Ghana's rural liquefied petroleum gas program scale up: A case study

Asante, Kwaku Poku; Afari-Asiedu, Samuel; Abdulai, Martha Ali; Dalaba, Maxwell Ayindenaba; Carrión, Daniel; Dickinson, Katherine L.; Abeka, Ali Nuhu; Sarpong, Kwesi; Jack, Darby

doi:10.1016/j.esd.2018.06.010

Cited by 74 publications

(61 citation statements)

References 9 publications

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“…First, translating Effectiveness for this project required acknowledgment that clean fuel scaleup initiatives have largely been driven by goals outside the health domain, e.g., pertaining to the environment and economic concerns. For example, Indonesia's "Zero Kero" program was designed to phase out highly-subsidized kerosene and thus provide savings to the national budget (31), while the aims of Ghana's rural LPG program included reducing deforestation, reducing drudgery, and creating jobs, as well as reducing the health impacts of cooking with wood and charcoal (32). We therefore proposed case study metrics for this dimension that covered effectiveness in two areas: not only effectiveness related to the reduction of household air pollution and associated health improvement, but also effectiveness in relation to the goals as put forth by the specific clean-fuel cooking program (however those may have been stated).…”

Section: Discussionmentioning

confidence: 99%

Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries

Quinn

Neta

Sturke

et al. 2019

Front. Public Health

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Introduction: The use of models and frameworks to design and evaluate strategies to improve delivery of evidence-based interventions is a foundational element of implementation science. To date, however, evaluative implementation science frameworks such as Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) have not been widely employed to examine environmental health interventions. We take advantage of a unique opportunity to utilize and iteratively adapt the RE-AIM framework to guide NIH-funded case studies of the implementation of clean cooking fuel programs in eleven low-and middle-income countries. Methods: We used existing literature and expert consultation to translate and iteratively adapt the RE-AIM framework across several stages of the NIH Clean Cooking Implementation Science case study project. Checklists and templates to guide investigators were developed at each stage. Results: The RE-AIM framework facilitated identification of important emerging issues across this set of case studies, in particular highlighting the fact that data associated with certain important outcomes related to health and welfare are chronically lacking in clean fuel programs. Monitoring of these outcomes should be prioritized in future implementation efforts. As RE-AIM was not originally designed to evaluate household energy interventions, employing the framework required adaptation. Specific adaptations include the broadening of Effectiveness to encompass indicators of success toward any stated programmatic goal, and expansion of Adoption to include household-level uptake of technology. Conclusions: The RE-AIM implementation science framework proved to be a useful organizing schema for 11 case studies of clean fuel cooking programs, in particular highlighting areas requiring emphasis in future research and evaluation efforts. The Quinn et al. RE-AIM for Clean Fuel Cooking Initiatives iterative approach used here to adapt an implementation science framework to a specific programmatic goal may be of value to other multi-country program efforts, such as those led by international development agencies. The checklists and templates developed for this project are publicly available for others to use and/or further modify.

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Section: Discussionmentioning

confidence: 99%

Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries

Quinn

Neta

Sturke

et al. 2019

Front. Public Health

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“…Compared to the 1.8 meals a week the evaluation of an improved cookstove program in India [45] found, the 22% adoption rate found by the biomass pellet company, Inyeyeri, the 63.7% partial adoption found in a study in Rwanda in conjunction with water filters [27], and 8% refilling LPG rate found at 18 months in Ghana [13], our study demonstrates high rates of adoption with ~70% using LPG for every meal and 47% exclusive LPG use. Without income data, we are unable to speak to the relative poverty between our sample and the other studies, as income is a factor in the ability to refill.…”

Section: Data Collection and Analysis Surveys And Interviewsmentioning

confidence: 48%

“…Despite a wave of many African countries setting goals for increased or exclusive LPG use, LPG programs faced common barriers to adoption of the clean fuel. Previous LPG studies in Ghana, Peru, and India have focused on the barrier of the high initial cost by providing the initial stove for free or free refill vouchers [12] [13] [14], yet still observed low rates of exclusive use or even partial adoption [13,15]. Kopa Gas in Tanzania offer pay-as-you-go LPG that allows the customer to obtain a gas cylinder, single burner, and a smart meter to address the challenge to purchase the initial cylinder and even the subsequent refills [16].…”

Section: Economic Community Of West African States and The Central Afmentioning

confidence: 99%

The Value of Community Technology Workers in LPG Adoption: A pilot in Shirati, Tanzania

