Clean Cookstoves Research Articles

Unearthing trends in environmental science and engineering research: Insights from a probabilistic topic modeling literature analysis

Academic contributions in environmental science and engineering (ESE) research are needed to ensure a cleaner, productive, and environmentally conscious society. Hence, an understanding of the critical trends, topics, and research developments in the field is crucial towards facilitating the identification, communication, and improved research collaboration of nascent and increasingly complex environmental problems. As a deeper analysis of the broader trend evolution of ESE research is lacking in the literature, we employ a more robust content analysis approach in the form of a topic modeling computational text analysis method to unearth key temporal and regional insights in the field. As such, we apply a latent Dirichlet allocation (LDA) model on abstract metadata based on 3572 articles procured from reputable journals that published subject matter related to ESE research from 2005 to 2019 inclusive. We analyze the statistical composition of each inferred topic in the form of word clouds and uncover general research trends, such as topics related to environmental impact assessments, improved clean cookstoves, solid waste management, and environmental lead pollution. We also perform temporal analysis experiments across each respective journal and observe a high degree of consistency and variance among topic focuses. Moreover, whilst quantifying trends at the regional level, we detect that certain countries display clearly discernible patterns, suggesting that research communities in ESE from various countries tend to focus on different sub-fields. The main contribution of our work is the application of a more refined computer-assisted content analysis method in ESE trend analysis research that can serve as the foundation for future exploratory trend analysis investigations in ESE and other related fields.

Socio-economic Aspects Influencing Rural Household Adoption of Improved Clean Cookstoves: A Case of Rwanda in Africa

Despite multiple socio-economic, health and environmental benefits of improved cook stove programmes, there is failure to capture the recognition worldwide and a set of sociocultural, economic, institutional barriers and cook stoves and fuel characteristics contribute to the slow adoption. This paper provides evidence of household driving factors that play a crucial role in the uptake of improved cook stoves empirically in Rwanda. The study was based on the fifth integrated household living standards survey (EICV-5) carried out by the National Institute of Statistics of Rwanda. Using binary logistic regression analysis, the study utilised socio economic, stove and fuel factors for determining the adoption of usage of improved cook stove. The study revealed that for a substantially improved rate of adoption there should be consistent and focused cooperation of government and non-governmental organizations to work in parallel for developing energy policy frameworks like dissemination of improved cook stoves.

Household air pollution, ultrasound measurement, fetal biometric parameters and intrauterine growth restriction

BackgroundLow birthweight, intrauterine growth restriction (IUGR) and perinatal mortality have been associated with air pollution. However, intervention studies that use ultrasound measurements to assess the effects of household air pollution (HAP) on fetal biometric parameters (FBP) are rare. We investigated the effect of a cookstove intervention on FBP and IUGR in a randomized controlled trial (RCT) cohort of HAP-exposed pregnant Nigerian women.MethodsWe recruited 324 women early in the second trimester of pregnancy. Between 16 and 18 weeks, we randomized them to either continue cooking with firewood/kerosene (control group) or receive a CleanCook stove and ethanol fuel (intervention group). We measured fetal biparietal diameter (BPD), head circumference (HC), femur length (FL), abdominal circumference (AC) and ultrasound-estimated fetal weight (U-EFW) in the second and third trimesters. The women were clinically followed up at six regular time points during their pregnancies. Once during the women’s second trimester and once during the third, we made 72-h continuous measurements of their personal exposures to particulate matter having aerodynamic diameter < 2.5 μm (PM2.5). We adopted a modified intent-to-treat approach for the analysis. Differences between the intervention and control groups on impact of HAP on fetal growth trajectories were analyzed using mixed effects regression models.ResultsThere were no significant differences in fetal growth trajectories between the intervention and control groups.ConclusionsLarger studies in a setting of low ambient air pollution are required to further investigate the effect of transitioning to a cleaner fuel such as ethanol on intrauterine growth.Trial registrationClinicalTrials.gov NCT02394574; September 2012

A case study of improved cookstoves and clean fuel use by selected Nigerian Households

