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Biomass Cooking Fuels and Health Outcomes for Women in Malawi

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Abstract

In sub-Saharan Africa, biomass fuels account for approximately 90% of household energy consumption. Limited evidence exists on the association between different biomass fuels and health outcomes. We report results from a cross-sectional sample of 655 households in Malawi. We calculated odds ratios between hypothesized determinants of household air pollution (HAP) exposure (fuel, stove type, and cooking location) and five categories of health outcomes (cardiopulmonary, respiratory, neurologic, eye health, and burns). Reliance on high- or low-quality firewood or crop residue (vs. charcoal) was associated with significantly higher odds of shortness of breath, difficulty breathing, chest pains, night phlegm, forgetfulness, dizziness, and dry irritated eyes. Use of high-quality firewood was associated with significantly lower odds of persistent phlegm. Cooks in rural areas (vs. urban areas) had significantly higher odds of experiencing shortness of breath, persistent cough, and phlegm, but significantly lower odds of phlegm, forgetfulness, and burns. With deforestation and population pressures increasing reliance on low-quality biomass fuels, prevalence of HAP-related cardiopulmonary and neurologic symptoms will likely increase among cooks. Short- to medium-term strategies are needed to secure access to high-quality biomass fuels given limited potential for scalable transitions to modern energy.

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Notes

  1. See http://fuel.web.unc.edu/mfls-survey/for further details of the rural sample.

  2. Household’s use of high- (e.g., wood sourced from natural forests, woodlots, or fuelwood markets, often hardwoods with relatively low moisture content) or low-quality firewood (woody plants and shrubs, smaller diameter trees, green, or wet wood) was based on respondents’ subjective assessment of the quality of firewood.

  3. Though our study collected data on cook anthropometrics, pulse oximetry and blood pressure, these indicators are being analyzed in separate papers.

  4. Well-ventilated kitchens were defined as those where most of the cooking was done partially or fully outdoors; there was a gap between the walls and roof; pitch of the roof in the cooking area was inverted “V”; and there were above average number of windows and ventilation holes.

  5. The asset ownership variable is a count of the number of assets (e.g., solar panel, electric fan, working television and/or radio, bicycle, cellphone, furniture, mattresses, metal or clay cookstove, lantern, mosquito net) households own.

  6. We exclude households that use crop residues as their primary fuel (n = 14) to limit the number of comparisons we make.

  7. Tables showing results of decomposed rural and urban samples are available upon request.

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Acknowledgments

This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01HD073329), the Fogarty International Center, and the National Heart, Lung and Blood Institute (R25TW009340). We are grateful to the Carolina Population Center (P2CHD050924) at The University of North Carolina at Chapel Hill for general support. Simon Chimwanza, Esther Giezendanner, and Laura Hamrick provided valuable inputs to this research. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the sponsoring agency.

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Authors and Affiliations

  1. Department of Public Policy, University of North Carolina at Chapel Hill (UNC-CH), Campus Box #3435, Abernethy Hall, Chapel Hill, NC, 27599-3435, USA

    Ipsita Das & Pamela Jagger

  2. Curriculum for the Environment and Ecology, UNC-CH, Campus Box #3435, Abernethy Hall, Chapel Hill, NC, USA

    Pamela Jagger

  3. Carolina Population Center, UNC-CH, Chapel Hill, NC, USA

    Pamela Jagger

  4. Department of Epidemiology, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA

    Karin Yeatts

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  1. Ipsita Das
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Correspondence to Pamela Jagger.

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Das, I., Jagger, P. & Yeatts, K. Biomass Cooking Fuels and Health Outcomes for Women in Malawi. EcoHealth 14, 7–19 (2017). https://doi.org/10.1007/s10393-016-1190-0

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