Opportunities for Transition to Clean Household Energy Application of the WHO Household Energy Assessment Rapid Tool (HEART)

Opportunities for transition to clean household energy Application of the WHO Household Energy Assessment Rapid Tool (HEART)

GHANA GHANA Opportunities for transition to clean household energy Application of the WHO Household Energy Assessment Rapid Tool (HEART) GHANA Opportunities for transition to clean household energy: application of the Household Energy Assessment Rapid Tool (HEART) in Ghana

ISBN 978-92-4-151402-6

Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”.

Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.

Suggested citation. Opportunities for transition to clean household energy: application of the Household Energy Assessment Rapid Tool (HEART) in Ghana. Geneva: World Health Organization; 2018. Licence: CC BY- NC-SA 3.0 IGO.

Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris.

Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing.

Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user.

General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.

Printed in Switzerland

Design and layout: Paprika, Annecy

Cover photo: Heather Adair-Rohani (WHO) Contents Annex. 9. 8. 7. 6. 5. 4. 3. 2. 1. Preface Acknowledgements Abbreviations andacronyms References Discussion Introduction 7.3 7.2 7.1 6.5 6.4 6.3 6.2 6.1 5.3 5.2 5.1 4.4 4.2 2.2 4.3 4.1 3.1 2.1 Conclusions andrecommendations Social interventions Stakeholder organization andcoordination Household energy: the current situation Health sectordata Country context LPG-related regulations inGhana �� Recommendations tothehealth sector for accelerating thetransition Opportunities for introducing cleanhousehold energy Barriers toadoptionofclean householdenergy GhanaRural LPGProgramme Health andenvironment information sharingsystem andotherdatasources Free MaternalHealth Services Initiative Ghana SchoolFeeding Programme Livelihood Empowerment AgainstPoverty Bilateral andmultilateral organizations (selectedexamples) Nongovernmental organizations (selectedexamples) Government agencies Perceptions ofsafety ofhouseholdenergy Household energy usefor lighting Demographic andeconomic data Household energy usefor heating Use for cooking Burden ofdiseasefrom airpollution Geographical data �� 35 33 32 28 25 19 30 29 28 27 26 26 25 25 23 22 19 17 17 14 vi iv 7 5 2 1 7 5 3 2 v iii iv Opportunities for Transition to Clean Household Energy in Ghana HAP HESA HEART GSA GIZ GDP acronyms Abbreviations and USAID SNV NPA LPG LEAP

United StatesAgencyfor InternationalDevelopment Netherlands Development Organisation National Petroleum Authority liquefied petroleum gas Livelihood Empowerment AgainstPoverty household airpollution Health andEnvironment Strategic Alliance Household Energy AssessmentRapid Tool Ghana Standards Authority Deutsche Gesellschaft fürInternationaleZusammenarbeit gross domesticproduct and SocialDeterminantsofHealth, Geneva, WHO DepartmentofPublicHealth, Environmental Rohani andJessica Lewis(Technical Officers), The report was reviewed by HeatherAdair- Office, local organizations and government officials. Edwards withinputfrom the WHO GhanaCountry Sarpong, EdithClarke, Karin Troncoso andRufus consisting ofKwaku Poku Asante, KwesiBaffour This report was prepared by ateamofconsultants Acknowledgements Rapid Tool(HEART). application oftheHouseholdEnergy Assessment transition tocleanhouseholdenergy incountries by funding theproject toidentifyopportunitiesfor WHO isgrateful toBloomberg Philanthropies for by ElisabethHeseltine. Switzerland. Editorialassistance was provided

