Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Testing a Method to Encourage LPG Adoption for Cooking

139 views

Published on

Enhancing LPG Use During Pregnancy a collaboration between KEM Health Research Center, Sri Ramachanda University, and University of California, Berkeley

An explanatory presentation provided to ProPublica.org

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Testing a Method to Encourage LPG Adoption for Cooking

  1. 1. Enhancing LPG Use During Pregnancy a collaboration between KEM Health Research Center, Sri Ramachanda University, and University of California, Berkeley May 25-26, 2017 Junnar Field Headquarters, Maharashtra, Indi
  2. 2. About the team Household energy in India a very brief review Our project May 25-26, 2017 Junnar Field Headquarters, Maharashtra, Indi
  3. 3. About the team Household energy in India a very brief review Our project May 25-26, 2017 Junnar Field Headquarters, Maharashtra, Indi
  4. 4. KEM Hospital Pune The KEM Hospital, Pune, the largest NGO hospital in Pune District. It is registered under the Societies' Registration Act 1860 and the Bombay Public Trusts Act 1950. Centenary Year : 2012 ©2010, KEMHRC Pune
  5. 5. KEM Hospital Research Centre Pune (KEMHRC) • KEMHRC was registered in 1985, as an independent society under the Societies Registration Act 1860. • Recognized as Center of National Importance from ICMR - 1988 • Recognition by DSIR – Scientific and Industrial Research Organization (SIROs) - 1988 • National Institute of Health and Family Welfare recognized as Collaborating Training Institute (CTIs) for RCH program - 2000 • NABH/NABL accreditation • Initiated Vadu Rural Health Program ©2010, KEMHRC Pune
  6. 6. - 1970: Vadu Primary Health Unit - 1985: Shirdi Sai Baba Rural Hospital (tripartite partnership with governments) - 1987: VRHP as out reach program - 1988: Research by KEMHRC from Pune - 2002: Vadu HDSS - 2003: Vadu Research Unit History
  7. 7. Vadu
  8. 8. University Sri Ramachandra University was established in the year 1985 as part of the Sri Ramachandra Educational & Health Declared under section 3 of the UGC Act, 1956 Accredited by NAAC with 'A' Grade ( CGPA 3.62 on a 4 point scale ) Medical Centre The University Medical Centre is the focus of the clinical teaching activity of the University. A 1800 bedded facility with the largest ICU in the region with state of the art equipment, the medical centre is a tertiary care facility that provides the trainee with the opportunity to acquire knowledge and skills from the finest doctors in the country Department of Environmental Health Engineering Established in 1998 as Environmental Health Engineering Cell by UNIDO-CLRI to provide Occupational Safety and Health Services to the Leather Industry Department Director: Dr.Kalpana Balakrishnan, Phd. FAMS, Associate Dean-Research, Director for WHO Collaborating center for Occupational and Environmetal Health Director for ICMR-CAR for Air Quality, Climate & Health. Head of the Department: Dr.S.Sankar Msc. Phd
  9. 9. CURRENT SCALE OF OPERATION • 34 Research/teaching personnel including 11 Faculty members • 10 Concurrent On-going Research Projects • Advisory Consultancy for Industries Involvement with • 6 Central Ministries (Health,Environment,Labour,Renewable Energy,Earth Sciences,Science and Technology) • 3 State Ministries(Health,Environment,Labour) • 3 UN Agencies(Who, ILO, UNEP) • 4 bilateral agencies(GTZ,USEPA,CDC,NIH) • 10 Long term international collaborators • 40-50 Local Institutional Collaborators
  10. 10. Research, Consultancy & Extension “Net-Working” Collaborations MOU Partners University of California, Berkeley,USA National Institutes of Health-USA TUFTS University-USA Smile Train – Cleft Lip Palate ,USA Transforming Faces (TF), Canada Utah State University, USA International Agency Partners World Bank ILO WHO UNIDO UNDP UNEP Fogarty International Center,NIH, USA USEPA, USA GTZ-CIM, Germany EU, Brussels IDRC, Canada SIDA, Sweden Research Partners Washington Univerity, St. Louis,USA Johns Hopkins University,USA Harvard School of Public Health,USA University of Ann Arbor , Michigan,USA NUS, Singapore Australian National University, Australia University of Umea,Sweden Lund University, Sweden University of Montreal, Canada University of Illinois, IL,USA Clarkson University, NY,USA University of Minnesota, MN,USA University of Sao Paulo, Brazil University of Kebansaan, Malaysia MOPH, Thailand
