A rapid assessment randomized-controlled trial of improved cook stoves in rural Ghana

We conducted a rapid assesssment randomized-controlled trial to quantify changes in fuel use, exposure to smoke, and self-reported health attributable to deployment of an improved wood cookstove in the Sissala West district of the Upper West region of Ghana. Women trainers from neighboring villages taught participants to build an improved cookstove and demonstrated optimal cooking techniques on such stoves. Participants were then randomly assigned to construct improved stoves at their homes. Several weeks after treatments built their new stoves, all participants engaged in a controlled cooking test while wearing a carbon monoxide monitor. At that time we surveyed study participants on cooking activity, fuel wood gathering, self-reported health, and socioeconomic status. We also installed stove usage monitors on the improved and traditional stoves at a subset of households for the following three weeks. During the controlled cooking tests, treatment participants used 12% less fuel wood than controls. There were no detectable reductions in a households’ weekly time gathering wood or in exposure to carbon monoxide. In contrast, there was a sharp decline in participants’ self-reported symptoms associated with cooking, such as burning eyes, and in respiratory symptoms, such as chest pain and a runny nose. Stove usage monitors show treatments used their new stove on about half of the days monitored. When we returned to three of the villages eight months after project implementation, half the improved stoves showed evidence of recent usage. Treatments had less traditional stoves than controls at follow-up, suggesting new stoves displaced some traditional stoves. Treatment homes reduced total time cooking on their traditional stoves by approximately 25%. Out method seems to offer a rigorous, less logistically-demanding method for evaluating user uptake, field-based stove performance, and exposure to smoke.