Usmani, F., Steele, J., & Jeuland, M. (2017). Can economic incentives enhance adoption and use of a household energy technology? Evidence from a pilot study in Cambodia. Environmental Research Letters, 12(3), 035009.

Abstract: While much work has examined approaches to increase uptake of a variety of household environmental, health, and energy technologies, researchers and policymakers alike have struggled to ensure long-term use. Drawing on a pilot-scale experiment conducted in rural Cambodia, this study evaluates whether economic incentives enhance continued use of, and fuel savings from, improved cookstoves (ICS). Specifically, capital-cost subsidies that have been traditionally employed to enhance ICS adoption were augmented with rebates linked to stated and objectively measured use in order to test for their impacts on both initial and sustained adoption in the treatment group. Results show that households do respond to these rebates by adopting the intervention ICS at significantly higher rates, and by using it more frequently and for longer periods. Consistent with these stove-use patterns, solid-fuel use and time spent collecting or preparing fuels also decline. However, this effect appears to diminish over time. Thus, while economic inducements may significantly increase adoption and use of new environmental health technologies, corresponding reductions in environmental or livelihood burdens are not guaranteed. Additional research on the design and implementation of incentive-based interventions targeting households directly—such as carbon financing or other forms of results-based financing (RBF) for improved cookstoves—therefore seems warranted prior to wider implementation of such solutions.

Lewis, J., Hollingsworth, J., Chartier, R., Cooper, E., Foster, W., Gomes, G., Kussin, P., MacInnis, J., Padhi, B., Panigrahi, P., Rodes, C., Ryde, I., Singha, A., Stapleton, H., Thornburg, H., Young, C., Meyer, J., & Pattanayak, S. (2017). Biogas Stoves Reduce Firewood Use, Household Air Pollution, and Hospital Visits in Odisha, India. Environmental Science & Technology, 51(1), 560-569.

Abstract: Traditional cooking using biomass is associated with ill health, local environmental degradation, and regional climate change. Clean stoves (liquefied petroleum gas (LPG), biogas, and electric) are heralded as a solution, but few studies have demonstrated their environmental health benefits in field settings. We analyzed the impact of mainly biogas (as well as electric and LPG) stove use on social, environmental, and health outcomes in two districts in Odisha, India, where the Indian government has promoted household biogas. We established a cross-sectional observational cohort of 105 households that use either traditional mud stoves or improved cookstoves (ICS). Our multidisciplinary team conducted surveys, environmental air sampling, fuel weighing, and health measurements. We examined associations between traditional or improved stove use and primary outcomes, stratifying households by proximity to major industrial plants. ICS use was associated with 91% reduced use of firewood (p < 0.01), substantial time savings for primary cooks, a 72% reduction in PM2.5, a 78% reduction in PAH levels, and significant reductions in water-soluble organic carbon and nitrogen (p < 0.01) in household air samples. ICS use was associated with reduced time in the hospital with acute respiratory infection and reduced diastolic blood pressure but not with other health measurements. We find many significant gains from promoting rural biogas stoves in a context in which traditional stove use persists, although pollution levels in ICS households still remained above WHO guidelines.

Rosenthal, J., Balakrishnan, K., Bruce, N., Chambers, D., Graham, J., Jack, D., Kline, L., Masera, O., Mehta, S., Mercado, I., Neta, G., Pattanayak, S., Puzzolo, E., Petach, H., Punturieri, A., Rubinstein, A., Sage, M., Sturke, R., Shankar, A., Sherr, K., Smith, K., & Yadama, G. (2017). Implementation Science to Accelerate Clean Cooking for Public Health. Environmental Health Perspectives, 125(1).

Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the Global Alliance for Clean Cookstoves, has launched the Clean Cooking Implementation Science Network that aims to address this issue. In this article, our focus is on building a knowledge base to accelerate scale-up and sustained use of the cleanest technologies in low- and middle-income countries. Implementation science provides a variety of analytical and planning tools to enhance effectiveness of clinical and public health interventions. These tools are being integrated with a growing body of knowledge and new research projects to yield new methods, consensus tools, and an evidence base to accelerate improvements in health promised by the renewed agenda of clean cooking.

