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• 1. [Article] The Economics of Household Air Pollution

  Traditional energy technologies and consumer products contribute to household well-being in diverse ways but also often harm household air quality. We review the problem of household air pollution at a ...

  Citation × Citation Citation Abstract Copy Title: The Economics of Household Air Pollution Author: Jeuland, Marc, Pattanayak, Subhrendu K., Bluffstone, Randall Year: 2015 Traditional energy technologies and consumer products contribute to household well-being in diverse ways but also often harm household air quality. We review the problem of household air pollution at a global scale, focusing particularly on the harmful effects of traditional cooking and heating. Drawing on the theory of household production, we illustrate the ambiguous relationship between household well-being and adoption of behaviors and technologies that reduce air pollution. We then review how the theory relates to the seemingly contradictory findings emerging from the literature on developing country household demand for clean fuels and stoves. In conclusion, we describe an economics research agenda to close the knowledge gaps so that policies and programs can be designed and evaluated to solve the global household air pollution problem. Title: The Economics of Household Air Pollution Author: Jeuland, Marc, Pattanayak, Subhrendu K., Bluffstone, Randall Year: 2015 Traditional energy technologies and consumer products contribute to household well-being in diverse ways but also often harm household air quality. We review the problem of household air pollution at a global scale, focusing particularly on the harmful effects of traditional cooking and heating. Drawing on the theory of household production, we illustrate the ambiguous relationship between household well-being and adoption of behaviors and technologies that reduce air pollution. We then review how the theory relates to the seemingly contradictory findings emerging from the literature on developing country household demand for clean fuels and stoves. In conclusion, we describe an economics research agenda to close the knowledge gaps so that policies and programs can be designed and evaluated to solve the global household air pollution problem. Close

• 2. [Article] Household Malaria Knowledge and its Association with Bednet Ownership in Settings without Large–scale Distribution Programs: Evidence from Rural Madagascar

  Background Insecticide–treated bednets are effective at preventing malaria. This study focuses on household–level factors that are associated with bednet ownership in a rural area of Madagascar which had ...

  Citation × Citation Citation Abstract Copy Title: Household Malaria Knowledge and its Association with Bednet Ownership in Settings without Large–scale Distribution Programs: Evidence from Rural Madagascar Author: Krezanoski, Paul J., Tsai, Alexander C., Hamer, Davidson H., Comfort, Alison B., Bangsberg, David Year: 2014 Background Insecticide–treated bednets are effective at preventing malaria. This study focuses on household–level factors that are associated with bednet ownership in a rural area of Madagascar which had not been a recipient of large–scale ITN distribution. Methods Data were gathered on individual and household characteristics, malaria knowledge, household assets and bednet ownership. Principal components analysis was used to construct both a wealth index based on household assets and a malaria knowledge index based on responses to questions about malaria. Bivariate and multivariate regressions were used to determine predictors of household bednet ownership and malaria knowledge. Results Forty–seven of 560 households (8.4%) owned a bednet. In multivariate analysis, higher level of malaria knowledge among household members was the only variable significantly associated with bednet ownership (odds ratio 3.72, P < 0.001). Among respondents, predictors of higher malaria knowledge included higher education levels, female sex and reporting fever as the most frequent or dangerous illness in the community. Household wealth was not a significant predictor of bednet ownership or respondent malaria knowledge. Conclusion In this setting of limited supply of affordable bednets, malaria knowledge was associated with an increased probability of household bednet ownership. Further studies should determine how such malaria knowledge evolves and if malaria–specific education programs could help overcome the barriers to bednet ownership among at–risk households living outside the reach of large–scale bednet distribution programs. Title: Household Malaria Knowledge and its Association with Bednet Ownership in Settings without Large–scale Distribution Programs: Evidence from Rural Madagascar Author: Krezanoski, Paul J., Tsai, Alexander C., Hamer, Davidson H., Comfort, Alison B., Bangsberg, David Year: 2014 Background Insecticide–treated bednets are effective at preventing malaria. This study focuses on household–level factors that are associated with bednet ownership in a rural area of Madagascar which had not been a recipient of large–scale ITN distribution. Methods Data were gathered on individual and household characteristics, malaria knowledge, household assets and bednet ownership. Principal components analysis was used to construct both a wealth index based on household assets and a malaria knowledge index based on responses to questions about malaria. Bivariate and multivariate regressions were used to determine predictors of household bednet ownership and malaria knowledge. Results Forty–seven of 560 households (8.4%) owned a bednet. In multivariate analysis, higher level of malaria knowledge among household members was the only variable significantly associated with bednet ownership (odds ratio 3.72, P < 0.001). Among respondents, predictors of higher malaria knowledge included higher education levels, female sex and reporting fever as the most frequent or dangerous illness in the community. Household wealth was not a significant predictor of bednet ownership or respondent malaria knowledge. Conclusion In this setting of limited supply of affordable bednets, malaria knowledge was associated with an increased probability of household bednet ownership. Further studies should determine how such malaria knowledge evolves and if malaria–specific education programs could help overcome the barriers to bednet ownership among at–risk households living outside the reach of large–scale bednet distribution programs. Close

