Skip to main content
Download PDF

Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh

BMC Public Health volume 24, Article number: 512 (2024) Cite this article

Abstract

Background

In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas.

Methods

This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems.

Results

The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors.

Conclusion

The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.

Peer Review reports

Introduction

In low- and middle-income countries, household cooking primarily relies on solid fuels such as wood, charcoal, dung, agricultural residues, and coal [1]. However, their use has raised significant public health concerns and garnered considerable attention. Traditional open-fire cooking methods are highly inefficient and release harmful particulates and gaseous substances into the household air, causing approximately 4 million premature deaths annually [2], with women and children being particularly vulnerable [3]. Literature indicates that the combustion of solid fuels in inefficient stoves produces hazardous substances, including suspended particulate matter (PM), carbon monoxide, poly-aromatic hydrocarbons, poly-organic matter, and formaldehyde, resulting in severe health consequences [4]. These adverse effects are associated with public health hazards such as reduced lung function, respiratory illnesses, asthma, pneumonia, tuberculosis, eye disorders, pregnancy complications, cardiovascular disease, and cancer [5]. Furthermore, traditional domestic energy methods also have detrimental effects on health, safety, and overall well-being [6].

Compared to solid fuels, cleaner alternatives like electricity and gases are often considered healthier and less detrimental to human health [7]. Cooking with clean fuel supports women’s empowerment, provides public health benefits, and reduces health damage from indoor air pollution [8]. Recognizing the extensive negative consequences of polluting solid cooking fuels, one of the Sustainable Development Goals (SDGs) prioritizes universal access to clean cooking (part of SDG target 7.1) [9]. This target has been directly linked to achieving various other SDG targets as well [10]. While clean cooking fuels or gases are prevalent in cities, biomass fuels continue to be widely used in rural areas. Current projections suggest that a third of the world’s population will still rely on polluting fuels in 2030 [2]. Efforts have been made over time to elucidate the factors contributing to this outcome.

Bangladesh, a lower-middle-income country, has the lowest access to clean cooking fuels. Approximately 94% of rural Bangladeshi households cook and heat using solid fuels like wood, coal, and animal dung [11]. Previous studies in Bangladesh have demonstrated the negative association of cooking with solid fuels with respiratory and eye health [12], cardiovascular health [13], under-five mortality [14], and adverse obstetric outcomes among women exposed to biomass fuel [15]. Solid fuel users, in comparison to clean fuel users, exhibited significantly higher blood pressure [16]. Furthermore, household air pollution (HAP) from solid fuel cooking has emerged as a significant contributor to fatalities and disabilities in many developing countries, including Bangladesh [17].

There exists a significant barrier or gap hindering the widespread acceptance and usage of clean cooking fuels in Bangladesh and globally, which poses a notable challenge [18]. Researchers attribute this barrier to a range of factors, including socio-cultural, economic, political, and institutional challenges [19]. Without addressing and dismantling these barriers through the implementation of integrated economic and social policies, the realization of various Sustainable Development Goal (SDG) targets remains an aspirational goal with limited chances of success [20].

This study aims to contribute to the existing literature by highlighting the comparison between health issues and cooking fuel categories, along with barriers to adopting clean cooking. The fuel categories are broadly classified into two groups. Initially, we assessed the predominant fuel types used by participants, categorizing them into: solid fuel and clean fuel, in alignment with findings from prior research [21, 22]. Given that the outcome or dependent variable in our study is binary, we opted for binary logistic regression, consistent with established practices outlined in the existing literature [23, 24]. The study investigates and compares health problems associated with these cooking fuels, specifically analyzing the frequency of health issues experienced by rural individuals when using solid fuels compared to clean fuels. Subsequently, the research delves into identifying barriers towards clean cooking in rural settings, despite the numerous health benefits associated with it.

Our study introduces two novel aspects. Firstly, unlike previous studies that primarily concentrate on the health effects of solid fuels within limited regions, we compare the health effects across different fuel categories, encompassing a large geographical area in rural Bangladesh with a substantial sample size. Secondly, despite some global studies addressing clean cooking barriers, none specifically focus on these barriers in Bangladesh. Our study offers valuable insights into the challenges of adopting clean cooking practices in rural Bangladesh. The transition to clean energy sources is a topic under consideration by regional governments, yet little has been explored regarding the potential health effects of such a shift. Our findings can provide valuable information for policymakers dealing with this specific population.

Literature review

Association between health problems and cooking fuel type

Household cooking fuel usage is associated with various health issues, with research indicating that opting for solid fuel over clean fuel negatively affects health [25]. A significant portion of the population, especially in low- and middle-income countries, lacks access to clean cooking facilities and predominantly uses solid biomass fuel for cooking [1]. Traditional solid-fuel cooking produces greenhouse gases and harmful air pollutants, increasing the risk of respiratory disease, cardiovascular disease, cerebrovascular disease, blindness, and neonatal mortality [26]. Women and children under 5 are particularly vulnerable to these health threats due to their increased involvement in cooking-related activities [3].

In Bangladesh, where this study was conducted, a substantial portion of the population relies on solid fuels such as coal, lignite, charcoal, and wood for cooking [27]. Various regional studies in Bangladesh have highlighted the association between this practice and adverse health outcomes, including respiratory symptoms [28], cardiovascular morbidity and mortality [29], eye problems [30], adverse pregnancy outcomes [17], elevated blood pressure [13], under-5 mortality [14], and respiratory diseases [31]. Furthermore, a study investigated that household air pollution (HAP) from cooking with solid fuels has become a leading cause of death and disability in many developing countries, including Bangladesh [17].