Brooks, N., Bhojvaid, V., Jeuland, M., Lewis, J., Patange, O., & Pattanayak, S. (2016). How much do alternative cookstoves reduce biomass fuel use? Evidence from North India. Resource and Energy Economics, 43, 153-171.

Abstract: Despite widespread global efforts to promote clean cookstoves to achieve improvements in air and forest quality, and to reduce global climate change, surprisingly little is known about the degree to which these actually reduce biomass fuel consumption in real-world settings. Using data from in-house weighing of fuel conducted in rural India, we examine the impact of cleaner cookstoves—most of which are LPG stoves—on three key outcomes related to solid fuel use. Our results suggest that using a clean cookstove is associated with daily reductions of about 4.5 kg of biomass fuel, 160 fewer minutes cooking on traditional stoves, and 105 fewer minutes collecting biomass fuels. These findings of substantial savings are robust to the use of estimators with varying levels of control for selection, and to alternative data obtained from household self-reports. Our results support the idea that efforts to promote clean stoves among poor rural households can reduce solid fuel use and cooking time, and that rebound effects toward greater amounts of cooking on multiple stoves are not sufficient to eliminate these gains. We also find, however, that households who have greater wealth, fewer members, are in less marginalized groups, and practice other health-averting behaviors, are more likely to use these cleaner stoves, which suggests that socio-economic status plays an important role in determining who benefits from such technologies. Future efforts to capture social benefits must therefore consider how to promote the use of alternative technologies by poor households, given that these households are least likely to own clean stoves.

Jeuland, M., Bhojvaid, V., Kar, A., Lewis, J., Patange, O., & Pattanayak, S., Ramanathan, N., Rehman, I., Tan Soo, J., & Ramanathan, V. (2015). Preferences for improved cook stoves: Evidence from rural villages in north India. Energy Economics, 52, 287-298.

Abstract: Because emissions from solid fuel burning in traditional stoves impact global climate change, the regional environment, and household health, there is today real interest in improved cook stoves (ICS). Nonetheless, surprisingly little is known about what households like about these energy products. We report on preferences for biomass-burning ICS attributes in a large sample of 2120 rural households in north India, a global hotspot for biomass fuel use and the damages that such use entails. Households have a strong baseline reliance and preference for traditional stoves, a preference that outweighs the $10 and $5 willingness to pay (WTP) for realistic (33%) reductions in smoke emissions and fuel needs on average, respectively. Preferences for stove attributes are also highly varied, and correlated with a number of household characteristics (e.g. expenditures, gender of household head, patience and risk preferences). These results suggest that households exhibit cautious interest in some aspects of ICS, but that widespread adoption is unlikely because many households appear to prefer traditional stoves over ICS with similar characteristics. The policy community must therefore support a reinvigorated supply chain with complementary infrastructure investments, foster experimentation with products, encourage continued applied research and knowledge generation, and provide appropriate incentives to consumers, if ICS distribution is to be scaled up.

Jeuland, M., Pattanayak, S., & Bluffstone, R. (2015). The Economics of Household Air Pollution. Annual Review of Resource Economics, 7(1), 81-108.

Abstract: Traditional energy technologies and consumer products contribute to household well-being in diverse ways but also often harm household air quality. We review the problem of household air pollution at a global scale, focusing particularly on the harmful effects of traditional cooking and heating. Drawing on the theory of household production, we illustrate the ambiguous relationship between household well-being and adoption of behaviors and technologies that reduce air pollution. We then review how the theory relates to the seemingly contradictory findings emerging from the literature on developing country household demand for clean fuels and stoves. In conclusion, we describe an economics research agenda to close the knowledge gaps so that policies and programs can be designed and evaluated to solve the global household air pollution problem.

