Clean Cookstoves Research Articles

Impacts of an abbreviated personal agency training with refugee women and their male partners on economic empowerment, gender-based violence, and mental health: a randomized controlled trial in Rwanda

IntroductionWe assessed the impact of a personal agency-based training for refugee women and their male partners on their economic and social empowerment, rates of intimate partner violence (IPV), and non-partner violence (NPV).MethodsWe conducted an individually randomized controlled trial with 1061 partnered women (aged 18–45) living in a refugee camp in Rwanda. Women received two days of training, and their partners received one day of training. The follow-up survey where all relevant outcomes were assessed was carried out at 6–9 months post-intervention.ResultsAt follow up, women in the intervention arm were more likely to report partaking in income generating activities (aIRR 1.27 (1.04–1.54), p < 0.05) and skill learning (aIRR 1.59 (1.39–1.82), p < 0.001) and reported a reduction in experience of physical or sexual NPV in the past six months (aIRR 0.65 (0.39–1.07), p < 0.09). While improved, no statistically significant impacts were seen on physical or sexual IPV (aIRR 0.80 (0.58–1.09), p = 0.16), food insecurity (β 0.98 (0.93 to 1.03), p = 0.396), or clean cookstove uptake (aIRR 0.95 (0.88 to 1.01), p = 0.113) in the past six months. We found statistically significant reduction in physical and sexual IPV amongst those experiencing IPV at baseline (aIRR 0.72 (0.50 to 1.02), p < 0.07). Small improvements in self-efficacy scores and our indicator of adapting to stress were seen in the intervention arm. Some challenges were also seen, such as higher prevalence of probable depression and/or anxiety (aIRR 1.79 (1.00-3.22), p = 0.05) and PTSD (aIRR 2.07 (1.10–3.91), p < 0.05) in the intervention arm compared to the control arm.ConclusionOur findings echo previous research showing personal agency training can support economic well-being of women. We also find potentially promising impacts on gender-based violence. However, there is some evidence that integration of evidence-based mental health support is important when enhancing agency amongst conflict-affected populations.Trial registration numberThe trial was registered with ClinicalTrials.gov, Identifier: NCT04081441 on 09/09/2019.

An umbrella review of health co-benefits from actions to reduce greenhouse gas emissions

BackgroundThere have been many modelled studies of potential health co-benefits from actions to reduce greenhouse gas emissions, but so far there have been no large-scale attempts to compare the magnitude of health and climate effects across sectors, countries, and study designs. MethodsAs part of the Pathfinder Initiative project an umbrella review of studies was done, and 26 previous reviews were identified with 57 primary studies included. Studies included in the review were required to have quantified changes in greenhouse gas emissions and health effects (or risk factors) from defined actions to reduce climate effects. Study data were extracted and harmonised by standardising impact measures per 100 000 of the national population (or urban population for city-level actions), averaging effects over a 1-year period and aggregating actions into their respective sectors by use of a predefined framework. FindingsFrom 200 mitigation actions, the majority were in the agriculture, forestry, and land use sector (103 actions [52%]), followed by the transport sector (43 actions [22%]). The largest effects on greenhouse gas emissions were seen from actions in the energy sector, and these actions also had substantial health co-benefits in lower middle-income countries, although benefits were smaller in high-income settings. The greatest health benefits were seen from actions to change diets and introduce clean cookstoves. The major pathways to health were through reduced air pollution, healthier diets, and increased physical activity from switching to active travel modes. Effect sizes tended to be larger from national modelling studies and smaller from localised or implemented actions. InterpretationThe potential co-benefits to health from actions to reduce climate change are large, but most evidence still comes from modelling studies and from high-income and middle-income countries. There are also major context-dependent differences in the magnitude of effects found, so actions need to be tailored to the local context and careful attention needs to be paid to potential trade-offs and spillover effects. FundingThe Wellcome Trust and the Oak Foundation.

