RESEARCH ON ENERGY, AIR POLLUTION AND HEALTH
Amref International University Efforts in Tackling Household Air pollution problems in East Africa
At Amref International University (AMIU), together with partners from Moi University, we are leading Kenyan efforts to address the public health burden from exposure to household air pollution. In Kenya more than two thirds of the population rely on wood, charcoal, crop wastes and kerosene for their household energy (cooking, heating and lighting). Burning these fuels leads to high levels of household air pollution responsible for the premature deaths of more than 20,000 Kenyans each year. Working within an international partnership, our Air Pollution, Energy and Health Theme at AMIU is conducting a program of Research and Health Systems Capacity Building to tackle this public health priority.
1. The CLEAN-Air(Africa) Global Health Research Group
In 2018 AMIU joined the UK NIHR funded Clean Household Energy for the prevention of Non-Communicable Disease in Africa (CLEAN-Air (Africa)) Global Health Research Group. CLEAN-Air (Africa) is a £2,500,000 funded partnership of international experts in air pollution and public health from the UK, Kenya, Ghana and Cameroon. The remit for CLEAN-Air (Africa) is to provide policy relevant evidence to support community transition to clean household energy (e.g. gas and electricity) in sub-Saharan Africa. By meeting Sustainable Development Goal 7 “Access to clean, modern energy for all by 2030” the substantial impacts on deforestation, environment, climate and public health from reliance on solid fuels will be addressed. More information on CLEAN-Air (Africa) can be found on www.cleanairafrica.com.
1.1 Research: Addressing Barriers to Clean Household Energy
AMIU is leading CLEAN-Air (Africa) funded research on household energy use in informal settlements in Nairobi where there is a reliance on polluting charcoal and kerosene fuels for cooking. AMIU led the first evaluation of pay-as-you-cook liquefied petroleum gas (PAYG LPG) smart meter technology that allows households to pay in small amounts to cook cleanly with LPG. This is an exciting technology that addresses a major barrier to adoption of LPG for clean cooking – the affordability of the fuel. Our research has already demonstrated the benefits of the technology in periods of financial instability. Our research team identified that during the COVID-19 pandemic and related control measures that greatly affected household incomes, people who had access to PAYGO LPG kept using the fuel for cooking whereas those that bought LPG in bulk (full cylinders) were more likely to switch back to polluting charcoal and kerosene.
Through funding from CAA and partnership from PAYGO project on piloting access to metered LPG, two studies were conducted in Mukuri kwa Ruben. Pay as You Go Evaluation (PAYGO Evaluation) trained 8 FWs on HAP, conducted a baseline Survey (n=150, HAP Monitoring (n=35) and stove Monitoring (n=150)
Two Preprint Publications
- COVID-19 Lockdown in a Kenyan Informal Settlement: Impacts on Household Energy and Food Security
- Pay-as-you-go LPG supports sustainable clean cooking in Kenyan informal urban settlement, including during a period of COVID-19 lockdown
Use of wood as primary fuel is rampant in most households in Kenya
1.2 Research: Measuring Household Air Pollution
AMIU is developing expertise and capacity under CLEAN-Air (Africa) to train, measure and analyse household and ambient air pollution for research, monitoring and health impact analysis. CLEAN-Air (Africa) will support AMIU gain expertise in state-of-the-art instrumentation for measuring particulate matter, carbon monoxide and black carbon and create an East African Air Pollution Monitoring Hub to be housed at AMIU. This will provide an air pollution measurement and analysis service available to research institutions, the public and private sector and the Ministry of Health in Kenya.
Field Workers mounting MicroPEMS at the Household Kitchens in AMIU research sites
Calibrating ECM at AMIU School of Public Health
1.3 Research: Institutional Use of Solid Fuels
Through a new CLEAN-Air (Africa) partnership (Amref International University), we will conduct a baseline evaluation of two primary schools in Mukuru Kwa Njenga, Nairobi of current fuel use practices for cooking meals under the National School Nutrition and Meals Strategy. This evaluation will include measurement of air pollution (PM2.5) concentrations (kitchen, classrooms and ambient) and exposures (cooks) throughout a school day. Working with the School’s School Meals Programme Committee (SMPC – required in all Kenyan schools including a chair, procurement supervisor, food quality supervisor and reporting supervisor) we will collect information from the school’s catering staff through focus group discussions (FGD) and photography about their experiences of using fuelwood to meet the school’s meal requirements and it’s perceived health impacts through exposure to smoke from cooking. We will also document fuel expenditures and amount of biomass used (to quantify impacts on environmental degradation). Finally we will explore the potential for the schools to transition to more efficient and clean LPG for cooking through discussions with the Schools’ procurement and financial management team and local LPG marketers. The aim of this scoping work will be to establish the groundwork for an intervention study to switch the schools to LPG through an intervention (LPG full cooking equipment and fuel supply) and to quantify the impacts on fuel costs/ consumption, cooking times, air pollution and acute health symptoms within the school.
2. Innovation for Clean Cooking
AMIU has teamed up with the University of Liverpool to conduct research on fuel efficient cooking pots in Nairobi. The research is funded by the Modern, Energy Cooking Services Initiative, led by Loughborough University and aims to look at how improved cooking technologies can be used to encourage more sustained use of clean fuels – necessary to achieve the health impacts from reduced exposure to air pollution from burning solid fuels and kerosene. The new pots include special patented designs to conserve fuel and improve energy transference. AMIU is leading a randomised controlled trial of the pots in Mukuru kwa Rueben and Mukuru kwa Njenge.
