Experimental evidence on promotion of electric and improved biomass cookstoves.

Improved cookstoves (ICS) can deliver "triple wins" by improving household health, local environments, and global climate. Yet their potential is in doubt because of low and slow diffusion, likely because of constraints imposed by differences in culture, geography, institutions, and missing markets. We offer insights about this challenge based on a multiyear, multiphase study with nearly 1,000 households in the Indian Himalayas. In phase I, we combined desk reviews, simulations, and focus groups to diagnose barriers to ICS adoption. In phase II, we implemented a set of pilots to simulate a mature market and designed an intervention that upgraded the supply chain (combining marketing and home delivery), provided rebates and financing to lower income and liquidity constraints, and allowed households a choice among ICS. In phase III, we used findings from these pilots to implement a field experiment to rigorously test whether this combination of upgraded supply and demand promotion stimulates adoption. The experiment showed that, compared with zero purchase in control villages, over half of intervention households bought an ICS, although demand was highly price-sensitive. Demand was at least twice as high for electric stoves relative to biomass ICS. Even among households that received a negligible price discount, the upgraded supply chain alone induced a 28 percentage-point increase in ICS ownership. Although the bundled intervention is resource-intensive, the full costs are lower than the social benefits of ICS promotion. Our findings suggest that market analysis, robust supply chains, and price discounts are critical for ICS diffusion

The value of and challenges for cholera vaccines in Africa.

The 21st century saw a shift in the cholera burden from Asia to Africa. The risk factors for cholera outbreaks in Africa are incompletely understood, and the traditional emphasis on providing safe drinking water and improving sanitation and hygiene has proven remarkably insufficient to contain outbreaks. Current killed whole-cell oral cholera vaccines (OCVs) are safe and guarantee a high level of protection for several years. OCVs have been licensed for >20 years, but their potential for preventing and control cholera outbreaks in Africa has not been realized. Although each item in the long list of technical reasons why cholera vaccination campaigns have been deferred is plausible, we believe that the biggest barrier is that populations affected by cholera outbreaks are underprivileged and lack a strong political voice. The evaluation and use of OCVs as a tool for cholera control will require a new, more compassionate, less risk-averse generation of decision makers

The cost of cooking a meal. The case of Nyeri County, Kenya

Energy for cooking is considered essential in achieving modern energy access. Despite this, almost three billion people worldwide still use solid fuels to meet their cooking needs. To better support practitioners and policy-makers, this paper presents a new model for comparing cooking solutions and its key output metric: the 'levelized cost of cooking a meal' (LCCM). The model is applied to compare several cooking solutions in the case study area of Nyeri County in Kenya. The cooking access targets are connected to the International Workshop Agreement and Global Tracking Framework's tiers of cooking energy access. Results show how an increased energy access with improved firewood and charcoal cookstoves could reduce both household's LCCMs and the total costs compared to traditional firewood cooking over the modelling period. On the other hand, switching to cleaner cooking solutions, such as LPG- and electricity, would result in higher costs for the end-user highlighting that this transition is not straightforward. The paper also contextualizes the results into the wider socio-economic context. It finds that a tradeoff is present between minimizing costs for households and meeting household priorities, thus maximizing the potential benefits of clean cooking without dismissing the use of biomass altogether

Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger.

In 2008, Africa accounted for 94% of the cholera cases reported worldwide. Although the World Health Organization currently recommends the oral cholera vaccine in endemic areas for high-risk populations, its use in Sub-Saharan Africa has been limited. Here, we provide the principal results of an evaluation of the cholera surveillance system in the region of Maradi in Niger and an analysis of its data towards identifying high-risk areas for cholera

The Costs of Climate Change: A Study of Cholera in Tanzania

Increased temperatures and changes in rainfall patterns as a result of climate change are widely recognized to entail potentially serious consequences for human health, including an increased risk of diarrheal diseases. This study integrates historical data on temperature and rainfall with the burden of disease from cholera in Tanzania and uses socioeconomic data to control for the impacts of general development on the risk of cholera. The results show a significant relationship between temperature and the incidence of cholera. For a 1 degree Celsius temperature increase the initial relative risk of cholera increases by 15 to 29 percent. Based on the modeling results, we project the number and costs of additional cases of cholera that can be attributed to climate change by 2030 in Tanzania for a 1 and 2 degree increase in temperatures, respectively. The total costs of cholera attributable to climate change are shown to be in the range of 0.32 to 1.4 percent of GDP in Tanzania 2030. The results provide useful insights into national-level estimates of the implications of climate change on the health sector and offer information which can feed into both national and international debates on financing and planning adaptation

Post-Construction Support and Sustainability in Community-Managed Rural Water Supply

Executive Summary This volume reports the main findings from a multi-country research project that was designed to develop a better understanding of how rural water supply systems are performing in developing countries. We began the research in 2004 to investigate how the provision of support to communities after the construction of a rural water supply project affected project performance in the medium term. We collected information from households, village water committees, focus groups of village residents, system operators, and key informants in 400 rural communities in Bolivia, Ghana, and Peru; in total, we discussed community water supply issues with approximately 10,000 individuals in these communities. To our surprise, we found the great majority of the village water systems were performing well. Our findings on the factors influencing their sustainability will, we hope, be of use to policy makers, investors, and managers in rural water supply