This issue of the newsletter highlights the emerging results of an ongoing study - Household Energy, Air Pollution and Health - supported by South Asia Region of the World Bank and the joint UNDP/World Bank Energy Sector Management Assistance Program (ESMAP). It presents an evaluation of current practices in Government of India's National Program of Improved Cookstoves (NPIC) based on case studies in selected states of India, where the penetration of improved stoves is relatively high. This evaluation exercise was designed in partnership with the Ministry of Non-Conventional Energy Sources of the Government of India, and undertaken by two leading institutions in the field ­ Tata Energy Research Institute (TERI) and Winrock International India (WII). The findings of the study provide a basis for developing more cost-effective interventions and strategies to address indoor air pollution. India's National Program of Improved Cookstoves ­ A Growing Challenge The Program has touched the lives of millions of poor people. However, greater effort is needed to improve its efficacy and make it self-reliant. T he improve biomass stove can be an important device India, based on an evaluation of NPIC and lessons learnt from for better household energy for millions of poor successful stove programs in other countries. people unable to afford expensive commercial fuels. The The evaluation was carried out in selected districts (see map) of stove can save fuel, diminish drudgery to collect fuels and six states - Andhra Pradesh, Gujarat, Haryana, Karnataka, reduce indoor air pollution resulting in substantial health Maharashtra and West Bengal - chosen to reflect geographical benefits. coverage and relatively higher rates of stove penetration, which The Government of India's National Program of Improved were considered indicators of success. The programs in these Cookstoves has introduced some 33 million biomass-based e improved stoves in rural areas during 1984-2000. Next to Bangalor China, this is the largest program in the world that has reached the lives of a large number of poor people in such Institute, ch a short time. Available studies, however, indicate that Resear gy problems, such as design failures, lack of public acceptance, Ener and quality control difficulties plague the program. Barring ataT ce: a few such studies, little attention has been given by Indian Sour rural energy and health experts to provide comprehensive inputs into future direction of the program. The World Bank, in partnership with the Ministry of Non- Conventional Energy Sources (MNES), a central agency under the Government of India, has carried out an evaluation of the Indian stoves program as part of an ongoing study entitled, The NPIC evaluation was undertaken in six Indian States on the basis of focus group Household Energy,Air Pollution and Health. The study aims at discussions and user surveys (See inset) the development of strategies to reduce indoor air pollution in qApproximate location of district surveyed districts were considered worth assessing in order to draw NPIC is a target-oriented program which implies that targets lessons. The evaluation is based on user response surveys and for stove installation are set by MNES and fulfiled by a focus group discussions with key stakeholders, such as users, network of functionaries at the state level. These targets are non-users, stove builders, designers and suppliers. While the communicated to the state-level nodal agencies which, in turn, evaluation is not intended to represent each state's situation, it pass their targets to local government agencies or NGOs provides some important snapshots of current practices working with them. The stoves are constructed by rural prevailinginNPIC.Anoverviewoftheprograminthesixstates women or unemployed youth as Self Employed Workers surveyed is given in Table 1 below. (SEWs) who receive training from the state's Technical Backup Unit (TBU) to build stoves. A total of 14 Technical Backup NPIC Overview Units provide research and development and training inputs for the program (See Figure 1: Institutional Structure of NPIC). Launched as a demonstration program in 1983 by MNES, Government of India, NPIC became a national-level dissemination program in 1986. The program's objectives include fuelwood conservation, removal of smoke, checking deforestation and environmental degradation, reduction in drudgery of women and employment generation. Currently, NPIC is implemented in all Indian states with more than 20 models of fixed and portable improved stoves available in