Indoor Air Pollution: Issues for Bangladesh

Exposure to indoor air pollution, resulting from the burning of biomass in homes (e.g. wood, agricultural residues, leaves and dung) has been linked to a number of acute respiratory infections (ARIs). ARIs are the biggest killer of children under five and responsible for 9% of the global burden of disease. This paper provides an overview of issues relating to indoor air pollution (IAP), describes why tackling IAP is important and looks at what has been learnt internationally and how lessons relate to Bangladesh. The paper begins by describing the background to IAP, and then places it in the context of the 'Health agenda' and 'People's agenda'. The former is that of the international donor community, the latter is concerned with users and potential beneficiaries. The next section links IAP to the millennium development goals to illustrate the multidisciplinary nature of issues relating to household energy. A number of interventions used in recent years to tackle indoor air pollution are presented, including promotion of improved cooking stoves. These are briefly discussed, and the author draws some broad lessons from their success and failure. The paper then focuses on Bangladesh, looking first at what organisations are doing to tackle IAP exposure, and then at what opportunities exist for further interventions and applied research. Nowadays, the most important driving force behind IAP-reduction interventions is health improvement, particularly as the evidence-base grows. However, there are many other reasons for improving the poor's access to clean household energy such as addressing deforestation and air pollution, saving people money, labour and time-saving, and making people's use of energy safer and more convenient. Successful interventions usually have participation and consultation at their centre, and many interventions fail because of the 'topdown' nature of their implementation. This paper strongly advocates participation and putting people at the centre of the process of developing solutions. Considerable research and projects are underway in Bangladesh, contributing to international understanding on the subject. However, certain major gaps persist, such as the exact relationship between exposure to IAP and ARI, and the extent by which different interventions reduce exposure to IAP.