The implementation of the United Nations Sustainable Development Goals (SDGs) in Nigeria and many African countries seek evidence-based approaches to make business, health and socio-economic justification for increased public and private sector investments to achieve the goals. Yet, access to resources to engender food, energy, social, economic, and environmental security by over 62% of Nigerians living below the poverty line of $1.90 per day, remains a challenge. The aim of this paper is to use the SDG framework to analyze the inter-linkages between food security, social, economic, climate and environmental outcomes of a national clean cookstoves project that was effectively implemented in Nigeria between 2014 and 2018. The project distributed improved cookstoves and clean fuels to 1000 households with the aim of using it as a pilot to stimulate demand, contribute to the expansion of energy access for cooking, improve the livelihood of women and girls, reduce forest degradation and fuelwood-induced carbon emissions. Structured questionnaires were used to collect primary data from 161 households drawn from a randomly stratified experimental layout in Kwara state. Project variables were classified into economic security (SDG1), food security (SDG2), social security (SDG4), energy security (SDG7), climate variable (SDG13), and environmental sustainability (SDG15). Regression estimates reveal that all the representative SDG variables significantly impacted the food security of beneficiaries in the following order: SDG1 > SDG4 > SDG15 > SDG13 > SDG7. A conceptual framework consisting of pentagonal linkages was developed from Pearson correlation estimates. The study established a pentagonal nexus for SDG1,2,4,7,13,15 hinged on food security, social, economic, energy, climate, and environmental factors. We suggest strengthening of climatic and environmental frameworks such as the integration of SDGs into Nationally Determined Contributions and long-term national development plans to drive food security. The study calls on the private sector to make use of SDG policy analysis to direct investments to help build back better from the COVID-19 pandemic. A matrix of food security-based policy, research, project, and knowledge activities were recommended to better understand SDG synergies.

The forgotten half: Men’s influence over cookstove adoption decisions in Northern Kenya

Current research on cleaner cookstoves (CCS) is focused primarily on women, thus removing men from the cookstove adoption equation despite their decision making role in households. Very little is understood about what would motivate men to purchase CCS, and whether such motivations are key factors that influence a household’s decision to acquire CCS. There is a paucity of comparative analyses of men and women perspectives on this topic. This study adopted a qualitative approach to gain a first-hand perspective of men on this issue, and to compare findings with that of women in order to identify any similarities and gaps that could shape the eventual outcome of acquisition of a CCS. Contrary to published literature of women’s perception of men as being naïve to the challenges associated with traditional cookstoves, we find men in our study to be highly aware of such challenges, having experienced them as child-cooks while growing up. However, this awareness does not translate into an interest in purchasing CCS. While women expressed a strong desire for CCS, men who wield power over decisions to acquire CCS viewed them as status symbols, unnecessary and unattainable. This gender imbalance in motivation and power forecloses opportunities for household adoption of CCS. We recommend that programs should equally target men with CCS messaging, bundle cookstoves with other products that men value, and take advantage of women’s groups as a source of collective bargaining power for women in the acquisition of CCS.

Enhancing LPG Adoption in Ghana (ELAG): A Trial Testing Policy-Relevant Interventions to Increase Sustained Use of Clean Fuels.

Rural Ghanaians rely on solid biomass fuels for their cooking. National efforts to promote the Sustainable Development Goals include the Rural Liquefied Petroleum Gas Promotion Program (RLP), which freely distributes LPG stoves, but evaluations have demonstrated low sustained use among recipients. Our study objective was to assess if cheap and scalable add-on interventions could increase sustained use of LPG stoves under the RLP scheme. We replicated RLP conditions among participants in 27 communities in Kintampo, Ghana, but cluster-randomized them to four add-on interventions: a behavioral intervention, fuel delivery service, combined intervention, or control. We reported on the final 6 months of a 12-month follow-up for participants (n = 778). Results demonstrated increased use for each intervention, but magnitudes were small. The direct delivery intervention induced the largest increase: 280 min over 6 months (p < 0.001), ∼1.5 min per day. Self-reported refills (a secondary outcome), support increased use for the dual intervention arm (IRR = 2.2, p = 0.026). Past literature demonstrates that recipients of clean cookstoves rarely achieve sustained use of the technologies. While these results are statistically significant, we interpret them as null given the implied persistent reliance on solid fuels. Future research should investigate if fuel subsidies would increase sustained use since current LPG promotion activities do not.

