Assessing household solid fuel use: multiple implications for the Millennium Development Goals

Eva Rehfuess, Sumi Mehta, Annette Prüss-Ustün, Eva Rehfuess, Sumi Mehta, Annette Prüss-Ustün

Abstract

Objective: The World Health Organization is the agency responsible for reporting the Millennium Development Goal (MDG) indicator "percentage of population using solid fuels." In this article, we present the results of a comprehensive assessment of solid fuel use, conducted in 2005, and discuss the implications of our findings in the context of achieving the MDGs.

Methods: For 93 countries, solid fuel use data were compiled from recent national censuses or household surveys. For the 36 countries where no data were available, the indicator was modeled. For 52 upper-middle or high-income countries, the indicator was assumed to be < 5%.

Results: According to our assessment, 52% of the world's population uses solid fuels. This percentage varies widely between countries and regions, ranging from 77%, 74%, and 74% in Sub-Saharan Africa, Southeast Asia, and the Western Pacific Region, respectively, to 36% in the Eastern Mediterranean Region, 16% in Latin America and the Caribbean and in Central and Eastern Europe. In most industrialized countries, solid fuel use falls to the < 5% mark.

Discussion: Although the "percentage of population using solid fuels" is classified as an indicator to measure progress towards MDG 7, reliance on traditional household energy practices has distinct implications for most of the MDGs, notably MDGs 4 and 5. There is an urgent need for development agendas to recognize the fundamental role that household energy plays in improving child and maternal health and fostering economic and social development.

Figures

Figure 1
Figure 1
Geographic distribution of ALRI deaths attributable to indoor air pollution in children

Figure 2

Geographic distribution of COPD deaths…

Figure 2

Geographic distribution of COPD deaths attributable to indoor air pollution, by sex and…

Figure 2
Geographic distribution of COPD deaths attributable to indoor air pollution, by sex and WHO region in 2000 (based on data from Smith et al. 2004). Abbreviations: Afr, African Region; Amr, Region of the Americas; Emr, Eastern-Mediterranean Region; Eur, European Region; Sear, Southeast Asian Region; Wpr, Western Pacific Region.
Figure 2
Figure 2
Geographic distribution of COPD deaths attributable to indoor air pollution, by sex and WHO region in 2000 (based on data from Smith et al. 2004). Abbreviations: Afr, African Region; Amr, Region of the Americas; Emr, Eastern-Mediterranean Region; Eur, European Region; Sear, Southeast Asian Region; Wpr, Western Pacific Region.