the country for family, community and commercial applications. The beneficiaries of the program include low- and middle- income households in rural and peri-urban settlements, especially traditional wood-based stove users. Approximately, 30 per cent reservation for improved stoves is given to economically and socially disadvantaged groups, such as the designated backward classises. TABLE 1: NPIC OVERVIEW IN SIX STATES COVERED IN THE EVALUATION Name of Type of fixed-type mud Average stove Names of Numbers of Numbers of Cumulative Technical Backup state stoves frequently in use efficiency districts stoves installed stoves installed total numbers Unit (TBU) (Name of model) (per cent) surveyed in surveyed in the state of improved districts (1999 - 2000) stoves installed (1999 - 2000) (1995 - 2000)* Andhra 2 pot with chimney; 20-28 Mehboobnagar 2,9112 1,86,000 12,59,892 Regional Pradesh pottery liners (Sukhad) Engineering 2 pot chimney; pottery College, liners (Gayathri) Warangal Gujarat 2 pot with chimney 24 Ahmedabad, 16522 99,885 3,97,785 MS University, (Mamta) Surat, Dangs Vadodara 1 pot without chimney (Sneha) Haryana 1 pot with chimney 23 Panchkula, 9,000 55,000 2,36,970 Punjab University, (Mohini) Fatehbad and Chandigarh 2 pot with chimney (Jetan 22 Gurgaon and Akash) Maharashtra 1 pot without chimney 24 Kolhapur, Satara 10,950 95,103 7,88,189 Appropriate Rural (Grihalaxmi) and Sangli Technology 2 pot with chimney (Laxmi) 28 Institute, Pune 2 pot without chimney 24 (Parvati and Bhagyalaxmi) Karnataka 2 pot stove with chimney; 20-29 Mysore and 4,500 59,033 4,38,785 Karnataka State pottery liners (Sukhad) Hassan Council of Science 2 pot with chimney, and Technology, pottery liners and mould Bangalore (Sarale Ole) West Bengal 1 pot with chimney 18 Medinipur, 1,59,076 4,97,589 20,93,735 Kalyani (Sohini Seva) South 24 Parga- University, 1 pot coal with chimney 22-40 nas and Kalyani (Kalyani) Jalpaiguri 2 pot with chimney 22 (Sugam Seva) * Includes both fixed and portable improved stoves 2 Role of Subsidies cement stoves (with a lifespan of 5 years) to be disseminated in all states. The central subsidy on the Stove subsidies should not be used to cement stoves has significantly increased, while the share create unsustainable demand but to of the beneficiary contribution is almost the same (see Box: determine where demand is strongest Promotion of New Generation... on next page) . and the best ways to meet it The Indian stoves program has reached significant numbers of poor people with cheap stoves. Subsidies have In India, all households targeted for improved stoves in also made improved stoves affordable for a class of people NPIC are entitled to obtain a subsidy on the stove. The who would otherwise not be able to afford these. But the central government subsidy given by MNES does not go policy of subsidising stoves has some undesirable directly to the user, but to the state nodal agencies to cover implications. The TERI and WII surveys show that the the stove material and building costs, creation of capacity usage and maintenance rates continue to be poor among and awareness and administrative costs. In the six states the households getting highly subsidised stoves. In some surveyed, the unit cost of a fixed-type mud improved stove parts of Maharashtra, improved stoves fell into disuse due varies from Rs. 110 to 190 (US $2-4), and the central subsidy to poor maintenance in households that paid negligible accounts for 50 per cent of the stove cost in most states. amounts for the stoves. In Haryana, users declared that In some states, such as Andhra Pradesh, Haryana, Gujarat they would continue to use the improved stove as long as and Karnataka, state governments (and district it lasts and then revert to the traditional stove. This administration) provide a subsidy over and above the central indicates that stove subsidies have ensured distribution of subsidy under various development schemes. This further stoves but not necessarily sustained stove use. Given that reduces beneficiary contribution. For example, in the life of these cheap stoves is very short ­ on an average Maharashtra, most stove users pay Rs. 110 (US $2) for a mud- 2-3 years, there are few benefits from such programs. improved stove, but beneficiaries belonging to the Scheduled Interestingly, in successful stove programs around the world, Caste/Tribe and Other Backward Classes pay only Rs.10-20 governments have only subsidised technical support and (US $0.2-0.4) as they receive an additional state-level subsidy. assistance in determining where demand is