Introduction: Implementation Science to Reduce Household Air Pollution (HAP) Exposures in Low and Middle-Income Countries (LMICs)

Abstract

HAP exposures are responsible for a major proportion of the total disease burden in LMICs. To address this, the NIH led Clean Cooking Implementation Science Network (ISN) is developing methods to elucidate technologies, conditions, and implementation strategies that can result in the largest reductions in HAP exposures. The challenge is to accelerate widespread, sustained and nearly exclusive adoption of clean cooking to promote public health. In this symposium we present a brief introduction to the network and its approach, followed by study results from interventional and natural experiments in India and Sub-Saharan Africa. For example, India has recently launched an enormous effort to provide access to clean cooking fuels such as Liquified Petroleum Gas (LPG) to nearly 50 million homes by 2019, but challenges of sustaining LPG use remain to be overcome. Implementation science has evolved precisely to meet this kind of complex, multidimensional problem. Finance, access to services, ambient air quality, climate, home construction, community structure, cultural traditions and gender are among the complex variables addressed in the network’s research. The ISN projects presented here use a diversity of methods – including social network analysis, microfinance experimentation, novel survey methodologies and sensor-based monitoring of stove-use and resulting exposure levels – to understand the potential drivers of decision making in rural and peri-urban, low income settings. In this brief introduction to the research we provide background on the scope of the problem and an outline of the approaches we are taking to employ research that will accelerate the transition to clean cooking fuels around the world.