References

    1. Boy E, Bruce N, Delgado H. Birth weight and exposure to kitchen wood smoke during pregnancy. Environ Health Perspect. 2002;110:109–114.
    1. Brouwer ID. 1998. When households run out of fuel: responses of rural women in Malawi to decreasing fuelwood availability. Energia News 2(2). Available: [accessed 31 January 2006].
    1. Bruce NG, Perez-Padilla R, Albalak R. Indoor air pollution in developing countries: a major environmental and public health challenge. Bull WHO. 2000;78(9):1078–1092.
    1. Bruce N, Rehfuess E, Mehta S, Hutton G, Smith KR. In press. Indoor air pollution. In: Disease Control Priorities in Developing Countries. 2nd ed. Washington, DC/Oxford, UK:World Bank/Oxford University Press.
    1. Collings DA, Sithole SD, Martin KS. Indoor woodsmoke pollution causing lower respiratory disease in children. Trop Doct. 1990;20:151–155.
    1. Courtright P, Haile D, Kohls E. The epidemiology of burns in rural Ethiopia. J Epidemiol Community Health. 1993;47(1):19–22.
    1. Dai X, Lin CY, Sun XW, Shi YB, Lin YJ. The etiology of lung cancer in nonsmoking females in Harbin, China. Lung Cancer. 1996;14:S85–S91.
    1. de Francisco A, Morris J, Hall AJ, Armstrong Schellenberg JR, Greenwood BM. Risk factors for mortality from acute lower respiratory tract infections in young Gambian children. Int J Epidemiol. 1993;22:1174–1182.
    1. Demographic and Health Surveys 2004. Demographic and Health Surveys Homepage. Available: [accessed 15 August 2004].
    1. Dennis RJ, Maldonado D, Norman S, Baena E, Martinez G. Woodsmoke exposure and risk for obstructive airways disease among women. Chest. 1996;109:115–119.
    1. Edwards R, Smith KR, Zhang J, Ma Y. Implications of changes in household stoves and fuel use in China. Energ Policy. 2004;32:395–411.
    1. Energy Sector Management Assistance Programme 1996. Energy for Rural Development in China: An Assessment Based on a Joint Chinese/ESMAP Study in Six Counties. Washington, DC:The World Bank.
    1. Energy Sector Management Assistance Programme 2004. The Impact of Energy on Women’s Lives in Rural India. Washington DC:The World Bank.
    1. Ezzati M, Kammen DM. Quantifying the effect of exposure to indoor air pollution from biomass combustion on acute respiratory infections in developing countries. Environ Health Perspect. 2001;109:481–488.
    1. Intermediate Technology Development Group 2004. Rape and pastoralists conflict. Peace Bulletin 5:7. Available: [accessed 31 January 2006].
    1. IEA and OECD 2004. World Energy Outlook 2004. Paris:International Energy Agency and Organisation for Economic Co-operation and Development.
    1. Johnson AW, Aderele WI. The association of household pollutants and socio-economic risk factors with the short-term outcome of acute lower respiratory infections in hospitalized pre-school Nigerian children. Ann Trop Paediatr. 1992;12:421–432.
    1. Liu Q, Sasco AJ, Riboli E, Hu MX. Indoor air pollution and lung cancer in Guangzhou, People’s Republic of China. Am J Epidemiol. 1993;137:145–154.
    1. Mavlankar DV, Trivedi CR, Gray RH. Levels and risk factors for perinatal mortality in Ahmedabad, India. Bull WHO. 1991;69:435–442.
    1. Mehta S, Gore F, Prüss-Üstün, Rehfuess E, Smith K. In press. Modeling household solid fuel use towards reporting of the Millennium Development Goal indicator. Energy for Sustainable Development.
    1. Mehta S, Shapar C.2004The health benefits of interventions to reduce indoor air pollution from solid fuel use. A cost-effectiveness analysis Energy for Sustainable Development 8353–59.Available: [accessed 31 January 2006].
    1. Mishra V, Dai X, Smith KR, Mika L. Maternal exposure to biomass smoke and reduced birth weight in Zimbabwe. Ann Epidemiol. 2004;14(10):740–747.
    1. Mishra V, Retherford RD, Smith KR. 2005. Cooking smoke and tobacco smoke as risk factors for stillbirth. Int J Environ Health Res 15(6).
    1. Modi V, McDade S, Lallement D, Saghir J. 2005. Energy and the Millennium Development Goals. New York:Energy Sector Management Assistance Programme, United Nations Development Programme, UN Millennium Project, World Bank.
