A single-arm trial examining the feasibility, acceptability and distribution of LPG cookstoves and gas cylinders to pregnant women living in rural Bangladesh, in preparation for The Poriborton

Abstract

TPS 722: Low and middle income countries: indoor air pollutants, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM Background/Aim: The burden of household air pollution on perinatal mortality has not been accurately defined. Our overall aim was to develop a protocol for a cluster randomised controlled trial (cRCT) to assess the impact of liquid petroleum gas (LPG) cooking compared to usual cooking on perinatal mortality in pregnant women in rural Bangladesh (ACTRN12618001214224). For this study we aimed to assess the feasibility of the planned trial and the barriers/facilitators of distributing LPG to rural households. Methods: We used a mixed method iterative design. We included pregnant women, their families, and local LPG stakeholders. We distributed LPG to households for 3 months and assessed process issues, acceptability and cooking/food behaviours. We interviewed LPG stakeholders, and conducted focus groups and interviews with users. The study had ethical approval and was conducted in Basail, north of Dhaka. Results: 50 pregnant women, and their family members trialed LPG. Initial distribution of LPG was hampered by process issues (fees, storage, timing) most of these were due to the lack of an established supply chain. Initial safety concerns were overcome with safety measures and training, LPG cooking was very acceptable, and all users reported a preference for continued use, fuel-sparing was heavily practised. Continuous LPG supply was hampered by the ad hoc supply chain. LPG stakeholders reported that LPG demand differed by season. Conclusions: Our iterative study meant that all issues were manageable. Implications for a larger trial include: ensuring safety, information to support continuous LPG use to ensure efficacy of the intervention is critical, a well-developed supply chain is essential for continuous supply, and changes in LPG demand due to season will need to be monitored to ensure timely cylinder replenishment. This was a very beneficial study for our protocol development, and overall, distributing LPG to pregnant women in rural Bangladesh was feasible.