Witinok-Huber Rebecca, Keller Kayleigh P, Abimana Egide, Ahishakiye Cleophas, Chang Howard H, L'Orange Christian, Manning Dale T, Mori Richard, Muhirwa Eddy Frank, Muhongerwa Liliane, Ntakirutimana Theoneste, Puzzolo Elisa, Quinn Casey, Rosa Ghislaine, Tanner Ky, Young Bonnie N, Zimmerle Daniel, Kalisa Egide, Volckens John, Clark Maggie L
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
Department of Statistics, Colorado State University, Fort Collins, CO, USA.
Energy Sustain Dev. 2024 Jun;80. doi: 10.1016/j.esd.2024.101455. Epub 2024 May 6.
The disease burden related to air pollution from traditional solid-fuel cooking practices in low- and middle-income countries impacts millions of people globally. Although the use of liquefied petroleum gas (LPG) fuel for cooking can meaningfully reduce household air pollution concentrations, major barriers, including affordability and accessibility, have limited widespread adoption. Using a randomized controlled trial, our objective was to evaluate the association between the cost and use of LPG among 23 rural Rwandan households. We provided a 2-burner LPG stove with accessories and incorporated a "pay-as-you-go" (PAYG) LPG service model that included fuel delivery. PAYG services remove the large up-front cost of cylinder refills by integrating "smart meter" technology that allows participants to pay in incremental amounts, as needed. We assigned three randomized discounted prices for LPG to each household at ~4-week intervals over a 12-week period. We modeled the relationship between randomized PAYG LPG price and use (standardized to monthly periods), analyzing effect modification by relative household wealth. A 1000 Rwandan Franc (about 1 USD at the time of the study) increase in LPG price/kg was associated with a 4.1 kg/month decrease in use (95% confidence interval [CI]: -6.7, -1.6; n=69 observations). Wealth modified this association; we observed a 9.7 kg/month reduction (95% CI: -14.8, -4.5) among wealthier households and a 2.5 kg/month reduction (95% CI: -5.3, 0.3) among lower-wealth households (p-interaction=0.01). The difference in price sensitivity was driven by higher LPG use among wealthier households at more heavily discounted prices; from an 80% to 10% discount, wealthy households used 17.5 to 5.3 kg/month and less wealthy households used 6.2 to 3.1 kg/month. Our pilot-level experimental evidence of PAYG LPG in a rural low-resource setting suggests that further exploration of subsidized pricing varied by household wealth is needed to ensure future policy initiatives can achieve targets without exacerbating inequities.
低收入和中等收入国家传统固体燃料烹饪方式造成的空气污染相关疾病负担影响着全球数百万人。虽然使用液化石油气（LPG）燃料烹饪可显著降低家庭空气污染浓度，但包括可承受性和可及性在内的主要障碍限制了其广泛采用。通过一项随机对照试验，我们的目标是评估卢旺达23个农村家庭中LPG成本与使用之间的关联。我们提供了一台双灶LPG炉灶及配件，并采用了一种“现用现付”（PAYG）LPG服务模式，包括燃料配送。PAYG服务通过整合“智能电表”技术消除了气瓶再充装的大额前期成本，该技术允许参与者根据需要按增量支付费用。在12周期间，我们每隔约4周为每个家庭分配三种随机折扣价格的LPG。我们对随机PAYG LPG价格与使用量（标准化为月度）之间的关系进行建模，分析家庭相对财富的效应修正。LPG价格每千克增加1000卢旺达法郎（研究时约合1美元），使用量每月减少4.1千克（95%置信区间[CI]：-6.7，-1.6；n = 69次观察）。财富对这种关联有修正作用；我们观察到较富裕家庭每月减少9.7千克（95% CI：-14.8，-4.5），较低财富家庭每月减少2.5千克（95% CI：-5.3，0.3）（p交互作用 = 0.01）。价格敏感性差异是由较富裕家庭在更大折扣价格下更高的LPG使用量驱动的；从80%折扣到10%折扣，富裕家庭每月使用17.5至5.3千克，较不富裕家庭每月使用6.2至3.1千克。我们在农村低资源环境中对PAYG LPG进行的试点水平实验证据表明，需要进一步探索根据家庭财富差异进行补贴定价，以确保未来政策举措能够实现目标而不加剧不平等。
