Impacts of a sustained, large-scale liquefied petroleum gas (LPG) cooking intervention in the Rohingya refugee camp on time use, household air pollution, and health

Humanitarian organisations typically provide refugees with shelter and food, but not cooking fuel. Many refugees harvest firewood for cooking, consuming considerable time and resulting in indoor and ambient air pollution. To address these issues, humanitarian agencies began distributing liquefied petroleum gas (LPG) for cooking to all approximately 200,000 Rohingya refugee households.

Households that were about to receive LPG (n=600) or had been receiving LPG for at least 12 months (n=600) were assessed at baseline, then 12 and 32 months later. A difference-in-difference analysis was used to quantify the impact of free LPG distribution on time use, expenditure, physical and mental health, and estimated averted deaths due to reduced exposure to air pollution.

Free LPG distribution allowed households to reallocate time from gathering firewood to caring for others and leisure time, and to increase food expenditure. Time-weighted exposure to PM2.5 fell by 195 µg/m3, averting an estimated 215 deaths and 6,608 disability-adjusted life years lost. There was a 10.0 percentage point decrease in reported clinic visits for children's breathing problems, a 7.4 percentage point reduction in reported child severe asthma, and a 9.8 percentage point reduction in the prevalence of caregivers at risk of depression.

Sustained, large-scale distribution of LPG in a humanitarian setting reduced exposure to PM2.5 and promoted wellbeing. Provision of free LPG in other humanitarian contexts could similarly foster better physical and mental health amongst displaced people.

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