    1. O’Dempsey T, McArdle TF, Morris J. A study of risk factors for pneumococcal disease among children in a rural area of West Africa. Int J Epidemiol. 1996;25:885–893.
    1. Onuba O, Udoidiok E. The problems of burns and prevention of burns in developing countries. Burns. 1987;13(5):382–385.
    1. Pandey MR. Domestic smoke pollution and chronic bronchitis in a rural community of the hill region of Nepal. Thorax. 1984;39:337–339.
    1. Pandey MR. Women, wood energy and health. Wood Energy News. 1997;12(1):3–5.
    1. Pandey MR, Neupane RP, Gautam A, Shrestha I. Domestic smoke pollution and acute respiratory infections in a rural community of the hill region of Nepal. Environ Int. 1989;15:337–340.
    1. Perez-Padilla R, Regalado J, Vedal S, et al. Exposure to biomass smoke and chronic airways disease in Mexican women: a case-control study. Am J Respir Crit Care. 1996;154:701–706.
    1. Pokhrel AK, Smith KR, Khalakdina A, Deuja A, Bates MN. Case-control study of indoor cooking smoke exposure and cataract in Nepal and India. Int J Epidemiol. 2005;34:702–708.
    1. Robin LF, Less PS, Winget M. Wood-burning stoves and lower respiratory illness in Navajo children. Pediatr Infect Dis J. 1996;15:859–865.
    1. Sinton JE, Smith KR, Peabody J, Yaping L, Ziliang Z, Edwards R, et al. An assessment of programs to promote improved household stoves in China. Energy for Sustainable Development. 2004;8(3):33–52.
    1. Smith KR. 1987. Biofuels, Air Pollution and Health: A Global Review. New York:Plenum Press.
    1. Smith KR, Mehta S, Maeusezahl-Feuz M. 2004. Indoor air pollution from household use of solid fuels. In: Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors (Ezzati M, Lopez AD, Rodgers A, Murray CJL, eds). Geneva:World Health Organization, 1435–1493. Available: [accessed 31 January 2006].
    1. Smith KR, Samet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax. 2000a;55:518–532.
    1. Smith KR, Uma R, Kishore VVN, Zhang J, Joshi V, Khalil MAK. Greenhouse implications of household stoves: an analysis for India. Annu Rev Energ Env. 2000b;25:741–763.
    1. United Nations 2005a. Millennium Development Goals. Available: [accessed24 April 2005].
    1. United Nations 2005b. Proportion of Population Using Solid Fuels. Millennium Development Goals Indicator Database, Goal 7, Indicator 29 New York:United Nations Statistics Division. Available: [accessed 24 April 2005].
    1. United Nations 2000. United Nations Millennium Declaration. Available: [accessed 24 April 2005].
    1. United Nations High Commissioner for Refugees 2001. Evaluation of the Dadaab Firewood Project, Kenya. Geneva:United Nations High Commissioner for Refugees.
    1. United Nations Millennium Project 2005. Investing in Development: A Practical Plan to Achieve the Millennium Development Goals. London:Earthscan. Available: [accessed 31 January 2006].
    1. U.S. EPA 1996. Air Quality Criteria for Particulate Matter. Vol 1. EPA/600/P-95/. Research Triangle Park, NC:U.S. Environmental Protection Agency.
    1. Wang TJ, Zhou BS, Shi JP. Lung cancer in nonsmoking Chinese women: a case-control study. Lung Cancer. 1996;14:S93–S98.
    1. WHO 2002. World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva:World Health Organization. Available: [accessed 31 January 2006].
    1. WHO 2005a. World Health Statistics 2005. Geneva:World Health Organization. Available: [accessed 31 January 2006].
    1. WHO 2005b. World Health Survey. Geneva:World Health Organization. Available: [accessed 24 April 2005].
    1. WHO 2005c. Global Indoor Air Pollution Database. Geneva:World Health Organization. Available: [accessed 5 April 2005].
    1. WHO 2005d. World Health Report 2005: Make Every Mother and Child Count. Geneva:World Health Organization. Available: [accessed 31 January 2006].
    1. WHO 2005e. Indoor Air Thematic Briefing 2: Indoor Air Pollution, Health and the Burden of Disease. Geneva:World Health Organization. Available: [accessed 31 January 2006].
    1. World Bank 2006. Living Standards Measurement Study. Available: [accessed on 1 February 2006].
    1. Wu-Williams AH, Dai XD, Blot W, Xu ZY, Sun XW, Xiao HP, et al. Lung cancer among women in north-east China. Br J Cancer. 1990;62:982–987.

Source: PubMed

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