• 3. [Article] Understanding Transportation in Urban China - Local Residents vs Migrant Workers

  With rapid urbanization in China and other developing economies around the world, it has become imperative to understand household transportation behavior and expenditures in these urban areas. The objective ...

  Citation × Citation Citation Abstract Copy Title: Understanding Transportation in Urban China - Local Residents vs Migrant Workers Author: Liu, Jenny H. Year: 2016 With rapid urbanization in China and other developing economies around the world, it has become imperative to understand household transportation behavior and expenditures in these urban areas. The objective of this study is to examine the differences in the determinants of household transportation expenditures within two very distinct populations in Chinese cities: local residents and migrant workers. In order to craft policies or strategies promoting sustainable transportation or livability, it is essential to understand whether the drivers that push the migrant population towards spending more on transportation or owning bikes or motorbikes are similar to drivers for the rest of the population. This is further complicated by the differential treatment of households within China’s hukou (household registration) system which determines eligibility to receive public benefits in housing or education. Because nearly 40% of the population in urban areas are migrants, it is particularly important to examine how the transportation choices and behavior of migrant households may diverge (or not) from the rest of the urban dwellers. Utilizing a unique dataset that surveys both types of households, we utilize descriptive statistics and regression models to analyze their transportation expenditures. We find that household income level and automobile ownership are the strongest predictors of household transportation expenditures. In addition, larger local resident households who are younger tend to spend more on transportation while migrant households generally spend less on transportation, particularly those with stronger social networks and those who do not hold urban hukou status. We conclude that significant differences do exist and may be exacerbated by inequitable access to public services, housing opportunities and other urban amenities in addition to major differences in household composition, preferences and levels of participation in the urban economic and social systems. Title: Understanding Transportation in Urban China - Local Residents vs Migrant Workers Author: Liu, Jenny H. Year: 2016 With rapid urbanization in China and other developing economies around the world, it has become imperative to understand household transportation behavior and expenditures in these urban areas. The objective of this study is to examine the differences in the determinants of household transportation expenditures within two very distinct populations in Chinese cities: local residents and migrant workers. In order to craft policies or strategies promoting sustainable transportation or livability, it is essential to understand whether the drivers that push the migrant population towards spending more on transportation or owning bikes or motorbikes are similar to drivers for the rest of the population. This is further complicated by the differential treatment of households within China’s hukou (household registration) system which determines eligibility to receive public benefits in housing or education. Because nearly 40% of the population in urban areas are migrants, it is particularly important to examine how the transportation choices and behavior of migrant households may diverge (or not) from the rest of the urban dwellers. Utilizing a unique dataset that surveys both types of households, we utilize descriptive statistics and regression models to analyze their transportation expenditures. We find that household income level and automobile ownership are the strongest predictors of household transportation expenditures. In addition, larger local resident households who are younger tend to spend more on transportation while migrant households generally spend less on transportation, particularly those with stronger social networks and those who do not hold urban hukou status. We conclude that significant differences do exist and may be exacerbated by inequitable access to public services, housing opportunities and other urban amenities in addition to major differences in household composition, preferences and levels of participation in the urban economic and social systems. Close

• 4. [Article] Trade-offs: The Production of Sustainability in Households

  Over the past half-century, environmental problems have become increasingly serious and seemingly intractable, and a careless, clueless, or contemptuous consumer is often portrayed as the root cause of ...