Most studies in Bangladesh have focused on the health effects of solid fuels within specific regions rather than comparing them with clean cooking fuels. This study aims to compare health problems between clean and solid fuels, considering a relatively large geographical area to provide a comprehensive perspective on the issue.

Key barriers towards clean cooking

In recent decades, various global organizations, international development agencies, regional governments, and the private sector have endeavored to promote the widespread use and adoption of cleaner cooking methods [32]. Numerous studies highlight the positive impacts of clean cooking, encompassing health and environmental benefits, as well as the value of time saved from collecting fuelwood, which counterbalances the costs associated with implementing clean cooking. Governments and non-governmental organizations in many developing countries, with the support of multilateral and bilateral funding organizations, have implemented several initiatives and programs over the past four decades to encourage clean cooking. However, the acceptance of clean cooking has been exceptionally slow [33], attributed to interconnected, deeply rooted socioeconomic, cultural, and technological factors. Economic and cultural barriers significantly contribute to the slow adoption of clean cooking [34].

A literature review was conducted to identify market barriers to the transition to clean cooking in Sub-Saharan Africa. One major hindrance to the use of clean cooking fuel is the cost to the consumer, which can be substantially higher in numerous places than the cost of conventional fuel. The transition to clean cooking fuels is complicated by a lack of distribution infrastructure and insufficient information exchange between producers, consumers, and intermediary organizations. In addition to the factors mentioned above—being the most significant barriers to fuel switching—there are various minor social and cultural issues that reinforce reliance on solid fuel [35].

Several systematic literature reviews on clean cooking from the demand-side perspective have already been published. For instance, one study analyzed 32 papers to identify the determinants of fuel and stove choice [36], while another review examined 44 studies focusing on the adoption of clean fuels [37]. Bonan et al. [38] conducted a review to identify the barriers to and drivers of the adoption of different types of clean fuels and their impact on economic development and poverty reduction.

While there is a substantial body of literature on clean cooking barriers globally, there is a notable absence of specific research on this topic in Bangladesh. Only a limited number of studies have attempted to address this issue, but they lack clear definition, organization, or appropriateness on the matter [39,40,41]. Despite the significance of these contributions, there is a pressing need for a more comprehensive analysis of the factors influencing the adoption of clean cooking from a consumer perspective in rural Bangladesh. This study offers valuable insights into the specific barriers to clean cooking and provides guidance for policymakers to initiate potential measures for the adoption of clean cooking practices.

Methods

Research framework

Research Framework of this study are demonstrated in Fig. 1.

Fig. 1
figure 1

Research framework

Full size image

Participants and procedures

Between January and May 2023, a cross-sectional face-to-face survey was conducted, involving 1240 rural individuals. The sample was selected using a convenient sampling technique. A semi-structured questionnaire, accompanied by informed consent, was employed to gather information during the face-to-face interviews. Participants had to be 18 years or older, reside in a rural area, and be directly or indirectly involved in cooking to qualify. Those under the age of 18 and individuals who declined to consent were excluded. Following the acquisition of informed consent, 1263 participants were surveyed. Subsequently, incomplete surveys were excluded, and data from 1240 participants (83.7% female; mean age 37.59 years [SD = 11.34]) were included in the analyses.

Sample size determination

The sample size was calculated using the following equation:

$$n=\frac{{z}^{2}pq}{{d}^{2}};n=\frac{{1.96}^{2}\times 0.5\times \left(1-0.5\right)}{{0.05}^{2}}=384.16\approx 384$$

Here,

n = number of samples.

z = 1.96 (95% confidence level).

p = prevalence estimate (50% or 0.5).

q = (1-p).

d = Precession of the prevalence estimate (10% of 0.05).

As there is no prior study concentrating on association between health problems and cooking fuel type, and barriers to clean cooking in Bangladesh simultaneously, we determined that the best assumption (p) for the current study would be 50%. With a 10% non-response rate, a sample size of 423.5 ≈ 424 participants was predicted. The size of our sample exceeded this projection.

Study area

The study areas consist of four divisions namely Dhaka, Chattogram, Rajshahi and Mymensingh in Bangladesh (Fig. 2). The data was collected from rural areas of these divisions conveniently.

Fig. 2
figure 2

Map of the study areas

Full size image

Measures

A semi-structured questionnaire full of informed consent along with three sections (i.e., socio-demographics, health related information and information about barriers towards clean cooking) was utilized during data collection.

Socio-demographic information

During the survey, some socio-demographic questions were asked including age (later categorized as 18–29 years/ 30–39 years/ ≥ 40 years) [42]; sex (male/female), educational status (Illiterate/primary/secondary/higher secondary/university or above), marital status (married/unmarried/divorced) [43], family type (nuclear [two parents and their children]/joint [family unit with more than two parents] [44];), monthly family income (later categorized: lower socio-economic status (SES) < 15,000 Bangladeshi Taka [BDT], middle SES 15,000–30,000 BDT and upper SES > 30,000 BDT) [45], divisions Dhaka/Chattogram/Rajshahi/Mymensingh) and duration of living (< 2 years/2–5 years/ > 5 years).

Dependent variable

During the survey, a question was asked about cooking fuel type (e.g., Which type of fuel do you primarily or mainly use for cooking? Solid fuel (wood, charcoal, dung, agricultural residues, coal etc./ Clean fuel (liquified petroleum gas (LPG), electricity, and piped gas etc.) [21].