the strongest. In In Haryana, users pay Rs. 20 (US $0.4) for an improved stove. China and Sri Lanka, the lower cost of supply in centralised In Andhra Pradesh, one of the nodal agencies provides a production of components has enabled the out-reach of stoves state subsidy that reduces the beneficiary contribution to Rs to local people who do not have significant cash resources and 15 (US $0.3). In Karnataka, stoves are provided free of cost to suffer from having to spend considerable time collecting fuel**. the economically backward, but the criteria are not very Further, attractiveness of improved stoves differs across areas clear. This creates a feeling of dissatisfaction among other where fuel is collected. The type of areas in which people users who pay more for the same stove. would value their stoves are those where people experience The subsidy structure of the Indian stove program in the various degrees of wood scarcity and thus have begun to show six states is described in Table 2. NPIC has recently interest in improving efficiency of traditional stoves. These are developed a new protocol, which allows only durable areas where people spend considerable time collecting fuel, TABLE 2: SUBSIDY STRUCTURE UNDER NPIC State Type of Stove Unit Cost of Central Subsidy given by Beneficiary % contribution by Stove 1 Subsidy2 State3 contribution 4 beneficiary Andhra 2 pot mud 148 70 63 15 10 Pradesh 2 pot mud 135 70 0 65 48 2 pot cement 190 110 0 80 42 Gujarat 2 pot mud 110 70 25 25 23 1 pot cement 280 100 145 35 13 2 pot cement 280 110 145 25 9 Haryana 1 pot cement 130 100 10 20 15 Maharashtra 2 pot mud precast 180 70 0 110 5 61 1 pot cement 220 100 0 120 55 2 pot cement 220 110 0 110 50 Karnataka 2 pot mud 140-190 70 23 47-97 33-51 West Bengal 1 pot mud 150 60 0 90 60 2 pot mud 180 70 0 110 61 1 pot cement 240 100 0 140 58 1 This includes charges for material of the stove and stove construction charges of Rs 20-30 paid to the SEW. 2 Central subsidy includes SEW charges. 3 In some states, state subsidy includes subsidy given by the district administration. 4 Beneficiary contribution gets reduced by Rs 10-20 further to the figures in this column whenever the beneficiary arranges for the stove material such as, mud or cement. 5 This amount gets further reduced (in some cases to Rs. 10-20) depending on the amount of state subsidy provided to the user by the Gram Panchayat. 6 Exchange rate US $1 = Rs. 47 3 have already had to move down the energy Stove building to empower women ladder to straw and dung, or pay cash for fuelwood supplies. In such areas, the Women's participation in the stove program through stove building activities is notable in programs have a better chance to work even some states. This has led to financial independence amongst rural women, productive without ­ or with minimal ­ subsidies. For utilisation of time and opportunities for travel and interaction with people. In Gujarat, women belonging to Self Help Groups (SHGs) are trained as SEWs to build stoves. Of the instance, the program has been relatively total SEW charges that the SHG members receive, 10 per cent is contributed towards the successful in Maharashtra, where people SHG's collective account. In Haryana, a network of 7,000 women's groups (Mahila typically purchase their traditional stoves and Mandals) supported by the Government of India's Department of Women and Child it is not uncommon for households to pay for Developmentimplementtheprogramatthevillagelevel.Thegroupsidentifybeneficiaries, wood fuels. motivate households and supervise stove building. Trained women SEWs build stoves. In West Bengal, a women's organisation (Asnan Ma Saradamoyee Mahila Samiti) is actively ** Kirk Smith et al, 1993, One Hundred Million Improved Cookstoves in China: How was it done?, World Development, pursuing dissemination of improved stoves. Three of the 55 villages covered by the Vol. 21, No. 66, pp 941-961 organisation have been declared "smoke free" with hundred per cent households using Global Environmental Facility, 2000, Improved Stove Program in Sri Lanka, Paper prepared for a study on Cleaner Rural improved stoves. Thirty women have been trained as SEWs to carry out stove operations. Household Fuels Commercialisation of Stoves whom have obtained loans from local On the whole, India has not had much success with c o o p e r a t i v e s . commercialisation of improved stoves. In the mid 1990s, the Commercialisation has Ram Krishna Mission, an established NGO in West Bengal, helped a large class of made an attempt to promote stove dissemination without