  Citation × Citation Citation Abstract Copy Title: Trade-offs: The Production of Sustainability in Households Author: Munro, Kirstin Marie Elizabeth Year: 2017 Over the past half-century, environmental problems have become increasingly serious and seemingly intractable, and a careless, clueless, or contemptuous consumer is often portrayed as the root cause of this environmental decline. This study takes a different approach to evaluating the demand for resources by households, assessing possible pro-environmental paths forward through a study of highly ecologically-conscious households. By modeling "green" households as producers of sustainability rather than consumers of environmental products, the sustainability work that takes place in households is brought into focus. An investigation of household sustainability production makes possible the evaluation of the trade-offs inherent in these pro-environmental activities. Ethnographic interviews with 23 sustainability-oriented households with young children living in and near Portland, Oregon, provide data on how households balance priorities and get things done in day-to-day life by employing the available resources, limited by constraining factors. An orienting perspective combining neoclassical and radical political economic theories of household production frames the analysis of how households make choices between alternatives. Sociological theories of consumption and theories of social practice aid in the analysis of how these choices have evolved over time, and how household members view the social meanings of these choices. Particular attention is paid to areas of day-to-day life neglected in previous research--household waste, comfort, and cleanliness. The results indicate that there is not one "sustainability" with varying degrees across a "green" spectrum, but rather varying priorities in the sustainability realm--personal health, nature, waste avoidance, technology, and community. This analysis reveals some of the negative consequences of shifting the responsibility for environmental protection to households. Ecologically-conscious households devote substantial time and money to these sustainability efforts, but their efforts frequently stimulate conflicts, and the end results are rarely perfect. Constrained resources and limited information mean household members must make trade-offs between competing priorities, often under duress. The results suggest that policies promoting household-level sustainability efforts may be misguided, as this transfer of institutional responsibility for environmental protection to individuals and groups results in even greater burdens on households, whose time and money are already stretched to their limits. Title: Trade-offs: The Production of Sustainability in Households Author: Munro, Kirstin Marie Elizabeth Year: 2017 Over the past half-century, environmental problems have become increasingly serious and seemingly intractable, and a careless, clueless, or contemptuous consumer is often portrayed as the root cause of this environmental decline. This study takes a different approach to evaluating the demand for resources by households, assessing possible pro-environmental paths forward through a study of highly ecologically-conscious households. By modeling "green" households as producers of sustainability rather than consumers of environmental products, the sustainability work that takes place in households is brought into focus. An investigation of household sustainability production makes possible the evaluation of the trade-offs inherent in these pro-environmental activities. Ethnographic interviews with 23 sustainability-oriented households with young children living in and near Portland, Oregon, provide data on how households balance priorities and get things done in day-to-day life by employing the available resources, limited by constraining factors. An orienting perspective combining neoclassical and radical political economic theories of household production frames the analysis of how households make choices between alternatives. Sociological theories of consumption and theories of social practice aid in the analysis of how these choices have evolved over time, and how household members view the social meanings of these choices. Particular attention is paid to areas of day-to-day life neglected in previous research--household waste, comfort, and cleanliness. The results indicate that there is not one "sustainability" with varying degrees across a "green" spectrum, but rather varying priorities in the sustainability realm--personal health, nature, waste avoidance, technology, and community. This analysis reveals some of the negative consequences of shifting the responsibility for environmental protection to households. Ecologically-conscious households devote substantial time and money to these sustainability efforts, but their efforts frequently stimulate conflicts, and the end results are rarely perfect. Constrained resources and limited information mean household members must make trade-offs between competing priorities, often under duress. The results suggest that policies promoting household-level sustainability efforts may be misguided, as this transfer of institutional responsibility for environmental protection to individuals and groups results in even greater burdens on households, whose time and money are already stretched to their limits. Close

• 5. [Article] The Trade-offs between Population Density and Households' Transportation-housing Costs

  As metropolitan area governments and others promote density-promoting “smart growth” policies, finer analysis is needed to quantify the impact of such policies on households' transportation and housing ...

