Important research over the past few decades has illustrated that indoor air pollution and indoor smoke from solid fuel poses important health risks in developing countries. Unfortunately, affordable and effective interventions for reducing these risks are limited. This may be because in designing new interventions, the complexities of household energy use and exposure have been often overlooked, and there is a lack of infrastructure to support technological innovations, marketing and dissemination, and maintenance. Even less is known about combinations of technologies that may be used in a household and the factors that motivate the households to adopt them.
In broad terms, design and implementation of appropriate interventions and policies that will positively impact health effects of exposure to indoor smoke require answers to five research questions:
1. What factors determine the details of exposure and what are the relative contributions of each factor to personal exposure? As described earlier, these factors include the energy technology (stove–fuel combination), the housing characteristics and ventilation (such as the size of the house and the building materials, the number of windows, and arrangement of rooms), and behavioral factors (such as the amount of time spent indoors or near the cooking area). It is important to be aware that these factors often interact, requiring a more integrated approach to research. Attention to details of individual exposure has been a subject of more recent research.
2. What is the quantitative relationship between exposure to indoor air pollution and disease (i.e., the exposure–response relationship) along a continuum of exposure levels?
3. Which determinants of human exposure will be influenced, and to what extent, through any given intervention or group of interventions?
4. What are the impacts of any intervention on human exposure and on health outcomes, and how would these impacts persist or change over time?
5. What are the broader environmental effects of any intervention, its costs, and the social and economic institutions and infrastructure required for its success?
