title: Behavioral attitudes and preferences in cooking practices with traditional open-fire stoves in Peru, Nepal, and Kenya: implications for improved cookstove interventions.
abstract: Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20-49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a "one size fits all" improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves.
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. erhodes@jhsph.edu.
authors.forename: Evelyn L
authors.initials: EL
authors.lastname: Rhodes
authors.affiliation: Department of Anthropology, University of Oklahoma, Norman, OK 73019, USA. rdreibe@ou.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Dreibelbis
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. emklasen@gmail.com.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Klasen
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. nvnaithani@gmail.com.
authors.forename: Neha
authors.initials: N
authors.lastname: Naithani
authors.affiliation: School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. nabitajoy@yahoo.com.
authors.forename: Joyce
authors.initials: J
authors.lastname: Baliddawa
authors.affiliation: School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. dianamenya@gmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Menya
authors.affiliation: Nepal Nutrition Intervention Project Sarlahi, Kathmandu, Nepal. skhatry@wlink.com.np.
authors.forename: Subarna
authors.initials: S
authors.lastname: Khatry
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. steph.a.levy@gmail.com.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Levy
authors.affiliation: Department of Global Health, School of Public Health and Health Services, George Washington University, Washington, DC 20052, USA. jtielsch@email.gwu.edu.
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 31, Peru. jaime.miranda@upch.pe.
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
authors.affiliation: Program in Social and Behavioral Interventions, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. caitlinkennedy@jhu.edu.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. wcheckl1@jhmi.edu.
authors.forename: William
authors.initials: W
authors.lastname: Checkley
mesh_terms: D000328:Adult; D001290:Attitude / Q000208:ethnology*; D003296:Cooking / Q000295:instrumentation / Q000379:methods*; D003466:Cultural Characteristics; D003906:Developing Countries; D004867:Equipment Design; D005260:Female; D006794:Household Articles; D006801:Humans; D007630:Kenya; D008875:Middle Aged; D009390:Nepal; D010568:Peru