  Citation × Citation Citation Abstract Copy Title: The Trade-offs between Population Density and Households' Transportation-housing Costs Author: Wang, Haizhong Year: 2015 As metropolitan area governments and others promote density-promoting “smart growth” policies, finer analysis is needed to quantify the impact of such policies on households' transportation and housing costs. Existing research suggests that households in urban areas trade-off between housing costs and transportation costs, but does not explore how policies to increase urban densities might explicitly impact this balance. Furthermore, the research does not adequately distinguish between the effect of urban area density and the effects of other factors associated with urban area density (e.g metropolitan area size and household incomes) on housing costs. This research uses the 2000 Census Public Use Micro Sample (PUMS) person and household data from 23 of the nation's most densely populated states to identify the impact of increased population density on three housing cost measures: household rents, housing unit values, and monthly mortgage payments. Log linear models were estimated for each housing cost measure using least-squares regression. Dependent variables included household, housing unit, and geographic area characteristics, including population density. The models were found to be very similar to one another in terms of the statistical significance and values of estimated model parameters. Population density (measured at the PUMS area level) was found to be statistically significant at the 0.01 level for all housing cost measures. Although significant, the parameter estimates show that the elasticity of housing cost with respect to population density is low, ranging from 0.041 to 0.05. This research also explores the relationship between housing costs and accessibility. Results show that households living in areas closer to jobs (as indicated by shorter average commute times) and households utilizing fixed route transit systems have marginally higher housing costs. Title: The Trade-offs between Population Density and Households' Transportation-housing Costs Author: Wang, Haizhong Year: 2015 As metropolitan area governments and others promote density-promoting “smart growth” policies, finer analysis is needed to quantify the impact of such policies on households' transportation and housing costs. Existing research suggests that households in urban areas trade-off between housing costs and transportation costs, but does not explore how policies to increase urban densities might explicitly impact this balance. Furthermore, the research does not adequately distinguish between the effect of urban area density and the effects of other factors associated with urban area density (e.g metropolitan area size and household incomes) on housing costs. This research uses the 2000 Census Public Use Micro Sample (PUMS) person and household data from 23 of the nation's most densely populated states to identify the impact of increased population density on three housing cost measures: household rents, housing unit values, and monthly mortgage payments. Log linear models were estimated for each housing cost measure using least-squares regression. Dependent variables included household, housing unit, and geographic area characteristics, including population density. The models were found to be very similar to one another in terms of the statistical significance and values of estimated model parameters. Population density (measured at the PUMS area level) was found to be statistically significant at the 0.01 level for all housing cost measures. Although significant, the parameter estimates show that the elasticity of housing cost with respect to population density is low, ranging from 0.041 to 0.05. This research also explores the relationship between housing costs and accessibility. Results show that households living in areas closer to jobs (as indicated by shorter average commute times) and households utilizing fixed route transit systems have marginally higher housing costs. Close

• 6. [Article] Edged Out: Location Efficient Housing and Low Income Households in the Portland Region

  Transportation costs are typically a household’s second largest expense after housing. Low income households are especially burdened by transportation costs, with low income households spending up to two ...

  Citation × Citation Citation Abstract Copy Title: Edged Out: Location Efficient Housing and Low Income Households in the Portland Region Author: Tremoulet, Andrée, Dann, Ryan Year: 2016 Transportation costs are typically a household’s second largest expense after housing. Low income households are especially burdened by transportation costs, with low income households spending up to two times as much of their income on transportation than higher income households (Litman, 2013). Thus, access to location efficient housing is especially important to low income households, including those who use a housing voucher to help pay for housing costs. This seminar presents the results of a two-year project supported by the Portland region's four public housing authorities to design and test tools to help people with housing vouchers find location efficient housing. We examine the challenges that residents faced and discuss policy implications. Title: Edged Out: Location Efficient Housing and Low Income Households in the Portland Region Author: Tremoulet, Andrée, Dann, Ryan Year: 2016 Transportation costs are typically a household’s second largest expense after housing. Low income households are especially burdened by transportation costs, with low income households spending up to two times as much of their income on transportation than higher income households (Litman, 2013). Thus, access to location efficient housing is especially important to low income households, including those who use a housing voucher to help pay for housing costs. This seminar presents the results of a two-year project supported by the Portland region's four public housing authorities to design and test tools to help people with housing vouchers find location efficient housing. We examine the challenges that residents faced and discuss policy implications. Close

• 7. [Article] Assessing the Impact of Water Filters and Improved Cook Stoves on Drinking Water Quality and Household Air Pollution: A Randomised Controlled Trial in Rwanda

  Diarrhea and respiratory infections remain the biggest killers of children under 5 years in developing countries. We conducted a 5-month household randomised controlled trial among 566 households in rural ...