Evaluation of the preference for and viability of clean cookstove adoption in rural Tanzania

BackgroundSustainable Development Goal (SDG) 7 calls for “universal access to affordable, reliable, modern energy services” for the 2.6 billion individuals lacking access to clean cooking fuels and stoves. Low- and middle-income countries are designing policies towards clean fuels, but often prioritize World Health Organization defined ‘clean’ fuels and stoves to urban areas. As clean solutions are explored, it remains unclear what rural households prefer as their clean alternative.MethodsThis study conducted household energy surveys with main cooks across four villages in Shirati, Tanzania to understand rural household preferences within the viable clean fuels. Data analysis includes descriptive statistics and a generalized linear model with the Poisson family and log link to estimate prevalence ratios, all of which were conducted in Microsoft Excel and STATA 16.1.ResultsThe results revealed that while 83% of households (n = 187) stacked a combination of firewood, charcoal, liquified petroleum gas (LPG), and/or kerosene, 82% [95% Confidence Interval: 74%, 89%] of households stated a preference to use LPG. We found that aggregate expenditure on LPG was less than daily purchases of charcoal and firewood. Our analysis found that all villages had a higher prevalence of stacking firewood, charcoal, and LPG, than areas further from the main trading center. Both areas with trading posts had a lower prevalence of using only firewood.ConclusionsHousehold preference should be systematically incorporated into clean cooking policy decisions. Our results imply that LPG should not be pursued only in urban contexts. We discuss how preference affect adoption and the need to include user preferences to meet universal clean cooking access (SDG 7).

Affording a clean stack: Evidence from cookstoves in urban Kenya

The unaffordability of clean cookstoves and fuels, as defined by the World Health Organization, is one of the most significant reasons for the persistent use of unclean fuels, even when “stacked” alongside a clean stove. To see health benefits, the entire cooking stack must be clean, and therefore the clean stack needs to be affordable. Using a case study of clean biomass pellet stoves in Nairobi, Kenya, we present scenario analyses to measure and evaluate the affordability of adopting a clean stack under various cooking scenarios, income ranges and affordability measures. We find that almost all clean stack scenarios are above the Energy Sector Management Assistance Program's threshold, regardless of displaced baseline fuels. Further research should evaluate multiple measures of affordability to understand the full household budgetary context. Our results indicate a cooking fuel affordability crisis, which can undermine the achievement of multiple Sustainable Development Goals.

Performance Assessment of a Portable Improved Bio-Ethanol Gel Clean-Cook stove

Performance Assessment of a Portable Improved Bio-Ethanol Gel Clean-Cook stove

Where the power lies: Developing a political ecology framework for just energy transition

AbstractThis critical review lays down the fundamentals for rethinking just energy transition. It reviews the theoretical perspectives of energy justice, socio‐technical transitions (STTs), and political ecology and presents a plausible and useful way to approach a just low‐carbon transition using Political Ecology as a broad framework. This Political Ecology framework for Sustainable Energy Transition (PESET) addresses power issues associated with low‐carbon transition, while also identifying the role of inclusivity and justice in low‐carbon transition. As energy transition studies have primarily focused on the Global North and the extraction and production of large technologies, this framework provides a more radical means to achieve just transition objectives with particular relevance for application in the Global South—a region largely overlooked in transitions scholarship and where mundane/simple technologies (e.g. Solar Home Systems and clean cookstoves) typify transitions processes to date. The PESET framework presents a novel contribution, linking the concepts of energy justice, STTs, and political ecology to provide a more comprehensive means of framing and analysing just energy transitions. It thus provides a novel overarching framework linking energy studies, sustainability transitions, development studies and innovation studies especially in an era where the globe is moving toward a clean and affordable energy for all (Sustainable Development Goal 7).

Influencing Motivations Linked to the Adoption of Improved Flame-Based Cookstoves among Indigent South African Households: A Behaviour-Centred Design Approach

The adoption of energy-efficient, clean, and safe cookstoves can improve the health of poor sub-Saharan households and reduce mortality and poverty, as identified in the United Nations’ Sustainable Development Goals (SDGs). Despite multiple interventions to increase the adoption of improved stoves and clean fuels, few interventions have borne fruit on a significant scale. The lack of adoption is shared in South Africa. (1) Background: The deleterious health hazards associated with flame-based cooking mainly affect women and children due to using portable and cheap paraffin (kerosene) cookstoves or self-constructed metal barrel wood stoves. A shift to improved cookstoves requires significant changes in users’ behaviour. Understanding and addressing the motivations for cookstove adoption and long-term use is critical for successfully implementing behavioural change campaigns. (2) Methods: A case study methodology is employed to evaluate the effectiveness of a behaviour-centred design (BCD) approach aimed at influencing cookstove-related motivations among low-income households in Dunoon, South Africa; the study gathers data via structured observations, co-creative workshops, and card-based choice questionnaires before and after a pilot intervention. (3) Results: The survey conducted before and after the abridged BCD intervention implementation in Dunoon indicates that the majority of touchpoints achieved significant success in influencing the selected cookstove-related motivations of the sampled households, further corroborated by an observed shift in household cookstove ownership patterns targeted by the intervention. (4) Conclusions: A BCD approach suggests possible methods for understanding and influencing the complex motivations determining cookstove use in a context similar to South Africa. The results suggest that linking pertinent motivations to a selected set of touchpoints as part of a cookstove-related campaign can influence cookstove-related motivations linked to the adoption of improved flame-based cookstoves in a localised South African low-income context.