households in the state subsidy. While the Mission was successful in motivating to be served who users in its areas of operation, severe pressure from the village would otherwise be out panchayats (village bodies comprising elected members that of reach of NPIC. It has are authorised to make decisions affecting the entire village) Delhi resulted in stove New made it revert to the subsidy-based program. The panchayat India, m a n u f a c t u r e r s members feared that commercialisation of stove adhering to better dissemination would dilute their influence on the International quality control norms community, because such rural development programs are ock inr W and innovative designs. used for furthering public relations activities. ce: Sour With modest Some success with commercialisation, however, can be seen in A two-pot improved stove in use in investments, stove Maharashtra which also heats water Maharashtra. One of the most striking aspects of the program using chimney smoke. entrepreneurs have inthestateisitspromotionofruralentrepreneurswhoselltheir Such innovative models are sold by earned reasonable entrepreneurs in the open market. products in the open market and through NPIC. With annual profits and are keen to turnovers each of Rs. 1,00,000, the entrepreneurs are expand their businesses. However, with a shift towards cement professional potters who have been trained by Appropriate stoves (see Box: Promotion of New Generation...) that are costly to Rural Technology Institute (ARTI), the state's Technical Backup produce, some entrepreneurs are grappling with problems Unit. Some 25 entrepreneurs operate in Maharashtra, some of related to profit margin and working capital issues. Promotion of new generation improved stoves The Technical Backup Units of NPIC have been developing and field-testing cement stoves having a minimum lifespan of five years since January 2000. In addition to durability, these stoves offer advantages, such as ease of transportation, better quality control of materials and adhering to design specifications. Under NPIC, MNES shifted its policy in October 2000 towards promoting durable improved stoves with chimneys. The fireboxes of these models are made of cement mortar, pottery liner or mild steel sheet. Considering the high costs of these new models, estimated to be Rs.140 to Rs.250 (US $3-5) per stove, the Government of India has enhanced the central subsidy to Rs. 80 (US $2) per stove. Besides, some State Governments provide additional subsidy in the range of Rs. 10 to Rs. 50 (US $0.2-1) under State Government Budget and beneficiaries meet the balance cost. Self employed trained workers (SEWs), mostly women, who are involved in building the new generation stoves and providing free maintenance in the first year, will be given higher incentives. The Government has announced an increase in the amount of SEW charges by Rs.10 (US $0.2). The TBUs will organise short duration courses for SEWs in the building and maintenance of new models. Trainees will be given moulds, each costing Rs. 500 (US $ 11) for building cement stoves, as a part of the training. For more information please contact Dr. K.C. Khandelwal, Advisor, MNES, Government of India, New Delhi -110 003, India at advkck@ren02.nic.in 4 Stove User Issues Some reasons-why people The users are not particularly concerned about the stoves don't adopt stoves? having to conform with technical specifications; rather © In houses with thatched roofs, installation of stove their primary interest is a smoke-free kitchen and adequate chimney leads to leakages during the rainy season. heat generation in the firebox. Common modifications © People cannot afford a one-time payment for the stove. made by users include altering the pothole size and © Lack of space in the house. removing the grate. © Unavailability of stove parts. In some Karnataka households, the users fixed an extra broken pipe to enhance the length of the prescribed 10-foot diameter of the chimney was increased from 3 to 4 inches chimney. Some households with thatched roofs removed to facilitate cleaning and smoke elimination. their chimneys during rainy season to avoid leakages inside In Andhra Pradesh, people changed the pothole size, the house through the roof removed grates and raised the hole made for the chimney. Common modifications made by stove height of pothole to be able to users include altering the see the flame while cooking. InHaryana,peoplecomplained pothole size and removing the This leads to more fuel being that improved stoves grate and chimney used and smoke that