The impact of health behaviour change intervention on indoor air pollution indicators in the rural North West Province, South Africa

Indoor air pollution has been associated with a number of health outcomes including child lower respiratory infections such as pneumonia. Behavioural change has been promoted as a potential intervention strategy but very little evidence exists of the impact of such strategies on actual indoor air pollution indicators particularly in poor rural contexts. The aim of this study was to evaluate a community counselling intervention on stationary levels of PM10 and carbon monoxide (CO) as well as CO measured on children younger than five. Using a quasi-experimental design, baseline data was collected in an intervention (n=36) and a control (n=38) community; the intervention was implemented in the intervention community only; and follow-up data was collected one year later amongst the same households. Despite the fact that indoor air pollution was reduced in both communities, the intervention group performed significantly better than the control group when stratified by burning location. The net median reductions associated with the intervention were: PM10=57%, CO=31% and CO (child)=33% amongst households that burned indoor fires. The study provides tentative evidence that a health behaviour change is associated with reductions in child indoor air pollution exposure. The intervention is relatively inexpensive and easy to replicate. However, more powerful epidemiological studies are needed to determine the impact on health outcomes.