Stop normalizing poverty: How can African children achieve their true lung health potential?

The British Thoracic Society (BTS) launched a Global Health Group in 2019 in partnership with the Pan African Thoracic Society. This paper reports the third of a series of BTS Winter Meeting global lung health symposia addressing lung health in African children in the context of poverty. In this report, we summarize the two presentations included in the symposium. The first talk, by Refiloe Masekela, focused on the legacy of poor lung health across generations providing an overview of factors known to be important in child respiratory health. The second talk, by Kevin Mortimer, summarized the evidence to date on intervention studies of clean cookstoves and child lung health.

Safety certification of improved biomass cooking stoves—A test method for tipping, sliding, and spilling stability

Usage of inefficient and unsafe cookstoves is a cause of significant health losses and injuries in low-income communities. Efforts to develop and disseminate clean cookstoves have concentrated on optimizing thermal and emission performance, but minimal attention was given to safety aspects. Discussions conducted by the ISO TC285 Technical Committee are ongoing on the derivation of a universal biomass cooking stove standard that aims to guide the development and marketing of products that are safe and efficient with clean burning. Under this, cooking stove safety guidelines addressing a range of hazards have been issued to the community of practice. This work critically addressed the current guideline on cooking stove stability by pointing out the inadequacy of the test and suggesting extra tests for an improved rating of a candidate stove. With a pot and fuel introduced to the research, there may be three different failure modes for various pot and stove combinations, which were tipping, sliding, or spilling. The tests were conducted on an inexpensive purposely built “tiltometer” that allowed testing the angles for stove tipping and sliding, as well as cooking pot sliding and spilling failure. The results indicated that tipping angles for a selected list of modern stoves varied widely based on different shapes and masses, from 18° to 72.2°. Also, the performance of the three different failure modes would place the same stove in different tiers by the current safety protocol. Theoretical geometric calculations for the tipping angle were conducted, and the relative errors were within 2.9%–12.7% for the three different orientations. It is suggested that a revision of the interim stove safety standard should be promoted to incorporate the findings of this study.

Evolutions in Gaseous and Liquid Fuel Cook-Stove Technologies

The rapidly growing global demand for pollutant-free cooking energy has proliferated the research and development of energy efficient and clean cook-stoves. This paper presents a comprehensive review on the gradual improvements in cook-stove designs, focusing on gaseous and liquid fuel-operated cook-stoves around the world. Various literatures concerning the technical aspects such as design and testing, are brought together to provide an insight into the present status of developments in cook-stoves. This review of cook-stove performance covers topics such as stable operating conditions, flame propagation aspects, heat transfer and temperature distribution within the burner, fuel consumption, thermal efficiency, and emissions. Covering both laboratory-scale and field studies, the various cook-stove technologies reported so far are summarized with relevant comments regarding their commercial viabilities. The numerical modeling of combustion in cook-stoves; human health and the environmental impacts of unclean cooking technologies; and various schemes, strategies, and governmental initiatives for the promotion of cleaner cooking practices are also presented, with suggestions for future work.

Health impacts of solid fuel use in Ghana: A nationally representative assessment of cooking-related burns