This MECS funded study commenced in November 2020 with 8 FWs and one coordinator. The study objective is to characterise and measure the potential savings in LPG fuel, costs and time from daily use of energy efficient cooking pots (TurboPots and FlarePans) for regular household cooking compared to use of standard cooking pots.
- PHASE 1: Cooking test and acceptability assessment of the TurboPot and FlarePan with first time users under controlled conditions
- Water-boiling test (WBT)
- Field Controlled Cooking Test (CCT)
- PHASE 2: Randomized control trial of the enhanced cooking pots (intervention) compared to cooking with a standard locally sourced pot (control)
- Group 1: less-intensive users with a 6kg cylinder for primary cooking (n=150) and
- Group 2: intensive users with a 13kg cylinder for primary cooking (n=150)
Conducting CCT on efficient pots at AMIU Stove monitoring using Geocene dots at AMIU
PM 2.5 and CO Monitoring using ECM and Lascars respectively at Mukuru slums, Nairobi
3. Primary And Secondary Prevention of Household Air Pollution Related Disease
Through its established relationship with community health at the Kenyan Ministry of Health, AMIU is leading an exciting initiative to provide the community health workforce with training in household air pollution, energy and health. Partnering with the Kenyan MoH and the University of Liverpool, AMIU has formed a Technical Working Group that has helped in developing a new training module for community health workers in Kenya. The technical module has been developed by international experts in air pollution and public health and has been developed by the TWG for the Kenyan context. It has recently been ratified by the Ministry for rolling out through a Train the Trainer initiative that will ultimately see Kenya’s 130,000 strong community health workforce trained in prevention of household air pollution across the 47 counties of Kenya. More information on the initiative can be found here at www. Amref.ac.ke
To complete the training curriculum, manual and job Aids, funding was sourced from various partners. CAA (through UOL and Moi University) supported the TWG with financial and technical support which contributed in coming up with fair drafts of the curriculum, manual and job Aids for piloting. UOL further supported in piloting the manual in Uasin Gishu County and finally the technical delivery in training of 61 TOTs from the counties as well as final editing of the manual. Other partners supporting in training of the MOH workforce include GIZ East Africa and Clean Cooking Association of Kenya
4. Short Course Training in Air Pollution And Health
AMIU runs a five days short course on Household Air Quality Management (Improve Health and Protect the Environment) whose mode of delivery is blended (face to face and virtual). The course targets community health extension workers and those working on matters pertaining environment and energy in countries where Amref health Africa operates
The course is delivered in four units which are as follows
Unit 1: Household Energy use, Air pollution and Principles for prevention of Health and Environment Impacts.
- House energy use and WHO guidelines
- How Household energy affects Health, Safety ,Climate and Environment
- Concepts for prevention of adverse health, safety and environmental impact.
Unit 2: Health and Safety Impacts of Household Energy use.
- Health Impacts of household Air pollution.
- Recognition and minimising safety risks from household energy.
- Vulnerable groups and social-economic impacts.
- Testing and standards for cleaner and safer cooking.
- Consolidating knowledge and exploring household perspectives.
Unit 3: Household Air pollution & Primary Preventive strategies.
- Primary Preventive through improved cooking solutions.
- Primary prevention through improved lighting solutions.
- Improved space and water heating solution.
- Have minimization through ventilation.
- Have minimization (reduce exposure), avoidance of smoke, fuel drying and other measures.
- Tools for supplying change in household energy technology, fuels and practices.
- Addressing the health and environmental impacts of energy supply and use it at an institutional level.
Unit 4: Monitoring, Evaluation and reporting on Household Air.
- Monitoring of household air pollution indicators.
- Methods for measurements of household air pollution.
- Reporting and interpretation of household energy /HAP indicators.
5. Energy, Air Pollution And Health Research Extension Services
One of the functions for AIU is to provide education for national service, community outreach and development which reflect the national cultural heritage. Under this function, AMIU works in collaboration with MOH and other partners involved in taking the household training to various countries in the country. The most recent one was that conducted in Nyeri County in December 2020 where a total of 50 CHEWs and CHVs were trained on energy, air pollution and health using the module 13b draft manual. The university also collaboration with EPHAK organises seminars and workshops on air quality management. The theme of the recently held one day webinar was an ‘Advocacy Platform for Mitigating Impacts of Household Air Pollution on Disease Burden in Africa’. The webinar covered the following areas:-
- The air pollution science and its impact on health, climate and environment
- Global and regional (Africa) Initiatives on household air pollution and air quality management
- Policy environment and role of environmental health practitioners
- Opportunities for public private partnership in air quality management in Africa
- Positioning Africa research and academic institutions in air pollution
Nyeri training of CHEWs & CHVs
Energy, Air Pollution & Health Webinar
The End of COVID-19 Epidemic in Kenya
Prof Marion Mutugi
Vice Chancellor Amref International University
Protecting your mental health during Isolation
Dr. Lucy Njiru Muriuki
Practicing Clinical Psychologist and Lecturer at Amref International University
Let’s boost morale of our frontline soldiers *published by the Standard Newspaper on Thursday 23rd April 2020.*
Nurse and a lecturer at Amref International University
Protecting Your Physical Health During Isolation
Physical therapist and Lecturer at Amref international University
Don’t put maternal health at risk as we fight pandemic
Dr. Micah Matiang’i
Director of Open, Distance and eLearning in Amref International University