v vi Opportunities for Transition to Clean Household Energy in Ghana cancer, aswell asseriousinjuriesfrom scalding, respiratory illness, cardiovascular diseasesand deaths annually amongchildren andadults from cookstoves causes almost4million premature cooking andheating. Widespread useofpolluting burnt in inefficient, highly polluting stoves for animal dung, charcoal, crop wastes andcoal) income countries, still rely onsolidfuels(wood, 3 billion people, mainly inlow- andmiddle- global environmental health risks today. Almost fuel combustion isoneofthemostimportant Household airpollution (HAP) from inefficient Preface and/or related health impacts. The toolisbeing policies and programmes on household energy relevant stakeholders, andmapoutacountry’s Assessment Rapid Tool (HEART), toidentify WHO hasdeveloped atool, theHouseholdEnergy In support of the implementation of the guidelines, benefits from thecleanenergy transition. environmental andotherissuestoensure health and specialists working on energy, health, technical recommendations for policy-makers household fuelcombustion (2014) provide The WHO guidelinesfor indoorairquality: burns andpoisoning. with polluting fuels, northesocialandpolitical global mappingofdiseaseprevalence associated identifying nationalenergy priorities, nationaland of thedetailedeconomic evaluation required in The rapid assessment does not take the place accelerate a transition to clean household energy. and opportunitiesfor thepublichealth sectorto country-specific barriers to implementation shared responsibilities andcoordinated actions, on theimpactsofhouseholdenergy interventions, impacts andtostimulateaninformed dialogue on household energy use and its public health It isusedtogatherandsynthesizeinformation to address access to clean energy technologies. situational assessmentsofcountries’ readiness pilot-tested asaguidetoconducting rapid presents the results obtainedwith HEART inGhana. support intersectoral cooperation. This report identifies key stakeholders andwill ultimately current householdenergy andhealth situation, energy. It does provide a broad overview of the social interventions tosupportatransition toclean considerations required for implementingmajor vii 1 Opportunities for Transition to Clean Household Energy in Ghana Introduction 1 the negative health impactsofthelackclean, socioeconomic development. Since 2010, deforestation andclimate change and, secondarily, on householdenergy was toaddress issuesof Initially, theprimaryrationale for programmes cooking, electrification andenergy efficiency. categorized intothree intervention areas: clean Household energy programmes inGhanacan be potential areas for support. stakeholders, programme implementationand household energy situation, includingkey for development. This report outlines the current into nationalprogrammes orthenationalagenda however, theseimpactsare notyet integrated efficient household energy have been increasing; Credit: Heather Adair-Rohani  Country context 2.1 2 Source: agro‑ecological zones + and elevation. that vary according todistance from thecoast the year, withtemperatures andrainfall patterns The country hasatropical climatethroughout savannah areas and an evergreen area (Fig. 1). Ghana hasseveral distinctecological zones, e.g. divided into216decentralized districts. regions, whichare further10 administrative an area of about238540km on thewestcoast ofAfrica. The country covers Ghana isalower middle-income country located + Geographical data Fig. 1. reference MapofGhanashowing (1)

2 , dividedinto The ambient temperature is generally high, per year). south, includingthecapital Accra (800mmrainfall per year, andthecoastal savanna areas inthe regions, where therainfall isaround 1000mm year. The driestareas are thenorthernsavannah of thewestcoast, where itreaches 2000 mm per year, andeven more rain falls onasmall portion where precipitation is greater than 1500 mm per The rainiest areas are the coastal evergreen areas, season generally dependsontheecological zone. followed by a rainy season. The duration ofeach the winterperiodintemperate countries andis Ghana hasadryseasonthatcorresponds to the country throughout theyear. to October. The temperature alsovaries across 39°C. The coldest monthsare25 to from June coastal area, daily temperatures range from although it varies throughout theyear. In the