BACKGROUND AND AIM Burns and burn-related injuries are still a major public health problem. Every day, over 30,000 people suffer new severe burns worldwide. Low- and middle-income countries (LMICs) bear a disproportionate burden (70%) of these burns. While burn prevention strategies have successfully been implemented in high-income countries, a paucity of data regarding the incidence and risk factors of burns in LMICs limits their expansion. Here, we aimed to describe the country-level incidence of serious cooking-related burns in Ghana and to identify household-level risk factors for adults and children. METHODS We conducted a nationally representative household energy use survey in Ghana in 2020. The final sample included 7,389 households across 370 enumeration areas in all 16 regions of Ghana. An adapted version of the Global Alliance for Clean Cookstoves Burns Surveillance Module was administered to each respondent. We computed incidence rates and 95% confidence intervals using the Byar’s approximation and conducted univariate logistic regression to identify potential risk factors. RESULTS Out of 7,389 households, we documented 129 serious cooking-related burns which had occurred in the previous 12 months. Slightly more than half (55%) of those burns occurred among adults. The incidence rate (95% CI) of cooking-related burns per 1000 person-years was 9.7 (7.7; 12) and 11 (8.5; 14) among adults and children respectively. Among adults, the odds (95% CI) of experiencing a serious cooking-related burn were 2.29 (1.02; 5.14) and 2.40 (1.04; 5.55) times higher among primary wood and charcoal users respectively compared to primary LPG users. No children burns were documented in households where LPG was primarily used. CONCLUSIONS Using a nationally representative sample, we characterized the incidence of cooking-related burns across demographic groups in Ghana. Solid fuel use compared to LPG use doubled the odds of experiencing such burns. KEYWORDS Burns; Solid fuel; Energy access; LMICs; Ghana

Demand for environmental health technologies: a clean cookstove experiment in Northern Ghana to investigate effects of prices and peers

BACKGROUND AND AIMS: Across a wide range of environmental health issues, understanding the drivers of technology adoption and behavior change is key to achieving exposure reductions. In areas reliant on biomass for cooking, reducing exposure to household air pollution requires shifts toward cleaner cooking technologies. We conducted an experiment in Northern Ghana to assess how prices and peer effects shape demand for two models of improved cookstoves. METHODS: Our experiment involved offering stoves at randomized prices to peers and non-peers of households who received free stoves during a prior study. This experimental design allows us fully estimate a two-good demand system for the high- and low-end stoves, and to econometrically identify complex changes in demand for these goods owing to peers’ adoption of the stoves. RESULTS: The peer treatment only affected demand for the less familiar and more expensive stove, making users less price-sensitive while leaving aggregate willingness to pay unchanged. We also find evidence that users found the two stoves offered to be complements: users preferred purchasing one of each stove over purchasing two of either stove. Estimated price elasticity effects translate into substantial positive or negative impacts to the predicted cost-effectiveness of subsidies for these technologies, depending on marketing costs and the relative performance of the two stoves. CONCLUSIONS: Programs and policies that seek to expand use of health-improving technologies must examine how social context and prior experiences with similar technologies among peers shape households’ decision. &amp;#x22;Market spoilage” is a risk when low-quality products are distributed in free trials, and these risks should be considered in the design of environmental health promotion strategies. KEYWORDS: Peer effects, social learning, environmental health, cookstoves, demand modeling

Thermo-electric generation (TEG) enabled cookstoves in a rural Indian community: a longitudinal study of user behaviours and perceptions

Background. Traditional cookstoves that burn solid biomass are associated with inefficient burning, a high degree of household air pollution and high morbidity rates. A key barrier to the adoption of clean cookstoves has been the cost of fuels. Hence, a Thermo-Electric Generating (TEG) cookstove that used solid biomass fuels more efficiently and released less smoke was developed. The TEG cookstove also generates electricity to power small electric devices. Fifteen TEG cookstoves were distributed to villagers in the Indian state of Uttarakhand in 2019. Objective. We wanted to understand whether, after two years of distribution, TEG cookstoves were still used, what and where they were used for, their perceived impacts on health, and the barriers to their use. Methods used. We surveyed 10 of the 15 recipient households. We applied the Capability, Opportunity, Motivation-Behaviour and Behaviour Change Wheel frameworks to understand what the barriers to adoption were, and what could be done to surmount these. Results. All respondents reported lower smoke levels and most respondents reported that the TEG cookstoves required less fuelwood than their traditional cookstoves, but none had used them in the month prior to the survey. Discussion. For those whose TEG cookstoves were still usable and had not been made redundant by clean cookstoves, we found there to be physical opportunity barriers and psychological capability barriers. Physical opportunity barriers included a small inlet for fuel, limited versatility beyond cooking at low temperatures, and the availability of only one hob. To surmount these barriers, we recommend co-design to suit user needs and education emphasising visible benefits of avoided soot on kitchen walls, in addition to the health benefits.

