Using photovoice methods as a community-based participatory research tool to advance uptake of clean cooking and improve health: The LPG adoption in Cameroon evaluation studies

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Study Justification:
– Household air pollution due to cooking with polluting fuels causes premature deaths, particularly in low and middle-income countries.
– The World Health Organisation recommends scaling the adoption of clean fuels to improve maternal and child health.
– Liquefied Petroleum Gas (LPG) is a clean fuel that can provide health and environmental benefits when used for household energy.
– In Cameroon, the government aims to increase LPG use from

The strength of evidence for this abstract is 8 out of 10.
The evidence in the abstract is strong, but could be improved by providing more details on the sample size and demographics of the participants.

Each year up to 2.6 million people die prematurely from household air pollution (HAP) due to cooking with polluting fuels such as wood and charcoal, particularly in low and middle-income countries (LMICs). The World Health Organisation recommends scaling the adoption of clean fuels to improve maternal and child health. Liquefied Petroleum Gas (LPG) represents a scalable clean fuel that provides health and environmental benefits when used for household energy in LMICs. In Cameroon, over 70% of people rely on biomass for cooking, and the Government aims to increase LPG use from <20% to 58% by 2030. Supporting households make this transition requires involvement of multiple stakeholders and an understanding of perspectives from the community's perspective. We used visual participatory methods ‘Photovoice’ to explore households’ perceptions of factors influencing the uptake of LPG for cooking in South-West Cameroon. Two groups of participants from rural (n = 7) and peri-urban (n = 8) areas photographed subjects they identified as preventing and facilitating LPG uptake in their communities. Subsequently, individual interviews (n = 15) and group discussions (n = 5) explored participants’ reflections on the photographs. Thematic analysis was conducted using NVivo 10 software. The main barriers identified included difficulty in affording the initial LPG equipment and ongoing refills, scarcity of LPG retail shops and refills, and safety concerns. Facilitators included (i) increasing awareness of the benefits of LPG (e.g. health), (ii) increasing retail outlet density in rural areas, (iii) addressing safety concerns (e.g. replacing damaged cylinders), and (iv) reducing the price of LPG refills. Participants presented their photos at a public exhibition, which generated discussions with key stakeholders (e.g. government ministries) about how best to assist communities in this transition. Photovoice was found to be an innovative and effective approach for exploring how to advance equitable access to LPG from a community perspective and successfully engage with key stakeholders.

Title: Using Photovoice to Improve Access to Maternal Health: The LPG Adoption in Cameroon Evaluation Studies

Description: The study conducted in Cameroon used a visual participatory method called “Photovoice” to explore households’ perceptions of factors influencing the uptake of Liquefied Petroleum Gas (LPG) for cooking in South-West Cameroon. The aim was to identify barriers and facilitators to LPG adoption and engage key stakeholders in discussions to improve access to clean cooking fuels.

Key Findings:
1. Barriers to LPG adoption:
– Affordability of initial LPG equipment and ongoing refills.
– Scarcity of LPG retail shops and refills.
– Safety concerns related to LPG usage.

2. Facilitators for LPG adoption:
– Increasing awareness of the benefits of LPG, particularly its positive impact on health.
– Increasing the density of retail outlets in rural areas.
– Addressing safety concerns by replacing damaged cylinders.
– Reducing the price of LPG refills.

3. Photovoice as an innovative approach:
– Participants used photographs to visually represent factors influencing LPG adoption.
– Individual interviews and group discussions were conducted to explore participants’ reflections on the photographs.
– Thematic analysis of the data was conducted using NVivo 10 software.
– The photographs were presented at a public exhibition, generating discussions with key stakeholders such as government ministries.

Implications:
– Photovoice was found to be an effective approach for understanding community perspectives on LPG adoption and engaging with key stakeholders.
– The study identified specific barriers and facilitators that can inform interventions to improve access to clean cooking fuels.
– Recommendations include increasing awareness, improving retail infrastructure, addressing safety concerns, and reducing the cost of LPG refills.

Overall, this study highlights the importance of community engagement and understanding local perspectives in promoting equitable access to clean cooking fuels, which can have significant benefits for maternal and child health.
AI Innovations Description
The recommendation to improve access to maternal health is to use photovoice methods as a community-based participatory research tool. This approach involves engaging with community members and allowing them to express their perspectives through photography. In the specific context of improving access to clean cooking fuels, such as Liquefied Petroleum Gas (LPG), in Cameroon, photovoice was used to explore households’ perceptions of factors influencing the uptake of LPG for cooking.

Through photovoice, two groups of participants from rural and peri-urban areas in South-West Cameroon took photographs of subjects they identified as barriers and facilitators to LPG adoption in their communities. These photographs were then used as a basis for individual interviews and group discussions to further explore participants’ reflections on the identified factors.

The main barriers identified through this process included the affordability of initial LPG equipment and ongoing refills, scarcity of LPG retail shops and refills, and safety concerns. On the other hand, facilitators included increasing awareness of the benefits of LPG, increasing retail outlet density in rural areas, addressing safety concerns, and reducing the price of LPG refills.

The photovoice approach also involved presenting the photos at a public exhibition, which generated discussions with key stakeholders, such as government ministries, to find ways to assist communities in transitioning to LPG. This innovative and effective approach allowed for a deeper understanding of the community’s perspective and successfully engaged with key stakeholders to advance equitable access to LPG and improve maternal and child health.

Overall, using photovoice methods as a community-based participatory research tool can be a valuable innovation to improve access to maternal health by involving multiple stakeholders, understanding community perspectives, and identifying specific barriers and facilitators to the adoption of clean cooking fuels like LPG.
AI Innovations Methodology
Based on the description provided, here are some potential recommendations for improving access to maternal health:

1. Increase awareness: Develop targeted campaigns to educate communities about the importance of maternal health and the available resources and services.

2. Improve transportation: Enhance transportation infrastructure to ensure that pregnant women can easily access healthcare facilities, especially in rural areas.

3. Strengthen healthcare facilities: Invest in improving the quality and capacity of healthcare facilities, including staffing, equipment, and supplies.

4. Train healthcare providers: Provide specialized training for healthcare providers to ensure they have the necessary skills and knowledge to provide quality maternal healthcare.

5. Community engagement: Involve local communities in decision-making processes and empower them to take ownership of maternal health initiatives.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Data collection: Gather baseline data on the current state of maternal health access, including factors such as distance to healthcare facilities, availability of transportation, awareness levels, and healthcare facility capacity.

2. Modeling: Use statistical modeling techniques to simulate the potential impact of the recommendations on various indicators, such as the number of women accessing maternal healthcare services, reduction in transportation barriers, and increase in awareness levels.

3. Sensitivity analysis: Conduct sensitivity analysis to assess the robustness of the model and understand the potential variations in outcomes based on different assumptions or scenarios.

4. Stakeholder consultation: Engage with key stakeholders, including healthcare providers, community leaders, and policymakers, to validate the model’s findings and gather additional insights.

5. Policy recommendations: Based on the simulation results and stakeholder inputs, develop policy recommendations that prioritize the most effective interventions for improving access to maternal health.

6. Monitoring and evaluation: Implement the recommended interventions and establish a monitoring and evaluation framework to track progress and assess the actual impact on improving access to maternal health over time.

By following this methodology, policymakers and stakeholders can make informed decisions and allocate resources effectively to improve access to maternal health.

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