does not consumed more wood pass through the chimney. compared to Some households felt traditional stoves. The In four of the six states surveyed, users perceive smoke elimination from that their improved Gujjar community in the kitchen as the primary benefit of an improved stove. Following this, stoves used more fuel Haryana preferred to people value their improved stove for fuel savings, convenience due to and pottery liners got increase the size of faster cooking and cleaner kitchen. None of the respondents reported cracked. In such firebox to accommo- better health benefits other than reduced eye burning/cough. cases, they reverted to datelargerotis(Indian RANKING OF BENEFITS OF IMPROVED STOVES PERCEIVED BY USERS traditional stoves. All bread) which are State Smoke Fuel Faster Cleaner kitchen Better Health of the problems cited baked inside the box. Removal Savings Cooking due to less (less eye burning/ above could be the In some households, soot cough) focus of research and the chimney outlet Andhra Pradesh 4 3 1 4 2 development by the was inside the house Gujarat 1 2 3 4 5 Technical Backup as people were Haryana 1 3 4 2 5 Units, most of which unwilling to make a Karnataka 1 2 3 4 5 are developing stoves hole in their roofs to Maharashtra 2 1 3 4 5 that take into allow the chimney to West Bengal 1 4 3 5 2 consideration user pass through. *Ranking is based of the proportion of users that acknowledged the benefit. A rank of 1 denotes highest benefit while a rank of 5 denotes least benefit concerns. In Gujarat, the size of the firebox was enlarged to fit bigger Metallic Cookstoves pieces of wood for burning. People also complained that the Metallic cookstoves are popular in states, such as Andhra Pradesh, Gujarat, roof got damaged when the chimney was cleaned or that the Kerala, Madhya Pradesh, Maharashtra, Punjab and North-Eastern Region States. More than 20 small industries are manufacturing portable metallic chimney mouth needs to be bigger. Some households had stoves in conformity with Indian Standards IS:13152 (Part I) 1991. The completely broken down the improved stoves and recast it. thermal efficiency of a portable metallic stove is 30 to 35 per cent. In hilly areas, metallic stoves are used for both cooking and space heating purposes. In Maharashtra, changing the pothole size and removal of A recent survey in Gujarat found that 93 per cent of the families who had received stoves a year ago, were regularly using them and reported the the grate are common modifications made by users. advantagesofconvenience,lesssmoke,savingoffirewoodandeasytomove. However, unlike other states, the practice is to make the Metallicstoveshavealsobeenfoundusefulinreliefcamps.MNESsupported distribution of 5000 community stoves in cyclone affected area in Orissa in potholes smaller. Women removed the grate because of 1999-2000 and recently directly procured and placed 4000 small size and 2000 difficulty in removing hot ash from under the grate and big size metallic stoves with the authorities in district Bhuj, Gujarat, for using lack of space to accommodate large pieces of wood. A in community kitchens and distributing among earthquake affected families. Ametallic stove suitable for a family costs about Rs. 160 to Rs. 250 (US $3-5) majority of the households belonging to one district had and MNES provides a subsidy of Rs. 50 (US $1) to Scheduled Castes and cast aside their stoves as the gap between the end of the Scheduled Tribes; Rs. 75 (US $2) in notified and hilly desert areas and island states and Rs.135 (US $3) in North-Eastern Region States. A high altitude chimney and tin roof had not been sealed properly stove costs about Rs. 500 (US $11) and subsidy of Rs. 450 (US $10) is given in resulting in leakages during the rainy season. North-Eastern Region States and Rs 250 (US $5) is given in other States. Community stoves cost Rs 1,100 (US $23) and are not subsidised In West Bengal, the diameter of the tunnel was increased to For more information please contact Dr. K.C. Khandelwal, Advisor, MNES, Government of India, New Delhi -110 003, India, at advkck@ren02.nic.in facilitate the flow of heat to the second pothole. Also, the 5 Interaction among Stove Quality Control Users, Builders and Designers 3 NPIC permits only SEWs trained and certified by the TBU The role of stove designers to meet to construct stoves. However, uncertified SEWs build and the needs of the users has to be install stoves leading to defective construction. strengthened. 