  11. 11. May 25-26, 2017 Junnar Field Headquarters, Maharashtra, Indi About the team Household energy in India a very brief review Our project
  12. 12. 66% of households use biomass for cooking Little change in abs. numbers using biomass over time – percentage changes, but population growth continues Leads to ~10% of national mortality 900,000 deaths per year ~25% of ambient air pollution
  13. 13. Three innovative, national Indian LPG programs PAHAL Paid fuel subsidies directly into bank accounts. All LPG sold at market rates, reducing diversion of fuel intended for households into other sectors. Give It Up Encouraged middle and upper class households to give up their subsidy, which was targeted one-to-one to the poor. XX million households have given up their subsidy to date. PMUY or Ujjwala Provides reduced cost connections to 50 million poor households by 2019 – as of early 2017, had reached over 20 million already.
  14. 14. 1 billion USD internal foreign aid program Now must shift focus to facilitating and increasing exclusive usage to obtain health benefits Apply learning from other health interventions – latrines, salt, condoms, bednets, TB drugs, etc
  15. 15. May 25-26, 2017 Junnar Field Headquarters, Maharashtra, Indi About the team Household energy in India a very brief review Our project
  16. 16. Maharashtra
  17. 17. Junnar Block
  18. 18. Location Junnar Block, Pune district, Maharashtra, India • 76,700 households • 360,000 people • 14,000 BPL families • 1250 pregnancies in BPL families per year • 150 weddings per wedding season (60% pregnant within a year) • 12 PHCs – we target 3
  19. 19. 1. NFHS 4 report, Pune District 2. DLHS 07-08, Pune District Indicator Urban Rural Total Mothers who had antenatal check-up in the first trimester (%) 88.9 87.3 88.2 Mothers who had at least 4 antenatal care visits (%) 85.7 83.2 84.5 Mothers who had at least one antenatal care visits in government facility (%) 43.9 Mothers who had at least one antenatal care visits (%) 2 97.7 Institutional births (%) 92.8 94.2 93.5 Age at Marriage 19.7
  20. 20. Given that pregnancy is a vulnerable period for mother and child, can we increase the number of months of a pregnancy covered by LPG, a clean fuel? Target two important life course events to increase adoption and usage of LPG
  21. 21. Control Arm Households receive the intervention package: connection, stove, table, tubing, lighter, 2 x cylinder ‘Pink Key’ Arm Intervention package + 2 INR / meal payment for cooking with gas. Use observed with novel meal-counting stove use monitor Free Fuel Arm Intervention package + up to 1 free refill per month Marriage Arm Households receive the intervention package shortly after marriage Pregnancy Increase number of months covered by clean fuels. Identified in cooperation with local healthcare workers (ASHAs + ANMs) Marriage Cover the crucial early pregnancy period. Target marriages through ASHA workers and through community-scale weddings.
  22. 22. Measurements Across all arms, LPG and the primary traditional stoves will be equipped with data-logging temperature sensors called “Stove Use Monitors.” The LPG + CCT arm will also be equipped with a Pink Key. In 30 homes per arm, we will measure kitchen air pollution and personal exposure before and after intervention.
  23. 23. LPG Chula May 04 May 05 May 06 50 100 150 50 100 150 Date DegreesC Location Chula LPG - Left LPG - Right Sample Stove Use Monitoring Data
  24. 24. 0 10 20 30 Mar 08 12:00 Mar 08 18:00 Mar 09 00:00 Mar 09 06:00 Mar 09 12:00 Date PM2.5(mg/m3) Location Kitchen Measurement Personal Measurement Sample PM2.5 Data
  25. 25. Current Status 93 pregnancies recruited; 49 have received LPG connection Pre-intervention air sampling finished in 84 houses; post-intervention sampling completed in 14 houses Refills starting to pick up speed Marriage recruitment starting
  26. 26. Plan for the next two days Today - Visit LPG Distributor in Junnar - Visit warehouse / godown - Visit Ganesh Temple and have dinner nearby Tomorrow - Visit homes in control and free fuel arms - In each arm, visit non-participant homes

×