Abstract
Household air pollution (HAP) caused by the combustion of solid fuels for cooking and heating is responsible for almost 5% of the global burden of disease. In response, the World Health Organisation (WHO) has recommended the urgent need to scale the adoption of clean fuels, such as liquefied petroleum gas (LPG), in low and middle-income countries (LMICs). To understand the drivers of the adoption and exclusive use of LPG for cooking, we analysed representative survey data from 3343 peri-urban and rural households in Southwest Cameroon. Surveys used standardised tools to collect information on fuel use, socio-demographic and household characteristics and use of LPG for clean cooking. Most households reported LPG to be clean (95%) and efficient (88%), but many also perceived it to be expensive (69%) and unsafe (64%). Positive perceptions about LPG’s safety (OR = 2.49, 95% CI = 2.04, 3.05), cooking speed (OR = 4.31, 95% CI = 2.62, 7.10), affordability (OR = 1.7, 95% CI = 1.38, 2.09), availability (OR = 2.17, 95% CI = 1.72, 2.73), and its ability to cook most dishes (OR = 3.79, 95% CI = 2.87, 5.01), were significantly associated with exclusive LPG use. Socio-economic status (higher education) and household wealth (higher income) were also associated with a greater likelihood of LPG adoption. Effective strategies to raise awareness around safe use of LPG and interventions to address financial barriers are needed to scale wider adoption and sustained use of LPG for clean cooking, displacing reliance on polluting solid fuels.
Highlights
It is estimated that over 700 million people living in Sub-Saharan Africa (SSA) are dependent on polluting biomass fuels for household cooking [1]
Reported reasons for this disparity include greater access to clean fuels in urban areas, lack of access to liquefied petroleum gas (LPG) in rural contexts, relative poverty and the opportunity costs of freely gathered biomass in rural settings [17,23,50]. In support of these hypotheses, this study found that people living in rural areas were significantly more likely to report perceiving LPG as expensive and more difficult to obtain than peri-urban households
The socio-economic determinants of new adoption of clean household energy are well documented [24,25,26,27,28,29,30,31,59]. In accordance with this evidence, we found that increased education, wealth and younger age were all significantly associated with increased likelihood of LPG adoption, whereas larger household size and land ownership were barriers to more exclusive use
Summary
It is estimated that over 700 million people living in Sub-Saharan Africa (SSA) are dependent on polluting biomass fuels (such as wood and charcoal) for household cooking [1]. These are often burnt on inefficient open fires or traditional stoves, resulting in high levels of air pollutants, such as respirable fine particulate matter (PM2.5 ) and carbon monoxide (CO), which pose a major risk to health [2]. Public Health 2020, 17, 5874; doi:10.3390/ijerph17165874 www.mdpi.com/journal/ijerph
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