The importance of establishing acceptability – Respiratory diseases, Senegal
Why this case study?
This illustrates the negative consequences of implementing an effective intervention without first assessing acceptability in a new context.
Title
The importance of establishing acceptability
Source
Beltramo T, Levine DI. The effect of solar ovens on fuel use, emissions and health: Results from a randomised controlled trial.(74)
Health issue
Respiratory diseases
Setting
Senegal
Target population
Households where cooking is conducted using solid fuels
Background
Traditional stoves for cooking and heating in LMICs are frequently fuelled with dung, coal and wood. The smoke resulting from burning such solid fuels pollutes the air and has been linked to a range of respiratory and other diseases.
Improved stoves have the potential to reduce exposure to household air pollution and so improve health outcomes. One such improved stove is the solar oven. During laboratory testing in highly controlled contexts, solar ovens frequently show positive results and do not emit any emissions. However, studies in real-world contexts are far less promising.
Description of policy or intervention
A phased, randomized controlled trial to test the effects of a solar oven called ‘the HotPot’ was carried out in Senegal.
What took place?
The solar oven was provided to 465 households. After six months, the intervention group had just as high carbon monoxide exposure as the control group and there was no reduction in self-reported health symptoms.
In the laboratory these stoves were shown to be effective – so what went wrong?
The study showed poor levels of adoption of the HotPot, with households using the stove very infrequently. A major reason for this was that the solar oven was far too small for the majority of households in the study.
Other studies(75) indicated additional reasons for solar oven unacceptability to communities: cooking could take longer, the ovens could not be used for heating and light, and the oven might need be used outdoors during sunlight.
What have we learnt?
Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of communities in order to succeed.(76)