Health related information

Throughout the survey, participants were queried about various health-related conditions, including hypertension, allergies, asthma, and diabetes. Responses to these conditions involved three options: ‘Yes’ indicating the clinical presence of the disease, ‘No’ indicating its clinical absence, and ‘Don’t know’ indicating either an absence of diagnostic attempts or lack of awareness about the presence or absence of the disease [21]. Additionally, participants were asked about other health effects, such as sneezing, coughing, breathing difficulties, chest pressure while breathing, itching or burning in the eyes, redness in the eyes, and eye discomfort, with two possible responses: ‘Yes’ or ‘No’.

Information about barriers towards clean cooking

While collecting data, participants were asked a question about barriers to clean cooking. The possible barriers included economic problems, attitudes towards technology, problems related to clean fuel distribution, lack of information about clean fuel, a shortage of clean fuel or its unavailability, socio-cultural norms, customs, practices, maintenance issues with clean fuel, a tendency to lose taste in food, social factors, and a lack of awareness of the risks associated with unclean fuel. Multiple responses were allowed for this question.

Statistical analysis

The data analysis was carried out using Microsoft Excel 2019 and SPSS version 25.0 (Chicago, IL, USA). Microsoft Excel was used to clean, modify, sort, and code the data. The spreadsheet was then imported into the SPSS software. Descriptive statistics (frequency, percentages, means, and standard deviations) as well as first-order analysis (chi-square tests, Fisher’s exact tests) were used. Finally, binary and multivariable logistic regression models were used to determine the relationship between solid fuel use and socio-demographic information. All statistical tests having a p-value less than 0.05 were considered significant at 95% confidence interval.

Results

The socio-demographic characteristics of the participants are introduced in Table 1. A total number of 1240 participants were included in this study, the majority of whom were female (83.4%) and fell within the age range of ≥ 40 years (42%). The majority of the participants (75.7%) were housewife where largest proportion of the respondent from lower socioeconomic status (59.8%). Additionally, Majority of respondents (41.8%) were from Chattogram division followed by Dhaka (28.3%), Rajshahi (16.9%), Mymensingh (13%) and largest proportion of people are living there over 5 years (85.9%). Solid fuels are used for cooking in majority households (73.3%) compared to clean fuel (26.7%). In terms of health-related information, a notable number of respondents had respiratory-related symptoms (cough 11.1%, Pressure in chest while breathing 11% etc.), eye related problems (Itching or burning in eyes 16.9%, Discomfort in eyes 17.9% etc.), diabetes (12.4%), hypertension (21.1%), and allergy (32.6%).

Table 1 Socio-demographic characteristics of the participants (N = 1240)
Full size table

Table 2 shows identified factors associated with cooking fuel type. The adjusted models contained the variables shown to be significant in the binary logistic regression analysis. In the adjusted model, participants who had no educational qualification, primary and secondary level education were 8.53 times, 7.60 times and 4.69 times more likely to have solid fuel user (AOR [Adjusted odds ratio] = 8.53, 95% CI [Confidence interval] = 3.22 – 22.61, p < 0.001, AOR = 7.60, 95% CI = 3.33 – 17.34, p < 0.001 and AOR = 4.69, 95% CI = 2.19 – 10.05, p < 0.001, respectively) compared to participants who had studied university or above. Participants from lower socioeconomic status were 13.27 times and 5.25 times more likely to solid fuel use (AOR = 13.27, 95% CI = 6.82 – 25.85, p < 0.001 and AOR = 5.25, 95% CI = 2.87 – 9.60, p < 0.001, respectively) compared to participants who had higher socioeconomic status. Respondents who lived in Chattogram and Rajshahi division were 6% and 10% less likely to have solid fuel user (AOR = 0.06, 95% CI = 0.04–0.12, p < 0.001 and AOR = 0.10, 95% CI = 0.05–0.20, p < 0.001, respectively) compared to respondents who lived in Dhaka division. People who were living for 2 to 5 years in their location were 25% less likely to have solid fuel use compared to people who were living for less than 2 years (AOR = 0.25, 95% CI = 0.07 – 0.84, p = 0.024).

Table 2 Binary and multivariate logistic regression analysis of factors associated with fuel type
Full size table

Table 3 shows identified health problems associated with cooking fuel type. The variables ascertained to be significant in the binary logistic regression analysis were added in the adjusted models. The adjusted model revealed that people who had cough related problems were 2.06 times more likely to have solid fuel use compared to people who had no cough related problems (AOR = 1.41, 95% CI = 0.80 – 2.92, p = 0.030). Participants who had pressure in chest while breathing were 2.52 times more likely have solid fuel user compared to those who had no pressure in chest while breathing (AOR = 2.52, 95% CI = 1.15 – 5.53, p = 0.021). Again, people who had discomfort in eyes were 2.31 times more likely to have solid fuel use compared to those who had no discomfort in eyes (AOR = 2.31, 95% CI = 1.18 – 4.55, p = 0.015). The adjusted model also revealed that participants who had no diabetes and didn’t know whether they had diabetes were 2.40 times and 9.54 times more likely to have solid fuel use (AOR = 2.40, 95% CI = 1.45 – 3.10, p < 0.001, AOR = 9.54, 95% CI = 4.06 – 22.41, p < 0.001, respectively) in comparison with those who had diabetes. People who didn’t know that they had asthma were 3.69 times more likely to have solid fuel user compared to those who had asthma (AOR = 3.69, 95% CI = 1.36 – 10.01, p = 0.011). Finally, the participants who didn’t know whether they had allergies were 35% less likely to have solid fuel use compared to participants who had allergies (AOR = 0.35, 95% CI = 0.14 – 0.87, p = 0.024).

