A rapid assessment randomised-controlled trial of improved cookstoves in rural Ghana

article i nfo We conducted a rapid assessment randomized-controlled trial to quantify changes in fuel use, exposure to smoke, and self-reported health attributable to deployment of an improved wood cookstove in the Upper West region of Ghana. Women trainers from neighboring villages taught participants to build an improved cookstove and demonstrated optimal cooking techniques on such stoves. Participants were then randomly assigned to construct improved stoves at their homes immediately (treatments) or in a few months (controls). Several weeks after the treatments built their new stoves, all participants engaged in a cooking test while wearing a carbon monoxide monitor. At that time we surveyed participants on cooking activity, fuel wood gathering, self-reported health, and socioeconomic status. At a subset of homes we also installed stove usage monitors on the improved and traditional stove for the following three weeks. During the cooking tests, treatments used 5% less fuel wood than controls, but the difference was not statistically significant. There were no detectable reductions in a households' weekly time gathering wood or in exposure to carbon monoxide. In contrast, there was a sharp decline in participants' self-reported symptoms associated with cooking, such as burning eyes, and in respiratory symptoms, such as chest pain and a runny nose. Stove usage monitors show that treatments used their new stove on about half of the days monitored and reduced use of their old stoves by about 25%. When we returned to three of the villages eight months after project implementation, about half the improved stoves showed evidence of recent usage. Overall the new stoves were not successful, but the evaluation was. Our methods offer a rigorous modest-cost method for evaluating user uptake, field-based stove performance, and exposure to smoke.