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Cooking fuel stunting dse 02082013_nisha

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Cooking fuel stunting dse 02082013_nisha

  1. 1. Nisha Malhotra,Vancouver School of Economics and International Relations, Faculty of Arts,University of British Columbia. Ravi Prakash Upadhyay, Senior Resident, Department of Community Medicine,Vardhman Mahavir Medical College, New Delhi, India
  2. 2. 70% of the Indian population relies on solid fuels Solid fuels produce toxic pollutants Serious health consequences
  3. 3. NFHS III (2005-2006) – Use of Solid Fuels
  4. 4. NFHS III (2005-2006) – Regional Differences
  5. 5. Biofuel smoke contain a large number of harmful pollutants.  Particular matter (PM)/SPM  carbon monoxide  Nitrogen dioxide  Polycyclicaromatic hydrocarbons (PAHs)  Benzo (alpha) pyrene extracted from SPM  1,3-butadiene, Benzene, selenium, formaldehyde, Styrene, etc. (Kandpal et al. 1994) Coal in addition also releases some toxic elements.  Sulfur dioxide (SO2), Fluorine (F), Mercury (Hg), Arsenic (As), Lead (Pb)
  6. 6.  Anaemia  ARIs & Respiratory Illnesses (Tuberculosis)  Cancer: Lung/Bladder/Kidney/Pancreatic  Immunodeficiency disorders  Cognitive decline Ref: Martorell et al. (1996) ; Haas et al. (1995); Erikson et al (2001); Pelletier (1994)
  7. 7.  70% of the Indian population relies on solid fuels.  Solid fuels produce pollutants with serious health consequences. Our Question  Do they also lead to Childhood Stunting?
  8. 8.  Higher likelihood of contracting illnesses,  lower recovery rates  lower likelihood of survival ▪ Future intellect ▪ Future health status  Percentage of women with short stature varies strikingly according to the degree of stunting at 3 years of age Martorell et al. (1992) ▪ Reproductive performance ▪ Predicts child’s birth size and survival Martorell et al. (1996) ; Haas et al. (1995); Erikson et al (2001); Pelletier (1994)
  9. 9.  Stunting:  Bone age retardation and bone maturation in children - F.R.G region (Schlipkoter et al. 1986)  Impair early childhood skeletal growth (coal – Czech) (Ghosh et. al. 2011)  Intrauterine Growth Retardation Birth weight and birth length, head circumference, cognitive skills at age 5-Poland - PAHs (Jedrychowski et. all. 2004)) ; PM and PAHs (Dejmek et. all. 2000) ▪ Benzo[a]pyrene and phenanthrene recognized as endocrine disruptors. ▪ Inhibit insulinlike growth factors (embryonic development) and epidermal growth factors in placenta ▪ Hayakawa et. all. (2009; Guyda et. all. (1991)
  10. 10.  Indoor Coal Use (Czech Republic) - Smith et. all 2005  Coal combustion Heating – Height forAge Z score  Biofuel smoke in 7 developing countries (Cambodia, Nepal Dominican Republic, Haiti, Jordan, Moldova, Namibia) - Kyu et. al. 2009  Biofuel Smoke-Height for age Z score; Stunting  Biofuel smoke in India-Mishra & Retherford 2007  Biofuel Smoke - Anaemia and Stunting
  11. 11. The Energy Ladder
  12. 12. DATA  NFHS III (2005-2006)  Children – Less than 3 years of age (~ 21,000) Outcome  Stunting - Standard indices of physical growth that describe the nutritional status: Height-for-age (stunting)  Height: Height by Age Z score (HAZ ) Exposure  Solid Fuel- Coal/Charcoal (2.25%); Wood (50%); CropWaste & shrubs (6.84%) ; Animal Dung (9.8%)  Reference – Natural Gas/LPG (26.85%); Kerosene (3.45%) Childhood Stunting associated with Solid Fuel?
  13. 13. ControlVariables:  Wealth Index (D.V);  Religion Dummies  Diet: Breastfeeding; Other than BM; 4 Food Groups; Iodine Salt  City Density: Mega City, Large City D.V.  Maternal Characteristic: Education;Work status; Age; Autonomy (Decision to access health care), Mother Smokes; Media Exposure; Maternal Height  Child Demography: Male; Birth Order;Twin Birth; Age  Sanitation: Open Defecation;WaterTreatment  Cooking Environment: Inside, Separate Kitchen, Window
  14. 14. Results
  15. 15. Wealth Index Why?
  16. 16. Source: www.tribuneindia.com LPG Scarcity Consumers turn to traditional fuels Mahesh Sharma, Mandi Ahmedgarh, January 2011 A woman burns cow dung cakes and wood Schools turn to wood as LPG costs dear Arun Sharma Bindrakh village (Punjab), November 2012 Cooking Staff preparing midday meals in a School
  17. 17. Affordability and Access
  18. 18. Stunting Causes
  19. 19.  70% of the Indian population relies on solid fuels.  Solid fuels produce pollutants with serious health consequences. Our Question  Do they also lead to Childhood Stunting?- Suggestive  Can this association be mitigated - cooking practices?
  20. 20. CookingEnvironment
  21. 21.  Much of the research has centered on whether the stoves reduce IAP. For example, McCracken and Smith (1998), Ezzati and Kammen (2002), Ezzati, Saleh, and Kammen (2000), Ezzati, Mbinda, and Kammen (2000), andAlbalak et al. (2001) have all found that various types of improved cooking stoves have resulted in reductions of toxic pollutants
  22. 22. Among those that live in HH using Solid Fuel– 33% live in these conditions 24% of children in the sample – live in these type of houses Ghar - House : 4962
  23. 23. A one room house with no Windows
  24. 24. Combined K-S: (D= 0.0628) & (P value =0.000) Two-sample Kolmogorov-Smirnov test
  25. 25. Results
  26. 26. Results
  27. 27. • Stunting is shown to be associated with the use of Solid Fuels • This association can be mitigated by following safer cooking practices • Outside • Separate location for a kitchen • Ventilation –Window Learn
  28. 28.  Efficient Cooking Stoves  Replacing solid fuel with cleaner fuels  Substitution across solid fuels?  Ensuring proper ventilation  We need a greater discussion on cooking practices that can reduce “Pollution concentrations”- cumulative exposure.

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