Table 3 Binary and multivariate logistic regression analysis of health problems associated with fuel type
Full size table

Figure 3 illustrates the barriers to clean cooking adoption. The data revealed that a higher percentage of participants (46.96%) cited economic problems as the primary reason for not using clean cooking fuel. Additionally, 8.63% of respondents identified a lack of awareness as a barrier, while 8.09% mentioned socio-cultural norms, customs, and practices. Furthermore, 6.22% of participants expressed concerns about losing the taste of food when cooking with clean fuel. Other barriers included social factors (7%), insufficient information about clean fuel (6.92%), maintenance issues with clean fuel (4.43%), a shortage of clean fuel or its unavailability (4.28%), attitudes towards technology (3.34%), problems related to the distribution of clean fuel (2.96%), and miscellaneous factors (1.17%), all contributing to obstacles in adopting clean cooking practices.

Fig. 3
figure 3

Barriers to clean cooking adoption

Full size image

Discussion

The use of solid fuel is a significant contributor to health problems in many low and middle-income countries, including Bangladesh. This study, to the best of our knowledge, is the first of its kind, covering four different divisions or regions in Bangladesh, aiming to investigate the association between health problems and cooking fuel type, along with barriers towards clean cooking. The findings revealed that approximately three-fourths of the participants used solid fuel for cooking. In the adjusted multivariate logistic model, the use of solid fuels was strongly associated with factors such as education, monthly family income, divisions/regions, and duration of living. Consequently, health problems such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies were strongly associated with solid fuel use. Economic problems were identified as the main barrier among others towards clean cooking.

Our study showed that 73.3% of rural households use solid fuel for cooking. While this finding is slightly more satisfactory than a previous study conducted in rural Bangladesh, which reported 94% of households using solid fuels for cooking [11], it still highlights a significant reliance on solid fuels. The government of Bangladesh has taken noteworthy initiatives for clean cookstoves to minimize solid fuel use [46]. Worldwide studies on the status of solid fuel use show diverse data, with around 80.5% of rural households in India using solid fuels [47], 95% in rural Pakistan [48], 95% in rural Myanmar [49], and 75% in rural China reported solid fuel use [50]. Factors associated with solid fuel use include economic problems, lack of awareness of the risks of solid fuels, and socio-demographic and socio-cultural influences [19].

A significant association was observed between illiteracy and the use of solid fuel, consistent with a previous cross-sectional study in Bangladesh that noted a higher prevalence of solid fuel use among individuals without formal education [39]. Similar patterns have been documented in other regions globally, such as in India [51] and Pakistan [52]. The likely causes contributing to this observation may include a lower awareness and a knowledge gap regarding the health risks associated with the use of solid fuel [18].

In the current study, a lower socioeconomic status (less than 15,000 BDT monthly) was significantly linked to the use of solid fuel. This finding aligns with a study in China, which reported that regions with low per capita household income are more reliant on solid fuel [50]. The prevalence of solid fuels in rural areas and the high prices of cleaner fuels compel households in rural Bangladesh to resort to cooking with solid fuel.

Our study revealed a significant association between cough, chest pressure while breathing, and eye discomfort with the use of solid fuel, consistent with similar findings in a study conducted in Bogura district, Bangladesh [31]. Comparable results have been reported in various parts of the world, including Nigeria [53], Uganda [54], China [55], and Nepal [12]. Moreover, diabetes, asthma, and allergies were also found to be significantly related to the use of solid fuel. Although a similar comprehensive study is lacking in Bangladesh, various global studies have addressed these issues. A cross-sectional study in China, for instance, established a strong connection between the use of household solid fuels and an elevated risk of diabetes [56]. Another study in India identified significant associations between asthma, allergies, and the use of solid fuel [57, 58].

Household members, particularly women and children, are highly exposed to household air pollutants such as respirable and fine particulate matter (PM2.5, PM10) and other gaseous substances released by solid fuels [26, 59]. These harmful air pollutants contribute to the development of asthma and allergy-related health problems in household members [60]. Additionally, PM pollution, particularly PM2.5, has a significant impact on blood glucose levels [61]. PM exposure elevates blood glucose levels through an increase in glucocorticoids [62]. Moreover, the majority of women who used solid cooking fuel experienced a negative impact on their blood pressure, a critical risk factor for diabetes mellitus [13]. Another study conducted in India reported that exposure to biomass fuel smoke significantly accelerates the prevalence of symptoms related to respiratory and eye problems [63]. Additionally, our findings indicate that economic problems are the main barriers to adopting clean cooking practices, consistent with results from a systematic literature review [19]. Furthermore, the tendency to lose food taste with clean fuels was identified as one of the significant barriers in Bangladesh.

Overall, this study provides valuable insights into the complex interplay of socio-demographic factors, health outcomes, and barriers influencing cooking fuel choices in rural Bangladesh. Addressing these factors is essential for promoting clean cooking practices, mitigating health risks, and contributing to sustainable development goals related to health and environmental sustainability.

