Applied Implementation Research for Clean Cooking in Cambodia (AIR-C3): equity, exposure, costs, and benefits of induction stove interventions

The goal of this study—Applied Implementation Research for Clean Cooking in Cambodia (AIR-C3)—is to design and demonstrate the effectiveness of a scalable strategy for achieving equitable access to and sustained and exclusive use of induction-based clean cooking in low- and middle-income settings. An

estimated 3 billion people use biomass fuels (e.g., wood, charcoal, animal dung, and coal) for cooking in polluting open fires or inefficient stoves. The resulting household air pollution (HAP), including fine particulate matter, is a leading environmental risk factor for ill-health worldwide and an important contributor to climate change. There

is recent, compelling evidence that switching to near-exclusive use of cleaner fuels such as liquified petroleum gas dramatically reduces HAP exposures. However, successful, at-scale implementation of clean cooking interventions has been limited, and few studies have evaluated the impacts of electric induction cooking,

arguably the cleanest household cooking solution. We will address these gaps by conducting the first large-scale implementation and effectiveness evaluation of induction-based clean cooking interventions among low-income households in peri-urban Cambodia. We will use implementation science methods and apply tested

frameworks to establish a rigorous, transferable, and reproducible evidence base. We will conduct formative research to assess barriers to and enablers of purchase and use of induction stoves, and refine and rapidly prototype implementation strategies for our context (SA1). We will employ a four-arm, hybrid type II cluster

randomized trial to test intervention strategies to transition households away from biomass fuels towards exclusive clean cooking. Trial arms will include direct sales, public sector promotion, and fuel and stove subsidies (SA2). Among a subset of our participants, we will measure the primary cook’s exposure to HAP before and after

introducing induction stoves, providing evidence on the exposure-reducing potential of our intervention strategies. We will provide paradigm-shifting evidence of (a) the viability of electric cooking in areas that can support it, accelerating the transition towards clean household energy for billions, and (b) the cost, benefits, and

effectiveness (SA2 and SA3) of these strategies to encourage uptake and sustained use of clean cooking. By providing evidence of successful implementation strategies and their effects on exposure to household air pollution, this study will serve as a model and motivation for adoption and scale-up of similar

programs across South and Southeast Asia and beyond.