Clean cooking energy transition in Nigeria: Policy implications for Developing countries

Lack of access to clean cooking energy systems negatively affects the health and welfare of millions of people in developing countries. Different factors such as household income, household size, fuel price, and information spread have been identified as barriers to the widespread uptake of clean cooking systems. However, analyses exploring the dynamic influences of these factors towards accelerating clean cooking from the long-term perspective are limited. Here, we employ a system dynamics modelling framework to simulate how various strategies could affect the adoption of clean cooking systems in Nigeria over time. Our results reveal that clean cooking adoption is a fluctuating process, and the trends present a non-linear behaviour. We found that the adoption of clean cooking energy systems would occur faster early in the simulating year among urban households than in rural households. The results indicate that, at low prices of liquefied petroleum gas, many rural households will switch to clean cookstoves with higher adoption rates than consumers in urban households. Additionally, results from baseline scenario analysis revealed that, without significant policy interventions, not all households would switch to clean cooking. Our analysis further indicates that households with fewer members tend to transition quicker to clean cooking options than larger households. The impact of clean cooking due to communication among households would be more significant among rural households than among urban households. While the model results are perceptive, we emphasise that potent policies are needed to accelerate the diffusion and adoption of clean cooking energy systems in Nigeria and other African countries.

Design Devices for Human Development: A Capabilities Approach in Kenya and Uganda

Despite progress in recent decades, many crucial challenges to the eradication of extreme poverty remain intractable. Development interventions often fail to deliver sustained, transformational outcomes to households and communities. The field of design has demonstrated its capacity to deliver designed artifacts that enhance the livelihoods and well-being of people living in resource poor communities, but it remains unclear how its tools can contribute to interventions seeking multidimensional and transformational development outcomes. We present insights from two case studies, conducted in Kenya and Uganda, where a service design approach was applied to the design of two development interventions: a clean cookstove and fuel system, and an innovative insurance product to help farmers cope with climate variability. In both cases, experience mapping, archetype construction, and prototyping served to reveal individual needs, capacities, and values, and enabled the translation of this information into design features for the interventions. Using Amartya Sen’s capabilities approach as an ex post analytical frame, we show how these devices could guide designers seeking to deliver transformational development outcomes when co-designing services that aim for environmental sustainability and social well-being among low-income communities.

Rice straw open burning: emissions, effects and multiple benefitsof non-burning alternatives

Rice is one of the most important staple foods not just to people in Asia, but around the world. To meet domestic and export demands, farmers in Southeast Asia (SEA) grow 2-3 crop cycles per year, which leaves only a short period for land preparation. Field open burning of rice straw has been widely practiced to quickly clear the surface biomass for the next crop planting. However, this uncontrolled open combustion of rice straw releases large amounts of toxic air pollutants including key conventional pollutants along with carcinogenic compounds like dioxins, polycyclic aromatic hydrocarbons, and benzene, as well as major climate forcing agents. Emissions from rice straw open burning (RSOB) have been shown to significantly elevate ambient levels of PM2.5 and surface ozone in adjacent urban areas. During the dry season, when stagnant meteorological conditions are prevalent, intensive open burning activities further intensify haze episodes. Rice straw, however, is a valuable resource that should be recovered and not disposed of by open burning. Indeed, several non-open burning alternatives are available that would bring in multiple benefits to air quality, climate, health, and economy. For example, the production of rice straw fuel pellets for cooking in clean gasifier cookstoves is one promising option. For the successful elimination of RSOB in SEA, technology development along with formulation and implementation of appropriate policies should be in place to mobilise active participation from all stakeholders.

Fidelity and Adherence to a Liquefied Petroleum Gas Stove and Fuel Intervention during Gestation: The Multi-Country Household Air Pollution Intervention Network (HAPIN) Randomized Controlled Trial.