Strength and limitations of this study

The primary strength of this study lies in its extensive coverage of four different divisional regions, employing a large sample size to examine the association between health problems and cooking fuel type. The inclusion of an investigation into barriers toward clean cooking adds additional value, marking this study as the first of its kind in rural regions of Bangladesh. The findings from this study offer clear guidance to policymakers in formulating effective clean cooking plans. However, it is important to acknowledge the study’s limitations. The cross-sectional design impedes the establishment of causal relationships between solid fuel use and health outcomes. Additionally, the study’s focus on rural areas restricts the generalizability of findings to urban regions. Unmeasured factors could potentially influence the observed associations. Despite these limitations, the study provides valuable insights into the correlation between fuel type and health outcomes, as well as the barriers hindering the adoption of clean cooking practices in Bangladesh.

Conclusion

In conclusion, this study underscores the substantial health risks associated with the persistent use of solid fuels for cooking in rural households in Bangladesh. Solid fuel use is linked to severe health consequences, including respiratory problems, eye ailments, diabetes, asthma, and allergies, compared to those using clean fuels. The findings emphasize the importance of considering cooking fuels as a significant factor in national-level policies and programs aimed at minimizing adverse health effects. Bangladesh’s ongoing efforts to achieve the SDGs, particularly the target of universal access to clean cooking energies, should prioritize addressing the implications of cooking fuel choices. Neglecting the development and implementation of technology for clean cooking compromises the attainment of other SDGs. This study contributes to policymaking by advocating for the adoption of clean fuels and raising awareness about the detrimental impacts of solid fuels. Collaborative efforts involving policymakers, local communities, and stakeholders, aimed at reducing barriers, can lead to meaningful improvements in clean cooking practices and overall well-being in rural areas. Future research, especially employing a qualitative approach, will further enhance our understanding of the current issues.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

SDGs:

Sustainable Development Goals

WHO:

World Health Organization

PM:

Particulate Matter

SD:

Standard Deviation

LPG:

Liquified Petroleum Gas

AOR:

Adjusted odds ratio

95% CI:

95% Confidence Interval

COR:

Crude odds ratio

References

  1. Puzzolo E, Pope D. Clean fuels for cooking in developing countries. Encycl Sustain Technol. 2017:289–297. https://doi.org/10.1016/B978-0-12-409548-9.10153-8.

  2. WHO. WHO publishes new global data on the use of clean and polluting fuels for cooking by fuel type. 2022. https://www.who.int/news/item/20-01-2022-who-publishes-new-global-data-on-the-use-of-clean-and-polluting-fuels-for-cooking-by-fuel-type%0A%0A.

  3. Mohapatra S, Simon L. Intra-household bargaining over household technology adoption. Rev Econ Househ. 2017;15(4):1263–90. https://doi.org/10.1007/s11150-015-9318-5.

    Article  Google Scholar 

  4. Kankaria A, Nongkynrih B, Gupta SK. Indoor air pollution in India: Implications on health and its control. Indian J Community Med. 2014;39(4):203–7. https://doi.org/10.4103/0970-0218.143019.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ahmed F, et al. Impact of household air pollution on human health: source identification and systematic management approach. SN Appl Sci. 2019;1(5):1–19. https://doi.org/10.1007/s42452-019-0405-8.

    Article  ADS  Google Scholar 

  6. Rehfuess EA, Bruce NG, Smith KR. Solid fuel use: health effect. Encycl Environ Heal. 2011:150–161. https://doi.org/10.1016/B978-0-444-52272-6.00716-9.

  7. Edwards JHY, Langpap C. Tulane economics working paper series fuel choice, indoor air pollution, and children’s health. 2008. Available: http://econ.tulane.edu/RePEc/pdf/tul0803.pdf.

  8. Goldemberg J, Johansson TB, Reddy AKN, Williams RH. A global clean cooking fuel initiative. Energy Sustain Dev. 2004;8(3):5–12. https://doi.org/10.1016/S0973-0826(08)60462-7.

    Article  Google Scholar 

  9. Guterres A. The sustainable development goals report 2020. United Nations Publ. issued by Dep. Econ. Soc. Aff, 2020. p. 1-64.

  10. Rosenthal J, Quinn A, Grieshop AP, Pillarisetti A, Glass RI. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain Dev. 2018;42:152–9. https://doi.org/10.1016/j.esd.2017.11.003.

    Article  PubMed  Google Scholar 

  11. NIPORT. Bangladesh demographic and health survey 2017–18. 2018. Available: https://dhsprogram.com/pubs/pdf/PR104/PR104.pdf.

  12. Tanchangya J, Geater AF. Use of traditional cooking fuels and the risk of young adult cataract in rural Bangladesh: A hospital-based case-control study. BMC Ophthalmol. 2011;11(1). https://doi.org/10.1186/1471-2415-11-16.

  13. Khan JR, Hossain MB, Das Gupta R. Household cooking fuels associated with elevated blood pressure among adult women: a national-wide assessment in Bangladesh. Environ Sci Pollut Res. 2021;28(47):67814–21. https://doi.org/10.1007/s11356-021-15344-w.

    Article  CAS  Google Scholar 

  14. Alam MB, et al. Household air pollution from cooking fuels and its association with under-five mortality in Bangladesh. Clin Epidemiol Glob Heal. 2022;17:101134. https://doi.org/10.1016/j.cegh.2022.101134.

    Article  CAS  Google Scholar 

  15. James BS, Shetty RS, Kamath A, Shetty A. Household cooking fuel use and its health effects among rural women in southern India-a cross-sectional study. PLoS One. 2020;15(4):1–12. https://doi.org/10.1371/journal.pone.0231757.