Geographical data 2 3 Opportunities for Transition to Clean Household Energy in Ghana northern regions beingtheleasturbanized. About the populationlives inurbanareas, thethree (Ashanti andGreater Accra, Table 1). Around half population live inGhana’smosturbanizedregions growth rate is 2.3%. A high proportion (35.7%) of the 27.41 million in 2015 Ghana’s population was estimated to be about 2.2 Demographic andeconomic data Ghanaians sitoutsideabuildinghousingstove forsmokingfishthatisdesignedtobemore efficient than traditional methods(althoughemissionsare stillgreater thanthosesafeforhealth) (2) ; the annual population four tiers ofhumandevelopment) is0.579. indicators, whichare usedtorank countries into life expectancy, education andpercapita income human development index (acomposite statisticof 15 years. Life expectancy is61years, andGhana’s 39% ofthepopulationare children younger than Credit: Jessica Lewis  in 2016to6.3%2017. growth rate was projected toincrease from 3.9% income was US$ 1367.70. The country’s real GDP 0.06% of the world economy), and per capita billion in 2015 (representing was US$ 37.543 (GDP) ofGhana, according tothe World Bank, of theeconomy. The gross domesticproduct and theindustrialsectorare themaindrivers services sector (including telecommunications) of itsnationalaccounts. The agricultural sector, middle-income country in2011afterrebasing status changed from developing country to lower the twelfthlargest inAfrica, anditseconomic as thesecond largest economy in West Africa and a diverse and rich resource base. It is recognized Development Goals. The Ghanaianeconomy has progress towards theattainmentofSustainable implementation ofhealth programmes and Economic indicators have implications for the . Source: Accra Greater Central Western Region Ashanti Eastern Volta Total Upper West Upper East Northern Brong Ahafo . Table 1. reference DistributionofGhana’s population (3) total % Of pop. 16.3 19.4 10.7 10.1 100 8.6 8.9 9.6 2.8 4.2 9.4 % Urban 50.90 90.5 47.1 42.4 60.6 43.4 33.7 16.3 30.3 44.5 21 household number of people in Average 4.4 4.1 4.1 4.2 3.8 4.2 6.2 5.8 7.7 4.6 4 per compound/ households number of Average house institutional andlegalframework. a young, vibrant, skilled populationandastrong economy, richendowment ofnatural resources, sustainable growth. This isanchored initsdiverse remain robust withhighpotentialfor long-term boosted investor confidence. Ghana’sprospects general cost ofdoingbusinessinGhanahave of policiesthathave considerably reduced the situation coupled withGovernment implementation business destinationsinAfrica. The stablepolitical Ghana isregarded asoneofthemostattractive stood at70%in2016. 13% inApril2017. The county’s debt to GDP ratio sustained downward trend, from 17%in2014to trading currencies. However, inflationsaw a and thedepreciation of the cedi against major owing tofactors suchasincreasing fuelprices Ghana’s inflation rate remains in double digits 1.6 1.5 1.2 2.2 1.5 1.5 1.3 1.6 1.2 1.5 2 compound pop. per Average house/ 7.3 6.1 5.3 8.4 6.4 6.3 8.3 8.5 9.2 9.6 7 total literate pop. outof 11 years + % Literate pop. aged 74.1 21.2 21.9 11.7 8.5 9.3 9.9 1.7 2.6 4.5 8.7 pop. outof 11 years + % Literate pop. aged regional 73.4 89.2 78.1 76.4 46.2 47.5 37.1 69.8 82.6 81

