Dynamics of sustained use and abandonment of clean cooking systems: study protocol for community-based system dynamics modeling.

BACKGROUND More than 3 billion of the world's population are affected by household air pollution from relying on unprocessed solid fuels for heating and cooking. Household air pollution is harmful to human health, climate, and environment. Sustained uptake and use of cleaner cooking technologies and fuels are proposed as solutions to this problem. In this paper, we present our study protocol aimed at understanding multiple interacting feedback mechanisms involved in the dynamic behavior between social, ecological, and technological systems driving sustained use or abandonment of cleaner cooking technologies among the rural poor in India. METHODS/DESIGN This study uses a comparative case study design to understand the dynamics of sustained use or abandonment of cleaner cooking technologies and fuels in four rural communities of Rajasthan, India. The study adopts a community based system dynamics modeling approach. We describe our approach of using community based system dynamics with rural communities to delineate the feedback mechanisms involved in the uptake and sustainment of clean cooking technologies. We develop a reference mode with communities showing the trend over time of use or abandonment of cleaner cooking technologies and fuels in these communities. Subsequently, the study develops a system dynamics model with communities to understand the complex sub-systems driving the behavior in these communities as reflected in the reference mode. We use group model building techniques to facilitate participation of relevant stakeholders in the four communities and elicit a narrative describing the feedback mechanisms underlying sustained adoption or abandonment of cleaner cooking technologies. DISCUSSION In understanding the dynamics of feedback mechanisms in the uptake and exclusive use of cleaner cooking systems, we increase the likelihood of dissemination and implementation of efficacious interventions into everyday settings to improve the health and wellbeing of women and children most affected by household air pollution. The challenge is not confined to developing robust technical solutions to reduce household air pollution and exposure to improve respiratory health, and prevent associated diseases. The bigger challenge is to disseminate and implement cleaner cooking technologies and fuels in the context of various social, behavioral, and economic constraints faced by poor households and communities. TRIAL REGISTRATION The Institutional Review Board of Washington University in St. Louis has exempted community based system dynamics modeling from review.