Lewis, J., Bhojvaid, V., Brooks, N., Das, I., Jeuland, M., Patange, O., & Pattanayak, S. (2015). Piloting Improved Cookstoves in India. Journal of Health Communication, 20(sup1), 28-42.

Abstract: Despite the potential of improved cookstoves to reduce the adverse environmental and health impacts of solid fuel use, their adoption and use remains low. Social marketing—with its focus on the marketing mix of promotion, product, price, and place—offers a useful way to understand household behaviors and design campaigns to change biomass fuel use. We report on a series of pilots across 3 Indian states that use different combinations of the marketing mix. We find sales varying from 0% to 60%. Behavior change promotion that combined door-to-door personalized demonstrations with information pamphlets was effective. When given a choice amongst products, households strongly preferred an electric stove over improved biomass-burning options. Among different stove attributes, reduced cooking time was considered most valuable by those adopting a new stove. Households clearly identified price as a significant barrier to adoption, while provision of discounts (e.g., rebates given if households used the stove) or payments in installments were related to higher purchase. Place-based factors such as remoteness and nongovernmental organization operations significantly affected the ability to supply and convince households to buy and use improved cookstoves. Collectively, these pilots point to the importance of continued and extensive testing of messages, pricing models, and different stove types before scale-up. Thus, we caution that a one-size-fits-all approach will not boost improved cookstove adoption.

Bhojvaid, V., Jeuland, M., Kar, A., Lewis, J., Pattanayak, S., Ramanathan, N., Ramanathan, V., & Rehman, I. (2014). How do People in Rural India Perceive Improved Stoves and Clean Fuel? Evidence from Uttar Pradesh and Uttarakhand. International Journal of Environmental Research and Public Health, 11(2), 1341-1358.

Abstract: Improved cook stoves (ICS) have been widely touted for their potential to deliver the triple benefits of improved household health and time savings, reduced deforestation and local environmental degradation, and reduced emissions of black carbon, a significant short-term contributor to global climate change. Yet diffusion of ICS technologies among potential users in many low-income settings, including India, remains slow, despite decades of promotion. This paper explores the variation in perceptions of and preferences for ICS in Uttar Pradesh and Uttarakhand, as revealed through a series of semi-structured focus groups and interviews from 11 rural villages or hamlets. We find cautious interest in new ICS technologies, and observe that preferences for ICS are positively related to perceptions of health and time savings. Other respondent and community characteristics, e.g., gender, education, prior experience with clean stoves and institutions promoting similar technologies, and social norms as perceived through the actions of neighbours, also appear important. Though they cannot be considered representative, our results suggest that efforts to increase adoption and use of ICS in rural India will likely require a combination of supply-chain improvements and carefully designed social marketing and promotion campaigns, and possibly incentives, to reduce the up-front cost of stoves.

Wendland, K., Pattanayak, S., & Sills, E. (2014). National-level differences in the adoption of environmental health technologies: a cross-border comparison from Benin and Togo. Health Policy and Planning, 30(2), 145-154.

Abstract: Environmental health problems such as malaria, respiratory infections, diarrhoea and malnutrition pose very high burdens on the poor rural people in much of the tropics. Recent research on key interventions—the adoption and use of relatively cheap and effective environmental health technologies—has focused primarily on the influence of demand-side household-level drivers. Relatively few studies of the promotion and use of these technologies have considered the role of contextual factors such as governance, the enabling environment and national policies because of the challenges of cross-country comparisons. We exploit a natural experimental setting by comparing household adoption across the Benin–Togo national border that splits the Tamberma Valley in West Africa. Households across the border share the same culture, ethnicity, weather, physiographic features, livelihoods and infrastructure; however, they are located in countries at virtually opposite ends of the institutional spectrum of democratic elections, voice and accountability, effective governance and corruption. Binary choice models and rigorous non-parametric matching estimators confirm that households in Benin are more likely than households in Togo to plant soybeans, build improved cookstoves and purchase mosquito nets, ceteris paribus. Although we cannot identify the exact mechanism for the large and significant national-level differences in technology adoption, our findings suggest that contextual institutional factors can be more important than household characteristics for technology adoption.

