Abstract
BACKGROUND: The environmental and health impacts of reliance on solid fuels and traditional cookstoves in low-income countries have motivated the promotion of household cooking energy systems that use cleaner burning fuels and cookstoves that lead to reduced exposure to harmful pollutants. Little is known about adoption and use of such systems from the users' perspective. METHODS: We explored the facilitators and barriers to adoption and use of a private sector marketed household cooking energy system that uses sustainably produced biomass pellets and the cleanest burning fan micro-gasification stove currently available. We conducted 48 in-depth qualitative interviews in Gisenyi, Rwanda with decision-makers and cooks in 16 households that adopted the improved cookstove system and 8 non-adopter households. RESULTS: Reported facilitators and barriers to adoption and non-adoption, as well as use and non-use were complex, and in some cases, contradictory. Some adopters noted that cleanliness and low smoke production were major facilitators to adoption and use, while other adopters and non-adopters said the cookstoves blackened and damaged cooking pots and produced excessive smoke. Our findings suggest that correct use of the stove mediates user experience. Cost was likewise reported as a facilitator among some adopters and a barrier among other adopters and non-adopters. Peer influence played a significant role as both a barrier and a facilitator to adoption and transcended other factors. Positive peer influence describing the cleanliness, affordability, and efficiency of the cookstove system encouraged adoption and use, while negative comments by peers regarding excessive smoke and damaged cooking pots discouraged adoption. Commentaries by some participants suggest that inadequate training and instruction may be primary causes of the discrepancies. CONCLUSION: Cost, cleanliness, communication among peer networks, and adequate training and instruction are important factors associated with the adoption and use of improved cookstoves and should be prioritized in the implementation of improved cookstove programs.