3 Stove parts must be bought from suppliers approved by the TBU. However, SEWs often purchase stove parts from In almost all the states covered by the survey, the close unapproved suppliers. coordination and understanding among users, SEWs and 3 While the SEWs are responsible for providing one year's NGOs is markedly absent in their interactions with the TBU. service to users after stove construction, however, they are The expectations of users from TBUs in affecting changes in not inclined to do this. stove design and development have remained unfulfiled to 3 No standards exist for Asbestos Cement Pipes used for a large extent. The users are largely unaware of the TBUs chimneys. These can be procured from any suppliers involvement in formalities of stove development and look upon the SEWs as informal stove designers. some complaints about the improved stoves and make modifications to the stove design to improve its The Karnataka survey revealed that only six per cent of the usability. This generally points to a weakness in the users had participated in a users training program feedback mechanism among stove designers (TBUs), organised by the TBU. While the TBUs conduct surveys to users and producers. assess the working status of stoves, the surveys do not take into account issues relating to stove design and efficiency. There is no uniform TBU policy to approve the modifications suggested by the NGOs. Also, users are Further, the interaction between stove builders and TBUs not trained adequately by the TBUs to understand the is limited to sporadic state-level meetings, capacity impact of stove modifications on quality and efficiency. building programs and feedback surveys. In most of the While the TBU's inability to address the stove design states surveyed, NGOs and SEWs used their ingenuity to problems at the field level has resulted in lowering of make modifications due to the lack of technical support quality control during construction, it has had no impact from the TBU (see photo below). on the numbers of improved stoves installed, with However, even after many years of stove higher penetration being a function mainly of efforts development, in most states, users either still have made by SEWs and NGOs, rather than improvement in stove design per se (see Box: Quality Control). Repurchase or Revert? A global review of successful programs has revealed that repurchase of the improved stove is the most practical definition of sustainability*. The repurchase is unlikely to be greatly influenced by factors other than the household's judgment of relative costs and benefits. In India, the fixed mud stove by virtue of design and construction is repaired and reused depending on the nature of the damage. Repurchase of improved stoves is not common. Most users reported that they would revert to the traditional stoves if their improved stove is broken. In Karnataka and Andhra Pradesh, people are not willing Gawhati to purchase the same type of stove again. The problems faced by them are non-availability of stove parts locally Institute, ch and lack of skilled masons to build the stove. The NPIC Resear gy policy is that villages where improved stoves are installed Ener ataT once are not visited again for installation. Hence, benefits ce: of improved stove last only up to 2-3 years, which is a Sour In West Bengal, NGOs have responded to user needs by replacing the stove's typical lifetime. roof chimney with the shorter bent chimney that goes through the wall * Douglas F. Barnes et al, What Makes People Cook with Improved Biomass Stoves?: A This change has helped avoid leakages inside the house during Comparative International Review of Stove Programs, World Bank Technical Paper, the rainy season ISSN 0253-7494; No.242, Energy Series, 1994. 6 CHARACTERISTICS OF NPIC VIS À VIS INTERNATIONAL BEST PRACTICES* INTERNATIONAL BEST PRACTICES IN STOVE DISSEMINATION NPIC PRACTICES Focus on need-based users Target approach, stress on covering certain number of villages with saturation approach to benefit all households of the selected village at one time. Demand for stoves is not taken into consideration. Minimal subsidy from government Subsidy on stove accounts for the largest share (50%) of government support. Users in peri-urban areas are willing to pay greater amounts subject to guarantee on stove quality Close interaction among the designer, producer and user Adequate interaction between producer and user, but negligible between designer, and producer and user Dependence on centralised production of stove and stove parts to enable For fixed stoves, there is no scope of centralised production as these are out-reach to larger