LSTM Home > LSTM Research > LSTM Online Archive

‘Pneumonia has gone’: exploring perceptions of health in a cookstove intervention trial in rural Malawi

Ardrey, Jane ORCID:, Jehan, Kate, Kumbuyo, Caroline, Ndamala, Chifundo, Mortimer, Kevin ORCID: and Tolhurst, Rachel ORCID: (2021) '‘Pneumonia has gone’: exploring perceptions of health in a cookstove intervention trial in rural Malawi'. BMJ Global Health, Vol 6, Issue 10, e004596.

e004596.full.pdf - Published Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview


Introduction Air pollution through cooking on open fires or inefficient cookstoves using biomass fuels has been linked with impaired lung health and with over 4 million premature deaths per annum. However, use of cleaner cookstoves is often sporadic and there are indications that longer-term health benefits are not prioritised by users. There is also limited information about how recipients of cookstoves perceive the health benefits of clean cooking interventions. We therefore
conducted a qualitative study alongside the Cooking and Pneumonia Study (CAPS).
Methods Qualitative methods and the participatory methodology Photovoice were used in an in-depth examination of health perceptions and understandings of CAPS trial participants. Fifty participants in five CAPS intervention villages collected images about cooking.
These were discussed in village-level focus groups and in interviews with 12 representative participants. Village community representatives were also interviewed. Four female and eight male CAPS fieldworkers took part in gender-specific focus groups and two female and two male fieldworkers were interviewed. A thematic content approach was used for data analysis.
Results We found a disconnect between locally situated perceptions of health and the biomedically focused trial model. This included the development of potentially harmful understandings such as that
pneumonia was no longer a threat and potential confusion between the symptoms of pneumonia and malaria. Study participants perceived health and well-being benefits including: cookstoves saved bodily energy; quick cooking helped maintain family harmony.
Conclusion A deeper understanding of narratives of health within CAPS showed how context-specific perceptions of the health benefits of cookstoves were developed. This highlighted the conflicting
priorities of cookstove intervention researchers and participants, and unintended and potentially harmful health understandings. The study also emphasises the importance of including qualitative explorations in
similar complex interventions where potential pathways to beneficial (and harmful) effects, cannot be completely explicated through biomedical models alone.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Housing. Buildings. Public Facilities > WA 795 Housing
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Rachel Dominguez
Date Deposited: 14 Oct 2021 11:18
Last Modified: 14 Oct 2021 11:18


View details

Actions (login required)

Edit Item Edit Item