 0.54, CI: 0.25-0.84), F value= 14.52. When the relative position to CCA’s efforts was used as an instrumental variable, the association between SFU and ECDI weakened but remained significant (beta: 0.15, CI: 0.07-0.24). Conclusion: The use of solid fuels in the household is an independent predictor of a child’s early development. Global efforts of the Clean Cooking Alliance appear to be improving early childhood development by facilitating better cleaning cooking practices.