Socio-economic Aspects Influencing Rural Household Adoption of Improved Clean Cook Stoves Case Study: Rwanda

The major causes of deforestation worldwide from human activities is the reliance of world population on the biomass fuel for domestic energy consumption through cooking, water boiling, heating and lighting, the usage of biomass in inefficient way increase the fuel demand for the household. Despite of multiple social economic, health and environmental benefit of improved cook stove program, the program failed to capture the recognition worldwide and a set of sociocultural, economic, institutional barriers and cook stove and fuel characteristics contribute to the slow adoption of this program. This paper provides an evidence of household driving factors that play a crucial role in the uptake of improved cook stove empirically in Rwanda. The study was based on fifth integrated household living standards survey (EICV-5) carried by National Institute of Statistics of Rwanda. Using binary logistic regression analysis, the study shows that homeownership, age of household head, household location and household size are the main significant household factors influencing the adoption of improved cook stove while value of cook stove, amount spent on cooking fuel and time spend on cooking fuels are the most significant stove and fuel factors determining the adoption of usage of improved cook stove. The study revealed that for substantially improved rate of adoption they should be consistent and focused cooperation of government and non -governmental organizations to work in parallel for developing energy policy frameworks like dissemination of improved cook stoves.

Time Use Implication of Clean Cookstoves in Rural Settings in Ghana: A Time Use Study.

Whilst the health benefit of using clean cookstoves and fuels is widely known, there is limited information on the non-health benefit of these stoves, especially in low-middle-income countries. This paper reports the time use implications of using clean cookstoves and fuels by comparing liquified petroleum gas (LPG), an improved biomass cookstove (BioLite), and traditional biomass cookstoves (three-stone fires) in Ghana. Using survey-based time diaries, information on all the activities undertaken by study participants during a 24-h was collected and analyzed. The findings of the study show that LPG users spent significantly less time gathering firewood compared to the users of improved cookstoves and three-stone fires. LPG users spent slightly less time per cooking episode, generally, and there was no significant difference in cooking time across the three cookstoves mostly due to stove stacking. Time spent engaging in economic activities was highest for LPG users and improved biomass cookstove users, at least when compared to three-stone fire users. In this study, we provide evidence on the time use implications of clean cookstoves, highlighting their non-health benefits and supporting efforts towards the adoption and sustained used of clean cookstoves

Experimental evaluation of electric clean cooking options for rural areas of developing countries

Worldwide, about 3 billion people, mainly located in rural areas, do not have access to clean cooking, due to lack of electricity access, low availability and affordability of clean cooking technologies. Most clean cookstoves are claimed to be energy-efficient and cost-effective, but there is a lack of independent comparative analysis with different food types and different cookstoves. This paper assesses the energy consumption, energy costs, efficiency, energy outputs/inputs, Net Present Values (NPV), and heat transfer behaviors of two electric resistance cookstoves (one locally manufactured in Ethiopia and a single hot plate), induction stoves and pressure cookers. Additionally, the temperature and energy consumption were monitored throughout the cooking process for each of the technologies and foods considered. The investigation assessed Ethiopian traditional foods, such as shiro, rice cooking and water boiling. The results indicate that pressure cookers provide a lower energy difference between the output and input, higher water boiling efficiency and lower energy costs, whereas locally manufactured products resulted in higher energy difference, lower water boiling efficiency, and higher energy costs. Concerning NPVs, the Single Hot Plate presents a better cost-benefit ratio compared with the other cookstoves options. Additionally, this paper highlights the policy and strategies that should be followed for the promotion of electric clean cooking technologies.

Status and Prospect of Clean Cookstoves in Terai Region of Nepal

Status and Prospect of Clean Cookstoves in Terai Region of Nepal

Household perspectives on cookstove and fuel stacking: A qualitative study in urban and rural Kenya

Stove and fuel stacking is becoming accepted as part of the clean cooking transition process, even though it attenuates positive health and climate benefits that can be realized by cookstove interventions. This study analyses the underlying drivers of stove and fuel stacking from the household perspectives, and its implications for improving impact of clean cooking programs.The study draws on a case study of two communities in Western and Northern Kenya: rural households predominantly using biomass fuels and urban households predominantly using liquefied petroleum gas for cooking. Data was collected through in-depth interviews and focus group discussions, and was analysed using the systematic procedures of grounded theory.Stove and fuel stacking is found to be a pervasive practice, necessitated by the inability of any single cooking device to fulfill all stove applications and needs in the household. Time-costs and practical limitations associated with the primary stove, such as inability to accommodate large pot sizes were identified as the major reasons for stacking. These reasons were much more dominant than cultural attachment to traditional stoves and associated food tastes. Stacking had some highly regarded positive benefits, such as providing a fallback stove when the primary one could not meet key functionalities; and saving time by allowing for multiple dishes to be prepared simultaneously.Our findings support other studies that have shown stacking to be a common practice, and highlights the implications of this practice for strategies aimed at scaling-out clean cookstoves.