    Article  CAS  Google Scholar 

  16. Islam R, Sheba NH, Siddique RF, Hannan JMA, Hossain S. Association of household fuel use with hypertension and blood pressure among adult women in rural Bangladesh: a cross-sectional study. Am J Hum Biol. 2023. https://doi.org/10.1002/ajhb.23899.

  17. Khan MN, Nurs CZB, Islam MM, Islam MR, Rahman MM. Household air pollution from cooking and risk of adverse health and birth outcomes in Bangladesh: a nationwide population-based study. Environ Heal A Glob Access Sci Source. 2017;16(1):1–8. https://doi.org/10.1186/s12940-017-0272-y.

    Article  CAS  Google Scholar 

  18. Jain A, Tripathi S, Mani S, Patnaik S, Shahidi T, Ganesan K. Access to clean cooking energy and electricity: survey of states. ACEESS - Surv. States. 2018. Available: http://ceew.in/pdf/CEEW-ACCESS-Report-29Sep15.pdf.

  19. Vigolo V, Sallaku R, Testa F. Drivers and barriers to clean cooking: a systematic literature review from a consumer behavior perspective. Sustain. 2018;10(11):4322. https://doi.org/10.3390/su10114322.

    Article  Google Scholar 

  20. Tucho GT, Kumsa DM. Challenges of achieving sustainable development goal 7 from the perspectives of access to modern cooking energy in developing countries. Front Energy Res. 2020;8:1–11. https://doi.org/10.3389/fenrg.2020.564104.

    Article  Google Scholar 

  21. Islam MA, et al. Association of household fuel with acute respiratory infection (ARI) under-five years children in Bangladesh. Front Public Heal. 2022;10:985445. https://doi.org/10.3389/fpubh.2022.985445.

    Article  Google Scholar 

  22. Islam MA, et al. Corrigendum: Association of household fuel with acute respiratory infection (ARI) under-five years children in Bangladesh. Front Public Health. 2023;11:1299521. https://doi.org/10.3389/fpubh.2023.1299521. Switzerland.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Islam S, Akter R, Sikder T, Griffiths MD. Prevalence and Factors Associated with Depression and Anxiety Among First-Year University Students in Bangladesh: A Cross-Sectional Study. Int J Ment Health Addict. 2022;20(3):1289–302. https://doi.org/10.1007/s11469-020-00242-y.

  24. Siddique AB, et al. Assessment of prevalence and factors affecting Mastalgia among early reproductive-aged women in Bangladesh: a cross-sectional survey. BMC Public Health. 2023;23(1):2269. https://doi.org/10.1186/s12889-023-17173-7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lim J, Petersen S, Schwarz D, Schwarz R, Maru D. A rights-based approach to indoor air pollution. Health Hum Rights. 2013;15(2):160–7.

    PubMed  Google Scholar 

  26. Wu S. The health impact of household cooking fuel choice on women: evidence from China. Sustain. 2021;13:12080. https://doi.org/10.3390/su132112080.

    Article  CAS  Google Scholar 

  27. Khan N, Action P. Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Short running title: household air pollution and elevated blood pressure in Bangladesh. 2022.

  28. Hasan M, et al. Association of biomass fuel smoke with respiratory symptoms among children under 5 years of age in urban areas: results from Bangladesh Urban Health Survey, 2013. Environ Health Prev Med. 2019;24(1):1–10. https://doi.org/10.1186/s12199-019-0827-3.

    Article  Google Scholar 

  29. Rahman MM, Begum BA, Hopke PK, Nahar K, Newman J, Thurston GD. Cardiovascular morbidity and mortality associations with biomass-and fossil-fuel-combustion fine-particulate-matter exposures in Dhaka, Bangladesh. Int J Epidemiol. 2021;50(4):1172–83. https://doi.org/10.1093/ije/dyab037.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tanchangya J, Geater AF. Use of traditional cooking fuels and the risk of young adult cataract in rural Bangladesh: a hospital-based case-control study. BMC Ophthalmol. 2011;11(1):1–3. https://doi.org/10.1186/1471-2415-11-16.

    Article  Google Scholar 

  31. Alim MA, Sarker MAB, Selim S, Karim MR, Yoshida Y, Hamajima N. Respiratory involvements among women exposed to the smoke of traditional biomass fuel and gas fuel in a district of Bangladesh. Environ Health Prev Med. 2014;19(2):126–34. https://doi.org/10.1007/s12199-013-0364-4.

    Article  PubMed  CAS  Google Scholar 

  32. Hewitt J, Ray C, Jewitt S, Clifford M. Finance and the improved cookstove sector in East Africa; barriers and opportunities for value-chain actors. Energy Policy. 2018;117:127–35. https://doi.org/10.1016/j.enpol.2018.02.044.

    Article  Google Scholar 

  33. Timilsina GR, Malla S. Clean cooking: Why is adoption slow despite large health and environmental benefits? Econ Energy Environ Policy. 2020;9(1):2021. https://doi.org/10.5547/2160-5890.9.1.GTIM.

    Article  Google Scholar 

  34. Kelkar G, Nathan D. Cultural and economic barriers in switching to clean cooking energy: does women’s agency make a difference? Energies. 2021;14:7242. https://doi.org/10.3390/en14217242.

    Article  Google Scholar 

  35. Schlag N, Zuzarte F. Market Barriers to Clean Cooking Fuels in Sub-Saharan Africa: A Review of Literature. Fuel. 2008. Available: https://mediamanager.sei.org/documents/Publications/Climate/market_barriers_clean_cooking_fuels_21april.pdf.

