Whose pollution, whose problem? Understanding perceptions of air pollution and implications for clean cooking (for health) in Nairobi schools.

Air pollution is a critical global public health and environmental concern, leading to over 6.7 million premature deaths annually, disproportionately affecting low- and middle-income countries (LMICs), where the use of polluting fuels for cooking remains widespread. Incorporating perceptions of air pollution is argued as vital for developing effective intervention strategies. However, this has seldom been given focus in the development of clean cooking interventions. The use of firewood in Kenyan schools is commonplace and the transition to clean cooking methods in school settings is gaining international attention. We investigated how air pollution is perceived and understood by staff in three schools from an informal settlement in Nairobi, Kenya which predominately use firewood or charcoal for school catering. We conducted focus group discussions and in-depth interviews and used thematic analysis to explore perceptions of air pollution in the schools and how these differed between different staff groups. Perceptions of air pollution were dominated by external environmental factors from the surrounding informal settlement. While the impacts of air pollution from firewood on catering staff and teaching activities were recognised, understandings of the long-term health impacts were often blurred and dislocated from the school setting. Responsibilities for addressing air pollution were said to be with external stakeholders, but the school staff cited a lack of government interventions to address underlying poverty and multiple pollution sources. Effective strategies to tackle air pollution must involve careful engagement with stakeholders and community members to incorporate local perceptions of air pollution and address broader systemic issues that increase exposure. Clean cooking interventions focused solely on reducing air pollution may face challenges due to competing financial demands and a tendency to shift responsibilities for tackling such an issue. Broader benefits, such as economic and environmental improvements, might be more compelling drivers for successful implementation.