Wiehl¹,

Sievers²,

Kammen³

2020

Preprint

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Background: The issue of clean cooking lies at the nexus of environmental engineering, environmental health, pollution, energy access, gender and household dynamics, behavioral sciences and international development. In Tanzania, approximately 96% of the population relies on polluting or “unclean” fuels for cooking. Moving away from firewood and charcoal has proven challenging due to low adoption of clean stoves. Here we investigate the application of community health workers, an existing community engagement model for health systems, to clean cooking adoption. We implemented a pilot study with Community Technology Workers as a means to overcome maintenance, education, and behavioral barriers. We evaluated the training, work, and impact of a CTW on stove adoption on a sample of 30 households over a one-year period. Technically trained local CTWs educated thirty families on the Liquefied Petroleum Gas (LPG) stove and conducted weekly check-in surveys.Results: The results from the mixed methodology approach show that families initially have very high rates (100%) of adoption, but as the issues of poverty, other obligations, and sickness arise, roughly 70% of families present sustained, regular refilling of LPG cylinders.Conclusions: The findings imply the feasibility of this type of community infrastructure model to promote and facilitate adoption, but also supports the need to couple this local support with financial mechanisms (e.g. a savings bank). The support from these community trainers paired with these high rates of adoption have large implications for this model’s use in rural, poor areas to increase LPG use and adoption.

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“…This implies that households within these regions are more likely to utilize the available economic and political advantage to adopt or adapt climate-friendly and health-promoting fuels for cooking than their counterparts in the other regions of the country. Secondly, the reference region (Northern) has only twelve LPG gas re lling stations compared to Greater Accra (179 outlets), Ashanti (95 outlets), Brong Ahafo (70 outlets), Central (76 outlets), Western (66 outlets) and Eastern (66 outlets) regions which have over 65 re lling outlets [30], making it easier for households in these regions to have access to LPG for their household needs. These nding shares some similarities with ndings of one other study [31].…”

Section: Discussionmentioning

confidence: 99%

“…However, the likelihood of households in the Upper East regions identi ed in this study to use CF&HPFs suggests some qualitative explanations. In 2013, Ghana launched The Rural LPG Promotion Program (RLP) in the Upper East Region with the aim to create access to households in rural areas to use LPG for cooking [30]. The RLP involved the distribution of free gas cylinders to households [30].…”

Section: Discussionmentioning

confidence: 99%

Correlates of Ghanaian households’ use of clean cooking fuels: insight from the 2014 demographic and health surveys

Dadzie

Kenney

Nakua

et al. 2020

Preprint

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Background: Globally, about 2.9 billion persons, the majority of whom are from low and middle-income countries, depend on poorly combusted biomass and coal for cooking and heating. Given the negative toll the use of poorly combusted fuels have on people’s health and quality of life, homes are admonished to use for cooking clean fuels that promote optimal health such as liquefied petroleum gas (LPG), natural gases, electricity, and improved biomass cook-stoves. The use of clean cooking fuels has other co-benefits such as reduce deforestation and lower climate-changing emissions. Although information on the prevalence of access to clean cooking energy is known, studies on the social, economic, and geographic factors that may explain the low adoption in households are rare. In this paper, we aim to determine the major covariates of households’ access to clean cooking energy in Ghana.Methods: The study used the data of the cross-sectional demographic and health surveys conducted in 2014. Chi-square test of independence was used to identify the covariates that were statistically significant related to households’ use of CF&HPFs for the multivariable model. In the multivariable model, we reported prevalence ratios using the generalized linear model (glm), setting the family to “Poisson” and the link to “log.” The estimation adjusted for the study designed and the household sampling weights.Results: The main finding was that rich households were 8.85 times likely to use CF&HPFs compared to poor households. We further found that the following factors were associated with a higher probability of a Ghanaian household to use climate-friendly and health-promoting fuels for cooking: male-headed households, households’ headed by persons between 24years and 55 years, households with heads that were currently married or never married, households with heads that have attained at least a primary level education, households with less than eight members, households with at least two women, and households in Western, Central, Greater Accra, Volta, Eastern, Ashanti, Brong Ahafo, Upper East region. Conclusion: In view of these findings, we recommend: a national effort to subsidize and make affordable the purchase of LPG and the stoves that burn it even to the poorest household; education on efficient and sustainable consumption must be intensified and incorporated in the basic school’s curriculum to ensure the future generation are more environmental sustainability and health-conscious; creation of multiple LPG refilling outlets in all the regions in Ghana.

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Ghana's rural liquefied petroleum gas program scale up: A case study

Cited by 74 publications

References 9 publications

Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries

Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries

The Value of Community Technology Workers in LPG Adoption: A pilot in Shirati, Tanzania

Correlates of Ghanaian households’ use of clean cooking fuels: insight from the 2014 demographic and health surveys

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