number of people due to lower cost of production built at user's homes. Mass production of stove parts (chimney, cowl, etc) undertaken by private manufacturer Onus on producers and designers to meet needs of consumers Consumer needs met by SEWs/NGOs through changes in stove design with low inputs from designers Maximum support for R&D, production and distribution of stoves, credit, Inadequate support given for R&D. Support for capacity and capacity building and publicity awareness awareness generation not adequate. Long-term funding Target-based funding by government, routed through nodal agencies and disbursed through NGOs for implementation * Douglas F. Barnes et al, What Makes People Cook with Improved Biomass Stoves?: A Comparative International Review of Stove Programs, World Bank Technical Paper, ISSN 0253-7494; No.242, Energy Series, 1994. Looking to the Future... provided to people to help them make the transition to a more expensive stove. Whatever steps are taken, however, The future of NPIC in India is at crossroads with the latest the goal of any successful stove program must be to directive to disseminate only durable models. Although become self-sustainable over a reasonable timeframe. many users are willing to pay for durable stoves, the There is a need to distinguish geographical areas in which economically backward users may not be able to raise the sustainability may be decades off from those where it is increased user contribution. Some NGOs feel that the just round the corner. In all cases, the Indian stove program current mud stoves should be continued, with a gradual is obliged to plot a course that responds to demand, phase-out, until acceptance of the durable model is promotes commercialisation and entrepreneurship and established. At the same time, incentives may need to be leads to eventual self-reliance. Measuring Health Outcome of Improved Stoves While growing evidence of significant health damages from at the Technical Backup Units have been trained for exposure traditional biomass household cooking in India is difficult to assessment and medical teams are being formed and trained confront, an understanding of health benefits of improved for the survey work in five states. biomass stoves -- vis à vis other possible interventions to Parallel to the Indian initiative, the Chinese authorities are change household behaviour, fuel and cooking technologies geared up to focus on indoor air pollution to further improve --needstobeimproved.Fewstudieshavebeenconductedin maternal and child health in two northern provinces of India to quantify the actual reduction in exposures to China.Ateam comprising the Chinese Ministry of Health, in respirable particulate matter and resulting health benefits collaboration with the Chinese Academy of Preventive from the use of improved stoves in field conditions. If indeed Medicine, and some local universities will undertake an showing a considerable impact on exposure levels and health intervention-based study of improved stoves. The ultimate out come, availability of this data can serve to bolster NPIC objective is to reduce respiratory disease and other related and help meet its objectives. More simply, stove users can be illness among women and children and prevent the motivated to adopt and sustain improved stoves on the basis development of dental fluorosis in children caused by of its health benefits. Recently, the Ministry of Non- exposure to coal smoke. The proposed study will assess Conventional Energy Sources (MNES), Government of India, alternative cost-effective and affordable household energy launched a study to examine the effects of improved stoves interventions (improved stoves, better ventilation, cleaner onindoorairquality,exposurereductionandhealthoutcome. fuels) that meet community needs and induce behaviour The study design will allow measurements of human changes for reducing exposure to indoor air pollution. exposure to respirable particulate matter and carbon monoxide before and after the introduction of improved For information on the Chinese Study, please contact Dr. Jin Yinlong, Director of Institute of Environmental Health and Engineering, Chinese Academy of stoves in households. In addition, lung function tests will be Preventive Medicine, at jinieche@public.bta.net.cn carried out to ascertain the effect of exposures. The field work FormoreinformationontheMNESStudy,pleasecontactDr.K.C.Khandelwal,Advisor, is expected to begin in November 2001. Meanwhile, scientists MNES, Government of India, New Delhi -110 003, India, at advkck@ren02.nic.in 