Association between maternal sociodemographic characteristics and Compliance to Clean Cookstove use in Rural Ghana

Background/Aim: The use of cleaner technologies and efficient biomass energy is an appropriate strategy to mitigate global climate, health risks, and help in attaining the sustainable development goal’s (SDG’s) target on access to reliable, affordable, and modern energy services by 2030. We evaluated the association between maternal sociodemographic characteristics and compliance to clean cookstove use in a rural setting in Ghana. Methods: This was a cluster-randomised intervention trial conducted among 890 women in the Kintampo North Municipality and Kintampo South District of Ghana, West Africa. Twenty-two rural communities were randomized to one of 2 efficient biomass interventions: BioLite (527 women from 13 communities) and LPG (361 women from 9 communities). Study fieldworkers visited participant homes weekly and documented use of intervention stoves. For each participant, compliance was computed as the number of visits for which assigned clean cookstove was used divided by the total number of visits made to that individual. Fractional logit model was used to assess the association between sociodemographic characteristics of study participants and compliance with efficient biomass use. Results: Overall compliance to clean cookstove use ranged from 0% (no clean cookstove use) to 100% (all clean cookstove use). Compliance was significantly higher for participants who used LPG compared to those who used Biolite (0.98% vs. 0.88%, p-value &lt;0.001). In an unadjusted analysis, participants with any form of education were less likely to comply with the use of clean cookstove compared to those with no formal education. Traders had significantly lower compliance compared to farmers (3.2% CI: 0.3% to 6.2%; p-value: 0.033). Compared to the poorest, less poor and least poor were significantly less likely to comply to clean cookstove use. Conclusions: Socio-demographic factors play a role in the adoption of cleaner cooking methods. Understanding these factors can help in providing targeted interventions on cleaners fuel use.

Using longitudinal survey and sensor data to understand the social and ecological determinants of suspending clean cookstove use in rural Ghana

Background: Efforts to reduce the health and ecological burdens of biomass combustion are underway in Ghana, primarily by promoting clean cookstoves. While studies often examine sustained use of clean or improved cookstoves, others show that intervention stoves often go unused or abandoned. We developed and employed a novel framework, based on health behavior theory, to understand reasons for disuse: stove use suspension.Methods: We leveraged data from the Ghana Randomized Air Pollution and Health Study (GRAPHS) (N=1412) where households received either improved biomass (BioLite) or liquified petroleum gas (LPG) stoves for free. LPG users were given free LPG refills during GRAPHS. Fieldworkers administered weekly questionnaires throughout GRAPHS, and digital stove use monitors tracked a subcohort (n = 220) 6 months before and after the fuel subsidy. We examined social and ecological determinants of stove disuse and suspension.Results: 60% of BioLite and 80% of LPG participants reported intervention stove use by GRAPHS’ termination. We found that participants cooked on intervention stoves less for meals requiring vigorous stirring. We also found that burns from intervention stoves were associated with less use among BioLite (RR: 0.96, p=0.009), but not LPG users. Using open response data, we found that device breakage was an impediment to intervention stove use in 18% of LPG user responses and 1% for BioLite. Finally, we assessed stove use suspension after the LPG subsidy using stove use monitor data, and household characteristics as explanatory variables, with Cox regressions. We found that tree canopy within a spatial buffer (a proxy for biomass access) was the only significant factor in univariate and adjusted analyses (HR = -0.56, p&lt;0.001).Conclusion: We recommend that future studies employ the suspension framework to identify leverage points for increasing sustained use of clean cookstoves, with the ultimate goal of decreasing household air pollution exposures.

Household Air Pollution Exposure and Childhood Blood Pressure: Evidence from GRAPHS

