Prices, peers, and perceptions (P3): study protocol for improved biomass cookstove project in northern Ghana

Katherine L Dickinson, Maxwell Dalaba, Zachary S Brown, Rex Alirigia, Evan R Coffey, Elise Mesenbring, Manies Achazanaga, Desmond Agao, Moro Ali, Ernest Kanyomse, Julius Awaregya, Clifford Amoah Adagenera, John Bosco A Aburiya, Bernard Gubilla, Abraham Rexford Oduro, Michael P Hannigan, Katherine L Dickinson, Maxwell Dalaba, Zachary S Brown, Rex Alirigia, Evan R Coffey, Elise Mesenbring, Manies Achazanaga, Desmond Agao, Moro Ali, Ernest Kanyomse, Julius Awaregya, Clifford Amoah Adagenera, John Bosco A Aburiya, Bernard Gubilla, Abraham Rexford Oduro, Michael P Hannigan

Abstract

Background: Despite their potential health and social benefits, adoption and use of improved cookstoves has been low throughout much of the world. Explanations for low adoption rates of these technologies include prices that are not affordable for the target populations, limited opportunities for households to learn about cookstoves through peers, and perceptions that these technologies are not appropriate for local cooking needs. The P3 project employs a novel experimental design to explore each of these factors and their interactive effects on cookstove demand, adoption, use and exposure outcomes.

Methods: The P3 study is being conducted in the Kassena-Nankana Districts of Northern Ghana. Leveraging an earlier improved cookstove study that was conducted in this area, the central design of the P3 biomass stove experiment involves offering stoves at randomly varying prices to peers and non-peers of households that had previously received stoves for free. Using household surveys, electronic stove use monitors, and low-cost, portable monitoring equipment, we measure how prices and peers' experience affect perceptions of stove quality, the decision to purchase a stove, use of improved and traditional stoves over time, and personal exposure to air pollutants from the stoves.

Discussion: The challenges that public health and development communities have faced in spreading adoption of potentially welfare-enhancing technologies, like improved cookstoves, have highlighted the need for interdisciplinary, multisectoral approaches. The design of the P3 project draws on economic theory, public health practice, engineering, and environmental sciences, to more fully grasp the drivers and barriers to expanding access to and uptake of cleaner stoves. Our partnership between academic institutions, in the US and Ghana, and a local environmental non-governmental organization creates unique opportunities to disseminate and scale up lessons learned.

Trial registration: ClinicalTrials.gov NCT03617952 7/31/18 (Retrospectively Registered).

Keywords: Behavior change; Cookstoves; Global health; Household air pollution; Study protocol.

Conflict of interest statement

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Influence diagram showing technology adoption dynamics. The solid arrows in the diagram are influences that this study will examine in detail. The dashed arrows are potential confounding feedbacks that our identification strategy will address. The signs in parentheses indicate whether effects are expected to be positive or negative, based on previous literature
Fig. 2
Fig. 2
Map of the study area. Source: Authors’ creation with map and imagery data from Google, ORION-ME, Data SIO, NOAA, U.S. Navy, NGA, GEBCO, Landsat/Copernicus, U.S. Geological Survey, IBCAO
Fig. 3
Fig. 3
Study design
Fig. 4
Fig. 4
Distribution of bids for the higher quality (upper panel) and lower quality (lower panel) stoves in the stove auctions
Fig. 5
Fig. 5
Placement of stove use monitors (SUMs) on improved stoves (Jumbo and ACE) and traditional stoves (Three Stone Fire and Coal Pot). Images source: study authors
Fig. 6
Fig. 6
Monitoring equipment arrangement at an outdoor cooking area with a three stone fire. Images source: study authors
Fig. 7
Fig. 7
Example cumulative CO exposure (pie) with source contributions (slices) identified
Fig. 8
Fig. 8
Preliminary data from a 48-h air quality household deployment. Pane a) shows user proximity to the nearest cooking area monitored with “at-home” status indicated by the green band. Pane b) shows CO and PM exposure with pane c) stove usage data for the five stoves located at this household (normalized to individual-stove maximum temperature)

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