Content uploaded by Dictus Atsu Azorliade
Author content
All content in this area was uploaded by Dictus Atsu Azorliade on Jun 03, 2020
Content may be subject to copyright.
A preview of the PDF is not available
THE IMPACT OF HOUSEHOLD COOKING FUEL CHOICE ON HEALTHCARE EXPENDITURE IN GHANA
Abstract and Figures
This paper investigates household cooking fuel choice and its impact on household healthcare expenditure as well as examining the socio-economic and demographic factors that influence household healthcare expenditure in Ghana.
We employed the Tobit regression technique and data from the sixth and seventh round of the Ghana Living Standards Survey conducted in 2012/13 and 2016/17 respectively. Our findings reveal that relative to households using wood, households using charcoal and gas are less likely to spend on healthcare services. The paper also identified the age of household head, household head’s years of education, household head’s illness reporting, household size, household income and region of residence as significant factors influencing healthcare expenditures.
Based on the findings, we, recommended policy choices to focus on sustainable healthcare financing, provision of education and awareness as well as the promotion of the use of cleaner fuels including the sustaining and extending the rural LPG promotion programme.
Figures - uploaded by Dictus Atsu Azorliade
Author content
All figure content in this area was uploaded by Dictus Atsu Azorliade
Content may be subject to copyright.
There has been reported low adoption of cleaner cooking fuel technologies and systems in Nigeria. The literature documents that socio‐economic, cultural/behavioral, and environmental factors influence the decision to adopt alternative cooking fuels. However, there is a dearth of evidence on the most important factors influencing transition to clean cooking fuels in South‐east Nigeria. This study therefore analyzed the knowledge, attitude, behavior and practice of rural households' with regards to transition to cleaner cooking fuels particularly liquified petroleum gas (LPG). The study also analyzed the socio‐economic determinants of the transition to LPG in southeast Nigeria. Two communities in southeast Nigeria that benefitted from the Modern Energy Cooking Services (MECS) project funded by UKAID (DFID) participated in the study. We administered questionnaire to 407 household heads randomly selected from the two communities. This study used descriptive statistics, Likert scale analysis and binary probit model to analyze the data collected. The results show that while LPG was the most (51.84%) preferred choice of cooking fuel, only 0.74% of the households in practice actually used LPG for cooking. The main reason for the very low use of LPG was high cost of LPG and its accessories. The study also revealed that gender, education, household size, membership of cooperative societies, were the significant predictors of clean cooking transition. Therefore, policies and programs should be designed to increase women's access to quality education and encourage them to organize themselves in cooperatives to enhance their access to LPG.
Ghana adopted LPG policy intervention as a recipe for dealing with the domestic cooking energy crises. Since the 1990s, Ghana has made several efforts to promote the usage of LPG as a domestic source of energy with the intention of curbing the problems posed by fuelwood and charcoal production to the vegetation in the country. Drawing from only secondary sources of data for the paper, it has been realized that, there has been an increase rather in demand for fuelwood and charcoal. The aim of this paper is to examine the policy and the way forward especially now that Ghana may be extracting her own natural gas.
Background
Ghana’s National Health Insurance Scheme (NHIS) has witnessed an upsurge in enrollment since its inception in 2003, with over 40% of the Ghanaian population actively enrolled in the scheme. While the scheme strives to achieve universal health coverage, this quest is derailed by negative perceptions of the quality of services rendered to NHIS subscribers. This paper presents an analysis on perceptions of service quality provided to subscribers of Ghana’s NHIS with emphasis on rural and urban scheme policy holders, using a nationally representative data.
Methods
The study used data from the 2014 Ghana Demographic and Health Survey. Ordered logistic regressions were estimated to identify the correlates of perceived quality of care of services rendered by the NHIS. Also, chi-square statistics were performed to test for significant differences in the proportions of subscribers in the two subsamples (rural and urban).
Results
Rural subscribers of the NHIS were found to identify more with better perception of quality of services provided by the NHIS than urban subscribers. Results from the chi-square statistics further indicated that rural subscribers are significantly different from urban subscribers in terms of the selected socioeconomic and demographic characteristics. In the full sample; age, out-of-pocket payment for healthcare and region of residence proved significant in explaining perceived quality of services rendered by the NHIS. Age, out-of-pocket payment for healthcare, region of residence, wealth status, and access to media were found to be significant predictors of perceived quality of services provided to both rural and urban subscribers of the NHIS. The significance of these variables varied among men and women in rural and urban areas.
Conclusion
Different factors affect the perception of quality of services provided to rural and urban subscribers of Ghana’s NHIS. Health financing policies geared toward improving the NHIS-related services in rural and urban areas should be varied.
Background:
One's house is believed to be the safest and the healthiest place to live in. Indoor air pollution (IAP) means the presence of unwanted substances in the indoor air at concentration toxic to health.
Objective:
The objective of this study is to study the presence of IAP, its associated factors and impact on health of women residing in an urban slum of Kolkata, West Bengal, India.
Methods:
It was a cross-sectional study done from January 2017 to March 2017 among 120 households of a slum. Data were collected using a pre-designed pre-tested schedule from the homemaker of the households. All analyses were conducted with R: A Language and Environment for Statistical Computing.
Results:
About 60% households used kerosene as cooking fuel predominantly. Smoke from the neighbouring houses troubled 57.5% respondents. More than 60% houses were overcrowded and more than 70% houses were poorly ventilated. IAP-related symptoms such as irritation in the eye, suffocation, dry cough significantly correlated with the presence of IAP sources and its contributory factors. Of 120, 78 (65%) perceived the presence of IAP in their houses. Lower per capita income (PCI), ground floor, and joint family were found to have higher odds of sources of IAP. Younger age, lower PCI, and ground floor were found to be strongly associated with higher contributory factors of IAP.
