Women’s Ideas about the Health Effects of Household Air Pollution, Developed through Focus Group Discussions and Artwork in Southern Nepal

Abstract

Household air pollution is a major cause of ill health, but few solutions have been effective to date. While many quantitative studies have been conducted, few have explored the lived experiences and perceptions of women who do the cooking, and as a result are those most exposed to household air pollution. In this study, we worked with groups of home cooks, and sought to use art as a means of engaging them in discussions of how household air pollution from cooking affects their lives. In the Terai district of southern Nepal, we held four focus groups that included 26 local women from urban and peri-urban areas, as well as six local artists. The women then met approximately weekly over four months, and produced images related to air pollution. Transcripts from the focus groups were reviewed independently by two authors, who initially categorised data deductively to pre-defined nodes, and subsequently inductively reviewed emergent themes. Women identified a number of health effects from air pollution. The main physical effects related to the eye and the respiratory system, and women and young children were seen as most vulnerable. The psychosocial effects of air pollution included reduced food intake by women and lethargy. Suggested solutions included modifications to the cooking process, changing the location of stoves, and increasing ventilation. The main barriers were financial. The lived experiences of women in southern Nepal around the problem of air pollution offers a more nuanced and context-specific understanding of the perceptions and challenges of addressing air pollution, which can be used to inform future interventions.

Socio-Cultural Reasons and Community Perceptions Regarding Indoor Cooking Using Biomass Fuel and Traditional Stoves in Rural Ethiopia: A Qualitative Study

“…From the discussions, they specifically mentioned almost all respiratory symptoms, pneumonia, tuberculosis, and effects on lungs including asthma. This is consistent with previous findings where mothers were aware of the health effects of wood smoke in the respiratory and eye health problems [ 28 , 29 , 30 , 31 ]. We included and asked the men/husbands in our study whose health they believed to be more affected by the smoke–they believed it is the women’s health.…”

“…In our study, some participants linked this with a low level of education and lack of enough awareness regarding the long-term effects of exposure to household air pollution. This was also consistent with responses in the Nepalese study [ 28 ]. The fear of fire hazard and being afraid of thieves were the safety and security reasons for not cooking outside and having open windows.…”

“…We were unable to find similar reasons in other studies. The tradition of cooking inside a house by considering a smoky indoor air as a natural event was consistent with the Nepalese study [ 28 ].…”

“…It is obvious the economy of the household could determine the type of house and the possibility to invest in alternative fuels and improved cook stoves. Other studies from Uganda and Nepal also identified financial considerations as the most influential factors related to improved cook stove acquisition and use [ 11 , 28 ]. A report from another region in Ethiopia also found that women were willing to change cooking practices but were unable to afford cleaner fuels or improved stoves [ 29 ].…”

Association Between Specific Indoor Air Pollutants and Pneumonia Episodes in Children Under Five in Abuja, Nigeria: A Case-control Study

“…This gender difference was also signi cant with a p-value <0.05. This is consistent with the literature that women and children, especially female children are often with their parents during cooking (Clougherty, 2010;Dong et al, 2011;Dutta & Banerjee, 2014;Devakumar et al, 2018). This gender bias means that women and female children are more frequently exposed to the dangers of indoor air pollution (Clougherty, 2010;Dong et al, 2011;Dutta & Banerjee, 2014;Devakumar et al, 2018).…”