Jeuland, M. & Pattanayak, S. (2012). Benefits and Costs of Improved Cookstoves: Assessing the Implications of Variability in Health, Forest and Climate Impacts. Plos ONE, 7(2), e30338.

Abstract: Current attention to improved cook stoves (ICS) focuses on the “triple benefits” they provide, in improved health and time savings for households, in preservation of forests and associated ecosystem services, and in reducing emissions that contribute to global climate change. Despite the purported economic benefits of such technologies, however, progress in achieving large-scale adoption and use has been remarkably slow. This paper uses Monte Carlo simulation analysis to evaluate the claim that households will always reap positive and large benefits from the use of such technologies. Our analysis allows for better understanding of the variability in economic costs and benefits of ICS use in developing countries, which depend on unknown combinations of numerous uncertain parameters. The model results suggest that the private net benefits of ICS will sometimes be negative, and in many instances highly so. Moreover, carbon financing and social subsidies may help enhance incentives to adopt, but will not always be appropriate. The costs and benefits of these technologies are most affected by their relative fuel costs, time and fuel use efficiencies, the incidence and cost-of-illness of acute respiratory illness, and the cost of household cooking time. Combining these results with the fact that households often find these technologies to be inconvenient or culturally inappropriate leads us to understand why uptake has been disappointing. Given the current attention to the scale up of ICS, this analysis is timely and important for highlighting some of the challenges for global efforts to promote ICS.

Lewis, J. & Pattanayak, S. (2012). Who Adopts Improved Fuels and Cookstoves? A Systematic Review. Environmental Health Perspectives, 120(5), 637-645.

Background: The global focus on improved cookstoves (ICSs) and clean fuels has increased because of their potential for delivering triple dividends: household health, local environmental quality, and regional climate benefits. However, ICS and clean fuel dissemination programs have met with low rates of adoption.

Objectives: We reviewed empirical studies on ICSs and fuel choice to describe the literature, examine determinants of fuel and stove choice, and identify knowledge gaps. Methods: We conducted a systematic review of the literature on the adoption of ICSs or cleaner fuels by households in developing countries. Results are synthesized through a simple vote-counting meta-analysis.

Results: We identified 32 research studies that reported 146 separate regression analyses of ICS adoption (11 analyses) or fuel choice (135 analyses) from Asia (60%), Africa (27%), and Latin America (19%). Most studies apply multivariate regression methods to consider 7–13 determinants of choice. Income, education, and urban location were positively associated with adoption in most but not all studies. However, the influence of fuel availability and prices, household size and composition, and sex is unclear. Potentially important drivers such as credit, supply-chain strengthening, and social marketing have been ignored.

Conclusions: Adoption studies of ICSs or clean energy are scarce, scattered, and of differential quality, even though global distribution programs are quickly expanding. Future research should examine an expanded set of contextual variables to improve implementation of stove programs that can realize the “win-win-win” of health, local environmental quality, and climate associated with these technologies.

Pattanayak, S. & Pfaff, A. (2009). Behavior, Environment, and Health in Developing Countries: Evaluation and Valuation. Annual Review of Resource Economics, 1(1), 183-217.

Abstract: We consider health and environmental quality in developing countries, where limited resources constrain behaviors that combat enormously burdensome health challenges. We focus on four huge challenges that are preventable (i.e., are resolved in rich countries). We distinguish them as special cases in a general model of household behavior, which is critical and depends on risk information. Simply informing households may achieve a lot in the simplest challenge (groundwater arsenic); yet, for the three infectious situations discussed (respiratory, diarrhea, and malaria), community coordination and public provision may also be necessary. More generally, social interactions may justify additional policies. For each situation, we discuss the valuation of private spillovers (i.e., externalities) and evaluation of public policies to reduce environmental risks and spillovers. Finally, we reflect on open questions in our model and knowledge gaps in the empirical literature including the challenges of scaling up and climate change.