  36. Lewis JJ, Pattanayak SK. Who adopts improved fuels and cookstoves? A systematic review. Environ Health Perspect. 2012;120(5):637–45. https://doi.org/10.1289/ehp.1104194.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Puzzolo E, Pope D, Stanistreet D, Rehfuess EA, Bruce NG. Clean fuels for resource-poor settings: a systematic review of barriers and enablers to adoption and sustained use. Environ Res. 2016;146:218–34. https://doi.org/10.1016/j.envres.2016.01.002.

    Article  PubMed  CAS  Google Scholar 

  38. Bonan J, Pareglio S, Tavoni M. Access to modern energy: A review of barriers, drivers and impacts. Environ Dev Econ. 2017;22(5):491–516. https://doi.org/10.1017/S1355770X17000201.

  39. Aziz S, Barua S, Chowdhury SA. Cooking energy use in Bangladesh: evidence from technology and fuel choice. Energy. 2022;250:123696. https://doi.org/10.1016/j.energy.2022.123696.

    Article  Google Scholar 

  40. Lipu MSH, Jamal T, Miah MAR. Barriers to energy access in the Urban Poor areas of Dhaka, Bangladesh: analysis of present situation and recommendations. Int J Energy Econ Policy. 2013;3(4):395–411.

    Google Scholar 

  41. Billah SM, Islam S, Tasnim F, Alam A, El Arifeen S, Raynes-Greenow C. Self-adopted ‘natural users’ of liquid petroleum gas for household cooking by pregnant women in rural Bangladesh: characteristics of high use and opportunities for intervention. Environ Res Lett. 2020;15(9):095008. https://doi.org/10.1088/1748-9326/ab7b25.

    Article  ADS  Google Scholar 

  42. Wang R, et al. Knowledge, attitudes, and practices (KAP) of the relationship between air pollution and children’s respiratory health in shanghai, china. Int J Environ Res Public Health. 2015;12(2):1834–48. https://doi.org/10.3390/ijerph120201834.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  43. Islam S, et al. Knowledge, attitudes and practices associated with the COVID-19 among slum dwellers resided in Dhaka City: a Bangladeshi interview-based survey. J Public Heal (United Kingdom). 2021;43(1):13–25. https://doi.org/10.1093/pubmed/fdaa182.

    Article  Google Scholar 

  44. Islam S, Ferdous Z, Islam U, Mosaddek A, Potenza M, Pardhan S. Tratamiento, síntomas persistentes y depresión en personas infectadas con COVID-19 en Bangladesh. Int J Environ Res Public Health. 2021;18(4):1–16. Available: https://pubmed.ncbi.nlm.nih.gov/33562427/.

    Article  Google Scholar 

  45. Rahman ME, Saiful Islam M, Mamun MA, Moonajilin MS, Yi S. Prevalence and factors associated with suicidal ideation among University Students in Bangladesh. Arch Suicide Res. 2022;26(2):975–84. https://doi.org/10.1080/13811118.2020.1833800.

    Article  PubMed  Google Scholar 

  46. Government of the People’s Republic of Bangladesh. Bangladesh country action plan for clean cookstoves. 2012. p. 56. Available: https://cleancooking.org/reports-and-tools/bangladesh-country-action-plan-cap/#:~:text=Bangladesh%20Country%20Action%20Plan%20for.

  47. Faizan MA, Thakur R. Association between solid cooking fuels and respiratory disease across socio-demographic groups in India. J Heal Pollut. 2019;9(23):190911. https://doi.org/10.5696/2156-9614-9.23.190911.

    Article  Google Scholar 

  48. Yasmin N, Grundmann P. Adoption and diffusion of renewable energy – the case of biogas as alternative fuel for cooking in Pakistan. Renew Sustain Energy Rev. 2019;101:255–64. https://doi.org/10.1016/j.rser.2018.10.011.

    Article  Google Scholar 

  49. Rana J, Islam RM, Khan MN, Aliani R, Oulhote Y. Association between household air pollution and child mortality in Myanmar using a multilevel mixed-effects Poisson regression with robust variance. Sci Rep. 2021;11(1):1–10. https://doi.org/10.1038/s41598-021-92193-0.

    Article  CAS  Google Scholar 

  50. Tang X, Liao H. Energy poverty and solid fuels use in rural China: analysis based on national population census. Energy Sustain Dev. 2014;23(11):122–9. https://doi.org/10.1016/j.esd.2014.08.006.

    Article  Google Scholar 

  51. Gould CF, Urpelainen J, Sais JH. The role of education and attitudes in cooking fuel choice: evidence from two states in India. Energy Sustain Dev. 2020;2020(54):36–50. https://doi.org/10.1016/j.esd.2019.09.003.

    Article  Google Scholar 

  52. Rahut DB, Ali A, Mottaleb KA, Aryal JP. Wealth, education and cooking-fuel choices among rural households in Pakistan. Energy Strateg Rev. 2019;24:236–43. https://doi.org/10.1016/j.esr.2019.03.005.

    Article  Google Scholar 

  53. Obaseki DO, et al. Domestic solid fuel combustion in an adult population in Nigeria: a cross sectional analysis of association with respiratory symptoms, quality of life and lung function. Respir Med. 2017;130:61–8. https://doi.org/10.1016/j.rmed.2017.07.014.

