Can India tackle indoor air pollution?

Talk of air pollution usually brings to mind busy streets of traffic, or heavy industry billowing out toxic particles. But outdoor pollutants are not the only threat to human health. Globally, people spend around 90% of their time indoors, where pollution has a dramatic impact.

The problem is most significant in Asia, Africa and Latin America, where 2.9 billion people burn solid fuels like firewood and dung to meet cooking needs. Breathing in those fumes causes several health problems, including pneumonia, lung disease, cancer, and poor perinatal outcomes like low birth weight. The health burden on countries is substantial: estimates suggests household air pollution has an annual global welfare loss of $1.5 trillion.

In India, cooking with solid biomass causes 1.3 million premature deaths every year, predominantly in low-income rural areas. In response, in 2016 the government launched the Pradhan Mantri Ujjwala Yojana (PMUY) program. Since then, it has helped a staggering 80 million low-income households obtain cleaner cooking stoves which use liquid petroleum gas (LPG).

But there is a problem. Only one-third are using LPG for the majority of their cooking, instead preferring traditional solids, and one-quarter have never bought a refill cylinder.

Why is this happening, and what can be done to fix it?

Toxic but free

Whether PMUY was successful “is one of the most hotly debated questions currently in India,” said Abhishek Kar, a postdoctoral researcher at Columbia University. The pace by which the government provided 80 million LPG stoves is “terrific,” he said, but important barriers remain to its widespread use among PMUY recipients.

India’s proportion of households with LPG connections increased from 56% in 2015 to more than 94% by September 2019. The government covered the LPG connection cost for 80 million households, which qualified due to low income, and offered interest-free loans to cover the cost of the stove and first LPG cylinder.

Most of the beneficiaries, however, who predominantly live in rural areas, have not been persuaded to stop cooking with biomass fuels like wood and dung.

The main reason for that is very simple: LPG refills are expensive, and biomass fuels are completely free – they just require time to collect. Usage tends to differ across Indian states depending on how much biomass is available. In cities, traditional fuels are harder to come by, so LPG usage is very high.

For a family of five, using LPG exclusively requires a new cylinder approximately every six weeks. The subsidised price is INR 500 (Indian rupees), or $7 USD, which is a significant outlay when three-quarters of rural households earn less than INR 5,000 each month.

Price and access

“Most of them do not understand the gravity of the [health] challenge,” said Abhishek Jain, Senior Program Lead at The Council on Energy, Environment and Water, a think-tank. Instead of worrying about the life-threatening consequences, he said, “immediate priorities take over.”

One of the main ways the government should improve the situation is by collecting more data and targeting the subsidies more effectively to those who need it, said Jain. Subsidising fuel for millions of people is an expensive job for the government, especially as they absorb fluctuations in global oil prices by guaranteeing a subsidised price. To target low-income families, they use income tax data which doesn’t tell the whole story, Jain said, meaning that some recipients don’t actually need it.

Subsidising poor, rural families to use LPGs make economic sense in the long run. One study suggested the economic loss per non-LPG household, due to the health burden from household air pollution, is INR 69,000 per year – nearly $1,000 USD. Shifting to LPG would also save significant time, boosting a household’s economic activity by INR 3,500 annually.

Price is not the only problem, though. It is often difficult to access LPG refills. Although the number of rural dealerships has increased significantly, it’s difficult to make refill shops in more remote areas economically viable. The cylinders weigh 14.2kg, so transporting them long distances without a vehicle is not an option.

New business models are needed to leverage existing community groups, said Jain, and create small-scale distributorships where LPG refills are not the only source of revenue. “Can we think of models where every village has a small dealership?” he said.

Culture change

The third significant barrier to overcome is not logistical but social. The texture and taste of the food changes, for example, said Kar, meaning you’re asking people to spend money to cook food they might not enjoy as much.

More importantly, the power dynamic of rural households means that healthy cooking oil is often not a priority. Among those households with LPG, more than two-thirds report a male member of the household decides when to order a refill. Women and children, who are frequently exposed to cooking indoors, benefit the most from using LPGs but the decision is usually out of their hands.

To try to improve the situation, “Panchayats” (village councils) have been set up where women share their challenges and “success stories of how they convinced their husbands,” Kar said. Usually with around 100 LPG customers, each Panchayat also includes women still trying to increase usage, as well as government officials.

“We need to learn much more” about how behavioural change interventions like this could improve usage, said Kar. There is a huge database of PMUY recipients for example, so they could trial customised messages or videos over WhatsApp, he suggests.

India’s effort to increase access to LPG stoves is an “exemplary example,” said Kar, and many countries like Ghana are looking to mirror their success. “Now it’s really time for the government to be serious about the usage issues.” — Jack Graham

(Picture credit: Sandeepatchetan.com/Flickr)