  Citation × Citation Citation Abstract Copy Title: Assessing the Impact of Water Filters and Improved Cook Stoves on Drinking Water Quality and Household Air Pollution: A Randomised Controlled Trial in Rwanda Author: Rosa, Ghislaine, Majorin, Fiona, Boisson, Sophie, Barstow, Christina, Johnson, Michael, Kirby, Miles, Ngabo, Fidele, Thomas, Evan A., Clasen, Thomas Year: 2014 Diarrhea and respiratory infections remain the biggest killers of children under 5 years in developing countries. We conducted a 5-month household randomised controlled trial among 566 households in rural Rwanda to assess uptake, compliance and impact on environmental exposures of a combined intervention delivering high-performance water filters and improved stoves for free. Compliance was measured monthly by self-report and spot-check observations. Semicontinuous 24-h PM2.5 monitoring of the cooking area was conducted in a random subsample of 121 households to assess household air pollution, while samples of drinking water from all households were collected monthly to assess the levels of thermotolerant coliforms. Adoption was generally high, with most householders reporting the filters as their primary source of drinking water and the intervention stoves as their primary cooking stove. However, some householders continued to drink untreated water and most continued to cook on traditional stoves. The intervention was associated with a 97.5% reduction in mean fecal indicator bacteria (Williams means 0.5 vs. 20.2 TTC/100 mL, p,0.001) and a median reduction of 48% of 24-h PM2.5 concentrations in the cooking area (p = 0.005). Further studies to increase compliance should be undertaken to better inform large-scale interventions. Title: Assessing the Impact of Water Filters and Improved Cook Stoves on Drinking Water Quality and Household Air Pollution: A Randomised Controlled Trial in Rwanda Author: Rosa, Ghislaine, Majorin, Fiona, Boisson, Sophie, Barstow, Christina, Johnson, Michael, Kirby, Miles, Ngabo, Fidele, Thomas, Evan A., Clasen, Thomas Year: 2014 Diarrhea and respiratory infections remain the biggest killers of children under 5 years in developing countries. We conducted a 5-month household randomised controlled trial among 566 households in rural Rwanda to assess uptake, compliance and impact on environmental exposures of a combined intervention delivering high-performance water filters and improved stoves for free. Compliance was measured monthly by self-report and spot-check observations. Semicontinuous 24-h PM2.5 monitoring of the cooking area was conducted in a random subsample of 121 households to assess household air pollution, while samples of drinking water from all households were collected monthly to assess the levels of thermotolerant coliforms. Adoption was generally high, with most householders reporting the filters as their primary source of drinking water and the intervention stoves as their primary cooking stove. However, some householders continued to drink untreated water and most continued to cook on traditional stoves. The intervention was associated with a 97.5% reduction in mean fecal indicator bacteria (Williams means 0.5 vs. 20.2 TTC/100 mL, p,0.001) and a median reduction of 48% of 24-h PM2.5 concentrations in the cooking area (p = 0.005). Further studies to increase compliance should be undertaken to better inform large-scale interventions. Close

• 8. [Article] Where the Ends Don't Meet in 2014: Measuring Poverty and Self-Sufficiency among Oregon's Families

  This report sheds light on the economic realities facing many of Oregon’s households and provides an initial picture of the extent of income inadequacy in Oregon. Although addressing this issue is challenging, ...

  Citation × Citation Citation Abstract Copy Title: Where the Ends Don't Meet in 2014: Measuring Poverty and Self-Sufficiency among Oregon's Families Author: Morehead, Elizabeth, Martin, Sheila A. Year: 2015 This report sheds light on the economic realities facing many of Oregon’s households and provides an initial picture of the extent of income inadequacy in Oregon. Although addressing this issue is challenging, it can be seen as encouraging that many householders with below-Standard incomes are already part of the workforce. It is possible that many householders have adequate levels of education and experience but face other barriers that keep their wages low or raise their expenses. Identifying and addressing such barriers is the next step in bringing household incomes and costs into balance. Title: Where the Ends Don't Meet in 2014: Measuring Poverty and Self-Sufficiency among Oregon's Families Author: Morehead, Elizabeth, Martin, Sheila A. Year: 2015 This report sheds light on the economic realities facing many of Oregon’s households and provides an initial picture of the extent of income inadequacy in Oregon. Although addressing this issue is challenging, it can be seen as encouraging that many householders with below-Standard incomes are already part of the workforce. It is possible that many householders have adequate levels of education and experience but face other barriers that keep their wages low or raise their expenses. Identifying and addressing such barriers is the next step in bringing household incomes and costs into balance. Close

• 9. [Article] Withholding taxes: household employees

  "150-206-627."

