‘Why would they spend all this money and give us these items for free?’: Exploring precarity and power in a cleaner cookstove intervention in rural Malawi

Ardrey, Jane ORCID: https://orcid.org/0000-0003-4558-5113, Jehan, Kate, Desmond, Nicola ORCID: https://orcid.org/0000-0002-2874-8569, Kumbuyo, Caroline, Nyirenda, Deborah, Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116, Mortimer, Kevin and Tolhurst, Rachel ORCID: https://orcid.org/0000-0002-3005-6641 (2023) '‘Why would they spend all this money and give us these items for free?’: Exploring precarity and power in a cleaner cookstove intervention in rural Malawi'. PLOS Global Public Health, Vol 3, Issue 2, e0001537.

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Abstract

We carried out a qualitative study to gain a deeper understanding of the social context of the Cooking and Pneumonia Study (CAPS) and implications for implementation of clean cooking and similar interventions. Such initiatives are recognised as complex, power-laden processes, which has consequences for outcomes and uptake. However, understanding of how precarious livelihoods and unequal power differentials impact on trials of technology is limited and potentially hampers the achievement of the SDGs including SDG 7, Affordable and Clean Energy. An in-depth exploration of experiences and perceptions of cooking and cookstove use within CAPS was completed using qualitative methods and the participatory methodology Photovoice. Ten CAPS participants from each of five villages participated in Photovoice activities and five village representatives were interviewed. Twelve fieldworkers participated in gender specific focus groups and four were interviewed. A thematic content approach was used for data analysis. The analysis showed that economic and power inequity underpinned the complex social relationships within CAPS impacting on trial participation, perceptions of the cookstoves, and on the potential of the intervention to affect health and other benefits. Power can be understood as relational and productive within the research environment. This is illustrated by an analysis of the role of fieldworkers and community representatives who needed to negotiate resistance to trial compliance decisions, including ‘satanic’ rumours about cookstoves and blood-taking. Transformative approaches that challenge existing power inequities are needed to maximise the success and beneficence of cookstove and other health promoting interventions, and achievement of the SDGs.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine. WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Air pollution > WA 754 Pollution and pollutants (incl. tobacco pollution; passive smoking)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pgph.0001537
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	09 Feb 2023 10:19
Last Modified:	09 Feb 2023 10:19
URI:	https://archive.lstmed.ac.uk/id/eprint/21886

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