J Lamarre‐Vincent. “What drives the adoption of stoves and improvements in respiratory health in
Indonesia? Evidence from three waves of IFLS (1997, 2000, 2007).” Duke University. 2011
This paper examines two factors involved in the environmental health risk of indoor air pollution for households in Indonesia. First, I examine the determinants of a household’s decision to switch to cleaner burning fuels. Based on the decision of a household to switch to cleaner burning fuels, I test if the decision of a household to switch to cleaner fuels impacts respiratory health outcomes. There are real and immediate policy implications for this type of analysis. Indoor air pollution has serious health impacts on individuals in developing nations, especially women and children. Understanding the factors that contribute to a household’s decision to adopt cleaner burning fuels has implications for the design of improved stove intervention programs. The ability to quantify the health benefits of stove switching will assist policy makers in allocating scarce resources for interventions, and justifying these interventions to funders. With renewed interest in improved stove projects and funding dollars being spent to scale up successful initiatives there is a need for a better understanding of the characteristics of the targeted population. To justify additional funding for improved stove efforts there is a need for more rigorous impact evaluations, linking them to improved health and increased productivity.
The data used to answer my research questions comes from the Indonesian Family Life Survey, a longitudinal dataset that has been conducted in four waves over a span of fourteen years. For the purposes of this research project the first IFLS wave, conducted in 1993, is not used, as they did not collect information on the household cooking fuel type. To examine determinants of household fuel use and fuel switching decisions I examine data from IFLS-2 (1997) to IFLS-3 (2000), the first two waves that have data on household cooking fuel choice. I have coded variables at the household level for this part of my analysis, with a sample size of 4,793 households. To examine health effects I examine data at the individual level. The sample size grows from 33,938 individuals in IFLS-2 (1997), to 42,650 in IFLS-3 (2000), and finally to 44,109 in IFLS-4 (2007).
Having electricity, living in an urban area, having indoor water, higher household member levels of education, and the log of per capita household income are all negatively correlated with the dirty fuel indicator, and positively correlated with the clean fuel indicator. All these variables are highly statistically significant. This conclusion is based on eight models on a sample of approximately 4700 households.
In terms of respiratory health effects the relationships are much more difficult to interpret based on a households fuel switching behavior. Young children are much more likely to experience respiratory problems, but households with biomass fuels are negatively correlated with these indicators. This same trend generally exists across models looking at individual respiratory indicators (cough, dry cough, cough with phlegm etc.). A more highly specified model may be necessary to make sense of these seemingly counter-intuitive results. Results for lung capacity measures are also frustrating in their difficulty to interpret. In the model included in this analysis using a biomass fuel is correlated with an increase in lung function. The indicator for switching to a cleaner burning fuel and continuing to use it is significant in the pooled respiratory indicator and cough models. This is the hypothesized effect, but is only significant at the five percent level. Again, a more narrowly focused model may be able to shed more light on the nuance of the fuel switching effect.
The evidence from the determinants of household fuel switching echoes previous studies showing that greater education and incomes lead to an increase in fuel switching behaviors. Conducting this analysis in a new country context and replicating previous research strengthens the literature regarding fuel-switching characteristics of households. Urban households are much more likely to use clean burning fuels, which lends some credence to arguments that fuel switching may largely be market driven, with rural household lacking access to easily accessible markets to buy cleaner burning fossil fuels. The main recommendation from this project is that more work needs to be done to properly analyze available information on stoves and their health effects. More rigorous analysis will wield evidence to strengthen interventions and provide support for those that have already taken place. With only a gross indicator of fuel type in the IFLS it is difficult to understand the duration and intensity of exposure, making accurate modeling of health effects difficult. Despite these limitations, there are certainly many more insights waiting to be uncovered in publicly available data. A corollary recommendation is to collect more detailed information on the exposure patterns of stove use. This study, like many others, relies on available data that was not collected with the question of stoves specifically in mind. To make more accurate causal claims, better data is needed. With an increased interest in stove interventions, policy makers must push for well thought out data collection and rigorous evaluations. In this way every intervention can contribute to improving the next.
Presentation: Lamar-Vincent Presentation