  Citation × Citation Citation Abstract Copy Title: Withholding taxes: household employees Year: 9999 "150-206-627." Title: Withholding taxes: household employees Year: 9999 "150-206-627." Close

• 10. [Article] Process Evaluation and Assessment of Use of a Large Scale Water Filter and Cookstove Program in Rwanda

  Background: In an effort to reduce the disease burden in rural Rwanda, decrease poverty associated with expenditures for fuel, and minimize the environmental impact on forests and greenhouse gases from ...

  Citation × Citation Citation Abstract Copy Title: Process Evaluation and Assessment of Use of a Large Scale Water Filter and Cookstove Program in Rwanda Author: Barstow, Christina K., Nagel, Corey, Clasen, Thomas, Thomas, Evan A. Year: 2016 Background: In an effort to reduce the disease burden in rural Rwanda, decrease poverty associated with expenditures for fuel, and minimize the environmental impact on forests and greenhouse gases from inefficient combustion of biomass, the Rwanda Ministry of Health (MOH) partnered with DelAgua Health (DelAgua), a private social enterprise, to distribute and promote the use of improved cookstoves and advanced water filters to the poorest quarter of households (Ubudehe 1 and 2) nationally, beginning in Western Province under a program branded Tubeho Neza (“Live Well”). The project is privately financed and earns revenue from carbon credits under the United Nations Clean Development Mechanism. Methods: During a 3-month period in late 2014, over 470,000 people living in over 101,000 households were provided free water filters and cookstoves. Following the distribution, community health workers visited nearly 98 % of households to perform household level education and training activities. Over 87 % of households were visited again within 6 months with a basic survey conducted. Detailed adoption surveys were conducted among a sample of households, 1000 in the first round, 187 in the second. Results: Approximately a year after distribution, reported water filter use was above 90 % (+/−4 % CI) and water present in filter was observed in over 76 % (+/−6 % CI) of households, while the reported primary stove was nearly 90 % (+/−4.4 % CI) and of households cooking at the time of the visit, over 83 % (+/−5.3 % CI) were on the improved stove. There was no observed association between household size and stove stacking behavior. Conclusions: This program suggests that free distribution is not a determinant of low adoption. It is plausible that continued engagement in households, enabled by Ministry of Health support and carbon financed revenue, contributed to high adoption rates. Overall, the program was able to demonstrate a privately financed, public health intervention can achieve high levels of initial adoption and usage of household level water filtration and improved cookstoves at a large scale. Title: Process Evaluation and Assessment of Use of a Large Scale Water Filter and Cookstove Program in Rwanda Author: Barstow, Christina K., Nagel, Corey, Clasen, Thomas, Thomas, Evan A. Year: 2016 Background: In an effort to reduce the disease burden in rural Rwanda, decrease poverty associated with expenditures for fuel, and minimize the environmental impact on forests and greenhouse gases from inefficient combustion of biomass, the Rwanda Ministry of Health (MOH) partnered with DelAgua Health (DelAgua), a private social enterprise, to distribute and promote the use of improved cookstoves and advanced water filters to the poorest quarter of households (Ubudehe 1 and 2) nationally, beginning in Western Province under a program branded Tubeho Neza (“Live Well”). The project is privately financed and earns revenue from carbon credits under the United Nations Clean Development Mechanism. Methods: During a 3-month period in late 2014, over 470,000 people living in over 101,000 households were provided free water filters and cookstoves. Following the distribution, community health workers visited nearly 98 % of households to perform household level education and training activities. Over 87 % of households were visited again within 6 months with a basic survey conducted. Detailed adoption surveys were conducted among a sample of households, 1000 in the first round, 187 in the second. Results: Approximately a year after distribution, reported water filter use was above 90 % (+/−4 % CI) and water present in filter was observed in over 76 % (+/−6 % CI) of households, while the reported primary stove was nearly 90 % (+/−4.4 % CI) and of households cooking at the time of the visit, over 83 % (+/−5.3 % CI) were on the improved stove. There was no observed association between household size and stove stacking behavior. Conclusions: This program suggests that free distribution is not a determinant of low adoption. It is plausible that continued engagement in households, enabled by Ministry of Health support and carbon financed revenue, contributed to high adoption rates. Overall, the program was able to demonstrate a privately financed, public health intervention can achieve high levels of initial adoption and usage of household level water filtration and improved cookstoves at a large scale. Close