Understanding why cleaner cooking fuels remain out of reach in rural India
Household air pollution was responsible for an estimated 2.9 million deaths in 2021, including more than 309,000 deaths among children under five. A community-focused study in rural India aims to uncover why families continue to rely on polluting cooking fuels, and develop practical approaches to support cleaner, healthier homes.
Air pollution is often seen as an outdoor problem. However, for millions of people, some of the greatest risks may be found inside their own homes.
An estimated 2.1 billion people worldwide use polluting fuels and technologies for cooking. In rural India, many families cook over traditional stoves using wood, coal and other biomass. Smoke can build up inside poorly ventilated homes, exposing families to harmful pollutants.
Long-term exposure can contribute to stroke, heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer. Women and children bear a disproportionate share of this burden because women are often responsible for cooking and collecting firewood, while babies and young children may remain close to them.
Anushka Diwakar
Anushka is a PhD student in the Division of Population Health, Health Services Research & Primary Care.
A PhD project led by Anushka Diwakar is examining why families in rural Bihar continue to rely on traditional cooking fuels, even when cleaner alternatives are available.
Looking beyond access
In 2016, the Government of India introduced a programme providing subsidised liquefied petroleum gas, or LPG, connections to lower-income households. The programme reached around 105 million households, significantly increasing access to LPG.
Although LPG is not entirely pollution-free, it produces substantially less household air pollution than burning wood or coal. The World Health Organization also identifies electricity, solar power, biogas, natural gas, alcohol fuels and lower-emission biomass stoves as cleaner options.
However, receiving an LPG connection does not guarantee continued use. Some households return to traditional fuels because refills are too expensive, collection points are too far away, and transport is difficult to arrange.
Understanding the barriers
Household fuel choices are shaped by financial, practical, social and cultural factors. Access to cleaner fuel does not always lead to lasting changes in cooking practices.
The cost of refilling a cylinder may be difficult for lower-income families to manage. Gender and household decision-making can create further barriers. Although women often experience the greatest exposure to cooking smoke, they may not control household income or spending decisions.
“Providing access to cleaner fuel is only one part of the solution. We need to understand what prevents families from using it in everyday life.”
Anushka Diwakar
Rather than treating traditional fuel use as an individual choice, the project will examine the wider circumstances affecting whether families can adopt cleaner alternatives.
Pollution levels will also be measured inside homes. Many harmful pollutants cannot be seen, making the risks difficult to recognise. Sharing clear measurements could help make household exposure more visible.
Developing solutions with communities
The project will work with local households to develop an intervention shaped by their experiences and priorities. Interviews, discussions and workshops will involve women and male household members, helping to build a fuller understanding of how decisions about cooking, income and fuel are made.
By assessing LPG use across participating villages, the project will explore the experiences of women who continue to use traditional fuels, including those who do not regularly refill their cylinders. It is hoped that the findings will identify barriers to sustained LPG use and the factors that could make cleaner cooking more achievable.
These insights will support the co-design of an intervention suited to local circumstances, developing an approach that can later be tested and, if successful, adapted for other communities.
Addressing respiratory health inequalities
Household air pollution is closely connected to poverty, gender and unequal access to healthier living conditions.
Families cannot simply be expected to stop using traditional fuels when cleaner options remain unaffordable or inaccessible. Making technology available is only the first step. Meaningful change depends on whether it can realistically become part of everyday life.
By working directly with communities, the research aims to support healthier and more sustainable solutions, contributing to a future where access to cleaner air inside the home is not determined by income, gender or location.