title: Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review.
abstract: BACKGROUND
  Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.
  
  
  METHODS
  We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.
  
  
  RESULTS
  The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.
  
  
  CONCLUSIONS
  Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.
  
  
  BACKGROUND
  The review was registered on Prospero (registration number CRD42014009796).
authors.affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. emma.thomas@dph.ox.ac.uk.
authors.forename: Emma
authors.initials: E
authors.lastname: Thomas
authors.affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. kremlin.wickramasinghe@dph.ox.ac.uk.
authors.forename: Kremlin
authors.initials: K
authors.lastname: Wickramasinghe
authors.affiliation: Chronic Disease Prevention and Management, World Health Organization, Geneva, Switzerland. mendiss@who.int.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Mendis
authors.affiliation: Bodleian Health Care Libraries, University of Oxford, Oxford, UK. nia.roberts@bodleian.ox.ac.uk.
authors.forename: Nia
authors.initials: N
authors.lastname: Roberts
authors.affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. charlie.foster@dph.ox.ac.uk.
authors.forename: Charlie
authors.initials: C
authors.lastname: Foster
mesh_terms: D016902:Air Pollution, Indoor / Q000032:analysis / Q000517:prevention & control*; D003296:Cooking / Q000379:methods*; D003906:Developing Countries; D005260:Female; D006794:Household Articles / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D012906:Smoke / Q000032:analysis / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D012906:Smoke