Background Household air pollution (HAP) exposure results in ~2.8 million premature deaths annually, largely due to cardiovascular disease. The effects of early life HAP exposure, or a clean cookstove intervention, on child blood pressure (BP), are unknown.MethodsThe Ghana Randomized Air Pollution and Heath Study (GRAPHS) randomized pregnant, non-smoking women to one of two cookstove interventions (liquefied petroleum gas, LPG, or improved biomass cookstove) or control, through the index child’s first birthday. Personal HAP exposures [fine particulate matter (PM2.5) and carbon monoxide (CO)] were repeatedly measured prenatally and through child age 4 years. At child age four and five years, we measured resting systolic BP (SBP) and diastolic BP (DBP) (Dinamap Pro 100) per protocol in N=631 children. We employed generalized estimating equations to examine associations between early life CO and PM2.5 and SBP and DBP, following adjustment for maternal age, child sex, BMI, ethnicity and second-hand tobacco smoke exposure. We then employed multivariable linear regression to determine associations between cookstove intervention arm and SBP and DBP. Sex-specific effects were explored.ResultsMedian PM2.5 and CO exposures were 67.5μg/m3 (IQR=42.3-103.6) and 0.87ppm (IQR=0.49-1.41) respectively. Higher early life PM2.5 and CO exposures were independently associated with higher SBP [(PM2.5: 0.24mmHg (0.12-0.35)] per 10μg/m3 increase in PM2.5; CO: 0.59 mmHg (95% CI 0.07-1.12) per 1ppm increase in CO]. Children born to mothers randomized to the LPG arm had lower SBP (-1.62mmHg, 95% CI -3.34, 0.09, p=0.06) and lower DBP (-1.63mmHg, 95% CI -3.13, -0.12, p=0.03), compared to control. Girls were more responsive to the LPG intervention (Girls SBP: -2.73mmHg, 95% CI -5.12, -0.34 vs Boys: SBP: -0.36mmHg, 95% CI -2.85, 2.13).Conclusion Early life HAP exposure is associated with increased SBP in early childhood and a clean-fuel cookstove intervention may ameliorate this effect, particularly amongst girls.

Long-term exposure to indoor air pollution and risk of tuberculosis.

Indoor air pollution (IAP) is a recognized risk factor for various diseases. This paper examines the role of indoor solid fuel exposure in the risk of mycobacterium tuberculosis (TB) in Delhi Metropolitan, India. Using a cross-sectional design, subjects were screened for a history of active TB and lifelong exposure to IAP sources, such as solid fuel burning and kerosene. The TB prevalence rate in the study area was 1117 per 100 000 population. Every year, increase in solid fuel exposure was associated with a three percent higher likelihood of a history of active TB. Subjects exposed to solid fuel and kerosene use for both heating home and cooking showed significant associations with TB. Age, household expenditure (a proxy of income), lung function, and smoking also showed significant associations with TB. Smokers and solid fuel-exposed subjects were four times more likely to have a history of active TB than non-smoker and unexposed subjects. These finding calls strategies to mitigate solid fuel exposure, such as use of clean cookstove and ventilation, to mitigate the risk of TB which aligns with the United Nations' goal of "End TB by 2030."

Impact assessment of clean cookstove intervention in Gujarat, India: a potential case for corporate social responsibility (CSR) funding.

Exposure to indoor air pollutants released from traditional cookstoves in rural Indian households is a matter of great concern. While there are various studies over several decades focused towards intervention strategies for reducing air pollutants, limited literature exists towards the identification of appropriate methodology for feasible intervention, adoption and usage of improved cookstoves (ICS). In the present study, PM2.5 and CO microenvironment concentrations are estimated in households using traditional and improved cookstove (NEERDHUR). The reduction in PM2.5 and CO microenvironment concentrations after the introduction of ICS was found to be 89-94% and 35-57%, respectively. Information-education-communication (IEC) activity was used as a tool to increase the adoption and usage rate in the ICS using households. The cost-benefit analysis was also performed to check the benefits of ICS use, and the benefit-cost ratio was found to be 3 to 4 times. Findings of the study suggest that, although the ICS intervention could significantly improve the indoor air quality, however, it fails to comply with the permissible safe limits; further focus on greener fuels and ventilation characteristics is suggested. The outcomes from the study can help decision-makers, corporate social responsibility fund mobilizers and policymakers for effective policy advocacy to design efforts by promoting clean cooking interventions and linking and mapping these with national missions and flagship programs.

Clean cooking interventions: Towards user-centred contexts of use design

Clean cookstove interventions largely fail to achieve their stated aims. In our view, the underlying flaw of many cooking interventions is a systemic lack of attention to users’ rank ordering of product features and contexts of use during the product design process. Drawing on examples of cookstove and product design, together with our experience in cookstove design, research and product standards development, we offer four suggestions for improving cookstove interventions. First, consider the benefits of incremental changes. Second, do not define the problem or the solution too quickly. Third, make no assumptions about how well you know the end user. Fourth, bring users, donors, manufacturers and implementing agencies into the design process. We conclude with a call for an inclusive approach to designing cookstove interventions that is centred around the lived experiences of users and rooted in context-specific knowledge.