    Article  PubMed  Google Scholar 

  54. Coker E, Katamba A, Kizito S, Eskenazi B, Davis JL. Household air pollution profiles associated with persistent childhood cough in urban Uganda. Environ Int. 2020;136:105471. https://doi.org/10.1016/j.envint.2020.105471.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Chan KH, et al. Long-term solid fuel use and risks of major eye diseases in China: a population-based cohort study of 486,532 adults. PLoS Med. 2021;18(7):1–23. https://doi.org/10.1371/journal.pmed.1003716.

    Article  Google Scholar 

  56. Qu W, Yan Z, Qu G, Ikram M. Household solid fuel use and cardiovascular disease in rural areas in Shanxi, China. Iran J Public Health. 2015;44(5):625–38.

    PubMed  PubMed Central  Google Scholar 

  57. Agrawal S. Effect of indoor air pollution from biomass and solid fuel combustion on prevalence of self-reported asthma among adult men and women in India: findings from a nationwide large-scale cross-sectional survey. J Asthma. 2012;49(4):355–65. https://doi.org/10.3109/02770903.2012.663030.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Kumar R, et al. Impact of domestic air pollution from cooking fuel on respiratory allergies in children in India. Asian Pac J Allergy Immunol. 2008;26(4):213–22.

    PubMed  CAS  Google Scholar 

  59. WHO. Deaths from household air pollution, 2012 World Health Organization, Geneva. 2014. http://apps.who.int/gho/data/node.main.140?lang=en.

  60. Baldacci S, et al. Allergy and asthma: effects of the exposure to particulate matter and biological allergens. Respir Med. 2015;109(9):1089–104. https://doi.org/10.1016/j.rmed.2015.05.017.

    Article  PubMed  CAS  Google Scholar 

  61. Ma R, Zhang Y, Sun Z, Xu D, Li T. Effects of ambient particulate matter on fasting blood glucose: a systematic review and meta-analysis. Environ Pollut. 2020;258:113589. https://doi.org/10.1016/j.envpol.2019.113589.

    Article  PubMed  CAS  Google Scholar 

  62. Li H, et al. Particulate matter exposure and stress hormone levels: A randomized, double-blind, crossover trial of air purification. Circulation. 2017;136(7):618–27. https://doi.org/10.1161/CIRCULATIONAHA.116.026796.

    Article  PubMed  CAS  Google Scholar 

  63. Chowdhury S, Chakraborty PP. Universal health coverage - there is more to it than meets the eye. J Fam Med Prim Care. 2017;6(2):169–70. https://doi.org/10.4103/jfmpc.jfmpc.

    Article  Google Scholar 

Download references

Acknowledgements

The authors appreciate all those who voluntarily participated in this study.

Funding

This study was not supported or funded by any organization or individual. Authors bear all the expenses of this study by themselves. So, this research is self-funded research of the authors.

Author information

Authors and Affiliations

  1. Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh

    Sayed Mohammad Rasel, Abu Bakkar Siddique, Md. Fahad Shahariar Nayon, Sanzida Amin, Sadia Sultana Mim & Md. Shakhaoat Hossain

  2. Air Pollution, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh

    Sayed Mohammad Rasel, Md. Fahad Shahariar Nayon & Md. Shakhaoat Hossain

  3. Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, 1342, Bangladesh

    Abu Bakkar Siddique

  4. Department of Public Health, School of Pharmacy and Public Health, Independent University, Bangladesh (IUB), Dhaka, Bangladesh

    Md Shakil Mahmud Suzon

Authors
  1. Sayed Mohammad Rasel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abu Bakkar Siddique
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Md. Fahad Shahariar Nayon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Md Shakil Mahmud Suzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sanzida Amin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sadia Sultana Mim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Md. Shakhaoat Hossain
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The manuscript has been read and approved by all named authors. The individual contribution of the authors is given herewith: Sayed Mohammad Rasel: Conceptualization; Methodology; Investigation; Data collection; Formal analysis; Writing- original draft; Writing- review and editing; Abu Bakkar Siddique: Conceptualization; Formal analysis; Methodology; Writing-original draft; Writing- review and editing; Md. Fahad Shahariar Nayon: Data collection; Data analysis; Writing- original draft; Md Shakil Mahmud Suzon: Data collection; Data Curation, Writing- original draft; Sanzida Amin: Data collection; Writing-original draft;; Sadia Sultana Mim: Data collection; Writing-original draft; Md. Shakhaoat Hossain: Conceptualization; Methodology; Supervision; Writing- review and editing.

Corresponding author

Correspondence to Md. Shakhaoat Hossain.

Ethics declarations

Ethics approval and consent to participate

All procedures in this study were carried out in compliance with the rules for human investigations (i.e., Helsinki Declaration) as well as the institutional research ethics guidelines. Formal ethics approval was granted by the Biosafety, Biosecurity and Ethical Clearance Committee, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh [Ref No: BBEC, JU/M 2023/ 09 (50)]. Participants in the study were informed about the study procedure and objective as well as confidentiality of information provided. During the data collection periods, all participants actively agreed to be a part of the study. All data was gathered anonymously and processed using a coding scheme. Informed consent was obtained from all the participants involved in the study. In terms of illiterate participants, informed consent was obtained from their legal guardian(s).

Consent for publication

Not applicable. (No identifying information/images of study participants were taken).

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rasel, S.M., Siddique, A.B., Nayon, M.F.S. et al. Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh. BMC Public Health 24, 512 (2024). https://doi.org/10.1186/s12889-024-17971-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-024-17971-7

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us