Demographic and economic data 4 5 Opportunities for Transition to Clean Household Energy in Ghana Health sectordata 3.1 3 14 000premature deathsperyear technologies aloneisresponsible for more than from cooking mainly with polluting fuels and year (Table 2). Householdairpollution (HAP) per are responsible for almost 23 000 deaths effects of household and ambient air pollution for premature deathinGhana. The combined Air pollution isoneoftheleadingriskfactors from respiratory illnesses inchildren in2012 7796 deaths from stroke inadults and4238 deaths fuels isestimatedtohave beenresponsible for In particular, HAP from cooking with polluting Source: Ghana, 2015 . Alcohol anddruguse Dietary risks pressure High systolic blood Air pollution malnutrition Child andmaternal Risk factor . Burden ofdiseasefrom airpollution Table 2. reference Smoke risesfrom aseriesofstoves usedtosmoke fishinacoastalcommunity. Credit: Jessica Lewis Riskfactors for premature deathsin (5) Premature deaths/year (4) . 15 434 16 633 21 230 22 396 22 988 household airpollution, 2012 . estimates suggest. burden islikely tobemuchlarger thanprevious exposure toairpollution. Thus, thetotalhealth growing globalbodyofevidence oflinkage with other diseaseoutcomes for whichthere isa (Table 3). Inaddition, there are anumberof diseases inGhana(Fig. 2). are three ofthe15mostimportantcauses of heart disease, whichare associatedwithHAP, Lower respiratory infections, stroke andischaemic Source: DALY: disability-adjusted life year. Cardiovascular disease Stroke Disease 5 years) infection (children under Acute lower respiratory tract Lung cancer pulmonary disease Chronic obstructive . Table reference 3 . Burden ofdiseaseattributed to (2) . 136 950 219 797 386 164 46 016 DALYs 4 257 Deaths 4 462 7 796 4 238  832 134 Mental &substanceusedisorders households. Kerosene poisoning is the most used for lightingcan posesignificant risks to For example, polluting fuelsandtechnologies risks inthehomethatare lesswell characterized. with polluting fuels on simple stoves poses other In additiontothesehealth outcomes, cooking Source: + + Fig. 2. Lower respiratoryinfections reference Ischaemic heartdisease Nutritional deﬁciences The 15mostimportant causesofdeathinGhana, 2015 Congenital anomalies Malignant neoplasms Diarrhoeal diseases Parasitic andvector Digestive disease Unintentional inj (4) . Tuberculosis Meningitis HIV/AIDS Neonatal Stroke Other 0.0 LPG cylinders usedforcookingare oftentransported by motorbike inGhana. 5.0 Deaths (thousands),2015 10.0 morbidity associatedwithcooking reported above. high, theseare notincludedintheestimatesof of burnsandinjuryfrom household fueluseis domestic settinginGhana. Although therisk common cause ofchildhoodpoisoninginthe 15.0 Credit: Heather Adair-Rohani 20.0 25.0  30.0

Burden of disease from air pollution 6 7 Opportunities for Transition to Clean Household Energy in Ghana the current situation Household energy: 4.1 4 and technologies(mostly firewood, 41.3%, of householdscook mainly withpolluting fuels cooking in Ghanaian households. About 76% Solid fuels remain the main energy source for . liquefied petroleum gas(LPG). In Accra, themost About 22%ofall householdsinGhanacook with extremely high(94%)(Table 4). primary useofpolluting fuelsfor cooking is and charcoal, 31.5%). In rural areas ofGhana, 4.1.1. technologies fuels and Clean technologies fuels and Polluting . Use for cooking Table

Cooking fueluse 4 . Primary householdcookingfuel(percentage Primary ofhouseholds) Electricity LPG Kerosene Crop residue Charcoal Wood Fuel type Urban Accra 52.7 38.9 0.6 0.5 0.8 0 Other 45.8 20.5 0.5 0.1 0.2 28 urban 35.8 43.6 14.3 0.5 0.2 0.1 All source inavery small fraction ofGhanaian Electricity isusedastheprimarycooking energy to food prepared usingLPG. even whenthere isnoflavour difference compared a preference for food cooked withcharcoal, fuel mix, andlessLPG. Householdsoftenhave fuelwood andcharcoal includedinthehousehold than Accra, there issignificantly more useof households cook with LPG. Inurbanareas other primary fuels. Inall urbanareas, around 35%of urban area inGhana, charcoal andgasare the households (lessthan1%)(Fig. 3). Rural Coastal 57.6 0.1 9.8 0.3 30 0 Forest 17.9 72.4 0.1 6.7 0.1 0.1 Savan 87.4 nah 0.1 1.3 0.1 2.2 7.6 - rural 16.5 74.8 0.1 5.5 0.1 0.7 All Ghana All 22.3 31.5 41.3 0.1 0.2 0.4 fuel use in Ghana. In particular, biomass and are additional geographical variations incooking Beyond simpleurbanandrural distinctions, there Source: + Charcoal 32% residues 0% LPG 22% + Fig. 3. Electricity 0% reference Crop Primary cookingfuelsusedby householdsinGh Primary (6) . Kerosene 0% No Cooking4% Firewood 42% Wood beingchopped in acoastalcommunityGhana. in thesoutherncoastal regions (Fig. 4). regions, whereas charcoal and LPG predominate agricultural residues are usedmore innorthern solid fuelsorkerosene 94% cookmainlywith 46% ofthepopulation live inruralareas ana Rural solid fuelsorkerosene 62% cookmainlywith 54% ofthepopulation live inurbanareas Credit: Jessica Lewis Urban 