Conclusion:
The present study found that the majority of the households were exposed to IAP due to kerosene, neighborhood smoke while overcrowding and ill-ventilation accentuated it. Effective intervention with intersectoral coordination is the need of the hour.
Background
The Government of Ghana launched the Rural LPG (RLP) promotion program in 2013 as part of its efforts to reduce fuelwood consumption. The aim of the RLP is to contribute to Ghana's overarching goal to provide LPG access to 50% of Ghana's population by 2020. The RLP has not announced long-term program objectives. However, in the interim the RLP targeted a cumulative total of 170,000 LPG cookstoves to rural households by the end of 2017. As of November 2017, 149,500 rural households had received the LPG cook stoves. Our case study documents Ghana's experiences to date with LPG scale up.
Methods
We carried out a desktop review/document analysis of literature on the RLP. Each document was reviewed for information related to the elements of the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework as it pertained to LPG promotion and adoption. In-depth interviews were held among key stakeholders in Ghana. Previously collected data from a field evaluation of the RLP was also assessed.
Findings
Generally, our evaluation suggests that the current form of the RLP is not achieving its stated goal. Our evaluation of the RLP in five rural communities showed that about 58% of households had never refilled their LPG cylinders nine months after the initial delivery of a filled cylinder. Only 8% still used their LPG at 18 months post distribution. Cost and distance to LPG filling stations were the main reasons for low LPG use. Beneficiaries did not exclusively use their LPG even at the initial stages when all of them had LPG in their cylinders. Ghana is currently undergoing transitions in the LPG sector including a change from the current private cylinder ownership model to a cylinder recirculation model for the distribution of LPG. There was no evidence of a well-documented implementation framework for the RLP.
Conclusion
Fuel cost, poor LPG access, and an inadequate implementation framework hinder the RLP implementation.
The pursuit for energy has evolved over the years and this has resulted in a sharp increase in demand with a corresponding increase in needs. With an ever-increasing awareness for the use of environmentally friendly fuels, the Government of Ghana initiated the Ghana LPG Promotion Programme in 1990 with the primary aim of eliminating the flaring of LPG at Tema Oil Refinery and encouraging the citizenry to switch to LPG usage due to its advantages over wood fuel. The Ghana LPG Promotion Programme has received good responses from citizens since its inception; however, there are some challenges that have to be addressed to ensure the long-term aim of the programme is accomplished and sustained. This research seeks to identify the opportunities and the challenges of LPG promotion in Ghana using secondary data. Some of the opportunities identified included job creation; reduction in the health and environmental problems associated with wood fuel and provided alternative fuel for gasoline powered vehicles. However, some of the challenges identified included lack of safety education on LPG usage, increasing cost LPG and its accessories, sporadic shortage of LPG, lack of prototype LPG stove, lack of accessibility and poor LPG transporting network. It is recommended that Government should increase LPG access to rural consumers by encouraging private investors to build refilling plants at safe locations that can easily be accessed during market days, ensure more education on best safety practices and innovations on LPG usage to reduce LPG associated hazards and also, government should institute a clear-cut policies and regulatory changes that will encourage the usage of LPG in Ghana.
Around 2.7 billion people in the world cook with polluting fuels, such as wood, crop residue, animal dung, charcoal, coal, and kerosene. Household air pollution from cooking with polluting fuels is recognized as a major risk factor for the disease burden. In this study, we examine the effect of using polluting fuels for cooking on the respiratory health of children in Pakistan. This study uses cross-sectional data from Pakistan Demographic and Health Survey 2012–13, with the sample size of 11,040 children under 5 years of age. Using logistic regression model, we control for factors such as averting activities, child characteristics, household characteristics, mother characteristics, and the unobserved factors using fixed effects. The results show that children in households using polluting fuels are 1.5 times more likely to have symptoms of acute respiratory infection (ARI) than children in households using cleaner fuels.
The present study aims to contextualize populations without access to modern energy in order to formulate effective policy considerations on modern energy adoption and continuity of usage by target groups. This objective was achieved by illustrating the linkage between fuel choice and energy poverty in low income households in an urban context. It employs a cross-sectional energy stacking model to illustrate fuel choice and the multidimensional energy poverty (MEP) index to establish the severity of energy poverty in low income households in Kisumu City, Kenya. The study also incorporates pico-solar products (PSPs) users, as this disruptive technology entered the Kenyan solar market in recent years, targeting low income households using kerosene for lighting purposes. The study identifies energy appliance type and household cooking location as key determinants of household energy choice. Moreover, the main determinants for household energy choice in households facing higher levels of energy poverty were closely associated with access concerns, whereas determinants in households facing lower levels of energy poverty were more associated with usage concerns as they already had access to modern energy. It was also noted that preferences were related to attributes of the energy source both experienced by current users and perceived by current non-users. There was a substantial persistent use of kerosene as an alternative lighting source among current PSPs users. There is a general preference and desire to use modern energy sources across most households, irrespective of the severity of energy poverty.
For meaningful improvement to be realized towards meeting the energy SDG by 2030, national and local energy policies should consider the energy technology adoption perception and behaviours of populations currently not having modern energy access. In conclusion, it is of great importance to put into context the specific characteristics of the households as well as user perspectives and how these characteristics and perspectives would affect continuity of usage of the modern energy source adopted.