7 Interview of India, has sponsored a research project entitled "Health risk assessment of rural and urban population The health aspects of improved due to indoor/ambient air pollution" at a cost of Rs. 1.36 stoves have not been crore. The objectives of the research project are as highlighted adequately... follows: NK Ganguly 3 Developadatabaseonthelevelsofbenzene,1,3butadiene, Director - General formaldehyde and PAHs in ambient/indoor air Indian Council of Medical Research 3 Assess the levels of relevant metabolites in the Government of India biological fluids as markers of exposures in exposed What, in your opinion, are the knowledge gaps in the populations. area of indoor air pollution and health? 3 Study the effects of pollutants using different biological end points Most of the published reports on indoor air pollutants from domestic fuel have focused on common air pollutants like 3 Determine patterns of morbidity due to air pollution suspended particulate matter (SPM), CO2, SO2 and NOX. 3 Suggest intervention strategies/remedial measures for There is a particular lack of information as regards the policy decision making quantitative analysis of poly aromatic hydrocarbons (PAH), Why does ICMR emphasise the need to address indoor aldehydes, benzene, 1, 3 butadiene and volatile organic air pollution and health in the Tenth Five Year Plan? compounds, many of which are known carcinogens. Sporadic It has been estimated that about half a million women and studies carried out in India and other developing countries children die of indoor air pollution in India each year. show that exposure to indoor air pollution results in acute Twentyeight per cent of all deaths due to indoor air respiratory infection in children, chronic lung diseases, such as pollution in developing countries occur in India. Further, a tuberculosis, cataract and adverse outcome of pregnancy. 1997 report of the World Health Organisation states that a However, well-planned epidemiological studies in the area pollutant released indoor is one thousand times more are still lacking. There is also a need for experimental studies likely to reach people's lung than a pollutant released to understand the biological mechanism of health effects of outdoors. Given the magnitude of the health problem, indoor air pollutants. Finally, there is a need to understand the ICMR will try to fill the knowledge gaps on various socio-behavioural aspects relating to the acceptability of aspects of indoor air pollution with the main objective of improved stoves and use of clean fuels for cooking. identifying mitigation strategies. What are your views on the main reasons for lack of health research in the area of indoor air quality in India? Where do you feel are the avenues for strengthening the multidisciplinary efforts needed to address these The adverse health effects of biomass fuels have been perceived problems? only recently. Most people tend to argue that biomass has been In the last two decades, the Ministry of Non-Conventional usedforcenturiesinIndiawithoutanynoticeableadverseeffect. Energy Sources (MNES) has strived to popularise the non- This complacency is seen even among the scientific community. polluting energy efficient stoves. However, the health What is being done by the Government of India aspects of improved stoves have not been highlighted (particularly Indian Council of Medical Research) to adequately. MNES can continue to act as a nodal agency address the problem? emphasising on health aspects and involving other The Ministry of Health and Family Welfare, Government relevant ministries/departments. Feedback We welcome your contributions, comments and suggestions. The last date for receiving articles for the next issue is Sept. 30, 2001. Sameer Akbar Kseniya Lvovsky South Asia Social and Environment Unit South Asia Social and Environment Unit The World Bank The World Bank 70, Lodi Estate 1818 H St., NW New Delhi 110003, India Washington DC 20433, USA Tel: 011-91-4617241 Fax: 011-91-4619393 Tel. 202-473-6120, Fax 202-522-1664 Email: sakbar@worldbank.org Email: klvovsky@worldbank.org If you would like to be included in the mailing list, please email to pritikumar@mantraonline.com Visit us at http://wbln1018.worldbank.org/sar/sa.nsf This newsletter is part of a World Bank study in India, Household Energy Air Pollution and Health, and is supported under the joint UNDP/World Bank Energy Sector Management Assistance Program (ESMAP). The material used in this newsletter does not represent the views of the World Bank. Produced by macro graphics.comm pvt. ltd.