Multiple Temporalities of Household Labour: The Challenge of Assessing Women's Empowerment

ABSTRACTThe economic empowerment of women remains a central feature of development projects worldwide. This article explores these empowerment aspirations by examining various temporal complexities related to two development projects in South India targeting individual cooking and fuel‐collection routines. It argues that three temporal considerations of household labour — polychronic time, collectivized time and hybrid labour/leisure time — are largely overlooked, thus challenging the appropriateness of empowerment strategies from the outset. By highlighting key household dynamics this study argues that efforts to pursue economic empowerment by members of the clean cookstove sector devalue unpaid labour and glorify waged work that is often tedious and mediated by powerful men. Further, waged work can be burdensomely added to pre‐existing unpaid domestic labour responsibilities. This common portrayal of empowerment by the clean cookstove sector can be viewed as facilitating the advancement of a neoliberal vision of rural women's livelihoods where empowerment and agency are reconfigured and incorporated into the problematic wage relations of capitalist economies. This view of empowerment, which privileges market participation, also overlooks many of the actually experienced positive effects of improved stoves; benefits which tend to be domestic, communal, routine, non‐economic and difficult to quantify. The article argues that conventional definitions and visions of ‘empowerment’ should be re‐evaluated to include forms of ‘mundane agency’.

An Agent-Based Model for Adoption of Clean Technology Using the Theory of Planned Behavior

Abstract Technology adoption in low-income regions is among the key challenges facing international development projects. Nearly 40% of the world's population relies on open fires and rudimentary cooking devices exacerbating health outcomes, deforestation, and climatic impacts of inefficient biomass burning. Clean technology alternatives such as clean cookstoves are among the most challenging technologies to approach their target goals through sustainable adoption due to a lack of systematic market-driven design for adoption. Thus, a method is needed to provide insight regarding how target customers evaluate and perceive causes for adopting a clean technology. The holistic approach of this study captures technology adoption through lenses of social networks, individual and society scale beliefs, and rational decision-making behavior. Based on the data collected in the Apac region in Northern Uganda, an agent-based model is developed to simulate emerging adoption behavior in a community. Then, four different scenarios investigate how adoption patterns change due to the potential changes in technology or intervention strategy. These scenarios include influence of stove malfunctions, price elasticity, information campaigns, and strength of a social network. Results suggest that higher adoption rates are achievable if designed technologies are more durable, information campaigns provide realistic expectations for users, policymakers, and education programs work toward women's empowerment, and communal social ties are recognized for influence maximization. The application of this study provides insight for technology designers, project implementers, and policymakers to update their practices for achieving sustainable and to the scale clean technology adoption rates.

Using longitudinal survey and sensor data to understand the social and ecological determinants of clean fuels use and discontinuance in rural Ghana

Efforts to reduce the health and ecological burdens of household biomass combustion are underway in Ghana, principally by promoting clean cookstoves and fuels. Recent studies have focused on the sustained use of clean cookstoves, but sometimes household adopt a new cookstove and then end use of that stove. In this study, we introduce a novel framework for understanding and encouraging household transitions to cleaner cooking: clean fuel discontinuance. We leveraged data from the Ghana Randomized Air Pollution and Health Study (GRAPHS) (N = 1412) where pregnant women received either improved biomass (BioLite) or dual burner LPG stoves for free. LPG users were given free LPG refills during GRAPHS. Weekly questionnaires were administered. Stove use monitors tracked a sub-cohort (n = 220) 6 months before and after the fuel subsidy. We examined social and ecological determinants of stove use and discontinuance. Overall intervention stove use adherence was high throughout GRAPHS, with self-reported use at 69% and 86% of participant-weeks for BioLite and LPG arms respectively. Participants used intervention stoves less for meals requiring vigorous stirring. Burns from intervention stoves decreased use among BioLite (RR: 0.96, p = 0.009), but not LPG users. Device breakage was mentioned as an impediment in 18% of free-text responses for LPG users and 1% for BioLite. Tree canopy within a spatial buffer—a plausible proxy for biomass fuels access—was the only variable explaining LPG discontinued stove use in adjusted Cox time-to-event analyses (HR = −0.56, p < 0.001). Future studies should consider the stove use discontinuance framework.