Background: Clean cookstove interventions can theoretically reduce exposure to household air pollution and benefit health, but this requires near-exclusive use of these types of stoves with the simultaneous disuse of traditional stoves. Previous cookstove trials have reported low adoption of new stoves and/or extensive continued traditional stove use. Methods: The Household Air Pollution Intervention Network (HAPIN) trial randomized 3195 pregnant women in Guatemala, India, Peru, and Rwanda to either a liquefied petroleum gas (LPG) stove and fuel intervention (n = 1590) or to a control (n = 1605). The intervention consisted of an LPG stove and two initial cylinders of LPG, free fuel refills delivered to the home, and regular behavioral messaging. We assessed intervention fidelity (delivery of the intervention as intended) and adherence (intervention use) through to the end of gestation, as relevant to the first primary health outcome of the trial: infant birth weight. Fidelity and adherence were evaluated using stove and fuel delivery records, questionnaires, visual observations, and temperature-logging stove use monitors (SUMs). Results: 1585 women received the intervention at a median (interquartile range) of 8.0 (5.0–15.0) days post-randomization and had a gestational age of 17.9 (15.4–20.6) weeks. Over 96% reported cooking exclusively with LPG at two follow-up visits during pregnancy. Less than 4% reported ever running out of LPG. Complete abandonment of traditional stove cooking was observed in over 67% of the intervention households. Of the intervention households, 31.4% removed their traditional stoves upon receipt of the intervention; among those who retained traditional stoves, the majority did not use them: traditional stove use was detected via SUMs on a median (interquartile range) of 0.0% (0.0%, 1.6%) of follow-up days (median follow-up = 134 days). Conclusions: The fidelity of the HAPIN intervention, as measured by stove installation, timely ongoing fuel deliveries, and behavioral reinforcement as needed, was high. Exclusive use of the intervention during pregnancy was also high.

Urban residential energy switching in China between 1980 and 2014 prevents 2.2 million premature deaths

Urban residential energy switching in China between 1980 and 2014 prevents 2.2 million premature deaths

Which Biomass Stove(s) Capable of Reducing Household Air Pollution Are Available to the Poorest Communities Globally?

Globally, household and ambient air pollution (HAAP) leads to approximately seven million premature deaths per year. One of the main sources of household air pollution (HAP) is the traditional stove. So-called improved cookstoves (ICS) do not reduce emissions to levels that benefit health, but the poorest communities are unlikely to have access to cleaner cooking in the medium term. Therefore, ICS are being promoted as an intermediate step. This paper summarises the current evidence on the ICS available to the global poorest, utilising data from the Clean Cookstoves Catalog and systematic review evidence from the field. The cheapest stoves offer little reduction in HAP. Only one ICS, available at US$5 or less, (the canarumwe) minimally reduced pollutants based on ISO testing standards and no studies included in the systematic reviews reported tested this stove in the field. We recommend field testing all ICS as standard, and clear information on stove characteristics, sustainability, safety, emissions efficiency, in-field performance, affordability, availability in different settings, and the ability of the stove to meet community cooking needs. In addition, ICS should be promoted alongside a suite of measures, including improved ventilation and facilities to dry wood, to further reduce the pollutant levels.

Constructing clean cookstove stack in Ghana

BACKGROUND AND AIM: Transition to cleaner cooking technologies has the ability to increase economic and environmental benefits, studies have shown that adoption of improved cooking stoves is very low and those who adopt clean cooking stove/ fuels are likely to stack with biomass fuel. The aim of this study was to identify promising “clean stacks” of stoves and fuels that are relevant to household energy needs in middle belt of Ghana. METHODS: A mixed method approach was used in data collection. Ten households who were exclusive users of biomass fuel were randomly selected from the Kintampo Health Demography Surveillance Survey. We used questionnaires to collect information on sociodemographic characteristics, household energy needs, stove use, and acceptability of stoves. The stoves that were given to participants were Mimi motos (a forced draft pellet biomass stove), Electric induction, Ethanol stoves and LPG stoves. Fuel was provided at no cost to participants. Each stove was assigned to the households for a period of two weeks, one after the other. After the single technology assessment, two most preferred stoves were given back to participants to use simultaneously for a period of one month. During this one-month period, participants exposure to PM2.5 were assessed. RESULTS:LPG and Ethanol stoves were the two most preferred stoves. The participants noted inconveniences and numerous mechanical and operational difficulties with the mimi moto and the electric stove. Induction electric stove recorded a mean reading of 0.10 volts Forty-eight-hour personal PM2.5 assessed during the clean stack period was slightly higher with mean concentration of 10.82 μg/m3 (0.54) compared to WHO guideline (10 μg/m3), but was substantially lower than baseline. CONCLUSIONS:Of the four stoves tested, participants expressed satisfaction with LPG stove and Ethanol stove as it met their daily energy needs. Adoption and acceptability of the improved stoves varied with different dishes or cooking tasks. KEYWORDS: clean fuel stack, exposure assessment, Ghana