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A Behavioural Intervention to Reduce Child Exposure to Indoor Air Pollution

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Ventilation practices declined during winter. Distinct lack of ambient air pollution. ... Ventilation varied from no windows/doors open to all windows/doors open. ... – PowerPoint PPT presentation

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Title: A Behavioural Intervention to Reduce Child Exposure to Indoor Air Pollution


1
A Behavioural Intervention to Reduce Child
Exposure to Indoor Air Pollution
  • Brendon Barnes, Angela Mathee, Halina Rollin
    Nkosingiphile Mngadi

2
Indoor air pollution and acute lower respiratory
tract infections
  • 50 of the worlds population and
  • 90 of rural households in developing countries
    still reliant on biomass fuels.
  • Children living in homes burning polluting fuels
    are 9.3 times more likely to develop ALRIs in
    South Africa.
  • ALRIs account for 33 of all deaths of infectious
    diseases.
  • 27 of the entire burden of infectious disease.
  • 80 occurs in children under 5 years.
  • In South Africa, ALRIs account for 14 of all
    deaths of children under 5.
  • At the minimum, 7 times higher than estimates in
    Western Europe.

3
Energy Ladder
Electricity Gas Kerosene Increase cost
Coal Increase health Wood Crop
Residues Animal Dung
4
Aims
  • To highlight why the current emphasis on
    behaviour change in relation to Indoor Air
    Pollution (IAP).
  • To present the methodology and preliminary
    findings of a study currently being conducted in
    South Africa.

5
Why study behaviour change to prevent exposure to
IAP?
  • Possibly less expensive and more sustainable than
    other prevention interventions.
  • Technical interventions
  • Costly
  • Socio-cultural factors

6
Why study behaviour change to prevent exposure to
IAP?
  • Not much is known about the relationship between
    behaviour change and the prevention of exposure
    to IAP.

7
The study of behaviour change to reduce child
exposure to IAP in South Africa
  • Aim to design, implement and evaluate a
    behavioural intervention to reduce child exposure
    to IAP.
  • Divided into two phases
  • Phase 1 formative phase
  • Phase 2 design, implementation and evaluation
    phase

8
Phase one aim
  • To inform the design of the behavioural
    intervention to be designed, implemented and
    evaluated in phase 2.

9
Phase one objectives
  • To describe all fuel use practices that might
    affect child exposure to IAP.
  • To describe and understand how practices might
    differ between a high and a low ALRI group.
  • To classify those practices as potentially
    positive or negative.
  • To understand the factors that influence those
    practices.
  • To make recommendations as to which negative
    practices should be improved and in what ways.

10
Setting
  • Brooksby and Ensulsrust (North West Province of
    South Africa).
  • Setswana
  • High levels of poverty and unemployement.
  • Rural, isolated, flat, dry and extremely cold
    during winter.
  • High levels of IAP ALRIs.
  • Children were in the burning room during burning.
  • Ventilation practices declined during winter.
  • Distinct lack of ambient air pollution.

11
Research Participants
  • 72 households (36 high ALRI and 36 low ALRI).
  • Child under 5 years of age.
  • Child present throughout the day.

12
Sampling
  • Community wide survey of ALRIs.
  • ALRI sampling questionnaire.
  • Background.
  • ALRI symptoms in the past 2 weeks
  • ALRI symptoms in the past 6 months.
  • ALRI diagnoses in the past 6 months.
  • Environmental conditions, immunization status,
    smoking and crowding

13
Sampling criteria
  • High ALRI group
  • Been diagnosed with an ALRI in the past 6 months
    OR
  • Been taken to a doctor in the past 6 months 5
    or more symptoms in the past 6 months (including
    the past 2 weeks).

14
Sampling criteria
  • Low ALRI group
  • Never been diagnosed with an ALRI in the past 6
    months
  • Could have been taken to a doctor/health worker
    in the past 6 months for respiratory illness BUT
  • 4 or less symptoms in the past 6 months
    (including the past 2 weeks).

15
Sample
16
Observations
  • 20 high and 20 low ALRI households.
  • Observation instrument
  • Background information.
  • Fuel use (type, appliance, location, length of
    burning, purpose).
  • Child location in relation to mother and others.
  • Activities.
  • Ventilation.
  • First to the last burning activity (06h30 to
    19h00).

17
Interviews
  • After each observation.
  • Semi-structured interview schedule.
  • Factors underlying practices (based on
    observations).
  • Audio-tape recorded.

18
Air quality monitoring
  • Continuous (24 hour) respirable dust monitoring
    (PM10).
  • 4 households.
  • 4 days.
  • After observations and interviews.

19
Focus group interviews
  • Yet to be completed.
  • 8-12 high ALRI and 8-12 low ALRI, 2 focus groups
    each.
  • To identify community norms.
  • Validate findings in semi-structured interviews.
  • To fill in information gaps identified in
    preliminary analysis.

20
Preliminary results
  • All households burned indoors.
  • Location and burning time varied.
  • Wood most commonly used, followed by animal dung,
    paraffin and maize cobs.
  • This varied by socio-economic status and time of
    the month.
  • Fuel sharing.

21
Preliminary results ctd.
  • Appliances coal stove and paraffin stove.
  • Handed down through generations.
  • No coal used.
  • Often in state of disrepair
  • Combinations varied
  • Purpose for cooking, space heating and water
    heating.

22
Preliminary results ctd.
  • All observation children exposed to at least some
    level of IAP.
  • Young children carried on mothers backs.
  • Older children kept near the stove Better near
    the stove and warm than outside and sick.
  • Better within eyesight than getting up to
    mischief.
  • Exposure time and location varied.
  • Outside during the afternoons.

23
Preliminary results ctd.
  • Ventilation varied from no windows/doors open to
    all windows/doors open.
  • Most common practice is open until smoke
    disappears then close.
  • Smoke equals danger, no smoke equals safety.

24
Way forward
  • To complete analysis of phase 1.
  • To select the key negative practices for
    intervention.
  • Phase 2
  • To design a possible intervention/s.
  • TIPs phase.
  • Implementation and evaluation phase.
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