Use for cooking 8 9 Opportunities for Transition to Clean Household Energy in Ghana of thefuelwood harvested inthisregion isnot in the south-west of the country. A larger fraction The availability ofsolidfuelsisparticularly limited Source: and coastal areas rely more heavilyoncharcoal andLPGfor cooking. householdsprimarilycookwithwood andcropthat northern residues, whilehouseholdsinurban + + Fig. 4. reference Geographical variation inmainfuelusedfor cookingby householdsinGhana, showing (3) . (Fig. 5). deforestation and environmental degradation renewably harvested, therefore contributing to technologies for cooking (aphenomenontermed Many householdsusemultiple fuelsor Source: fNRB: fraction ofnon-renewable biomass;LULCC: landuseandcover changes. + + Fig. 5. reference Fuelwood andrenewability harvesting (top panel)andcharcoal cost(bottom panel) (3) . technologies used differs based on geography “stove stacking”). The particularmixof fuels and 10 Use for cooking 11 Opportunities for Transition to Clean Household Energy in Ghana capacity toproduce 45000barrels aday, was shut only oil refinery, the Tema Oil Refinery, with a Regarding LPGcapacity, outputfrom Ghana’s cooking stoves andethanolfuels. available for cooking inGhanaare LPG, electric Clean householdenergy alternatives currently technologies for cooking. number ofhouseholdsusingpolluting fuelsand are likely tobeanunderestimate ofthetotal reported here for primaryormainfuelused and theavailable resources Thus, thestatistics but withreduced capacity. after reconfiguration through asecond furnace, meantime there are proposals torestart theplant on buildinga200000barrel-a-day plant. Inthe Tema Oil Refinery will complete studies next year underinvestment, lack of maintenance and debt. below capacity for decades, reportedly dueto furnace. The refinery, however, has performed due to damper failure, which destroyed the installed, €5.8million crudeoilheatingunit in January 2017afteranexplosion atanewly 4.1.2.

Clean cooking capacity In contrast, cooking innorthernregions tends spaces tendtobeshared orunderverandas. density, suchassouthernurbanareas, cooking and verandas. In areas with higher population tend tocook inseparate rooms orundercanopies In Ghana, householdslocated incoastal regions the suitability of interventions for different regions. Cooking location can affectthelevel of exposure and local capacity. however, committed toensuringanincrease in energy isunlikely. The Government ofGhanais, rapid scaling up to provide LPG for household build newplantsinorder toincrease local capacity, increase LPGsuppliesthrough importsandto Given thesignificant investment required to adjacent tothehome(Fig. 6). northern region, cooking is done inan open space upper westernregions, underaveranda. Inthe without aroof, and, intheuppereasternand to bedoneinaseparate room oranenclosure 4.1.3.

Cooking behaviour Wood collectioninAccra, Ghana. Credit: Gettyimages  of providing improved cooking devices to decrease “Ahibenso coalpot programme”, with the objective in thelate1980s, withtheMinistryofEnergy’s deforestation. Cookstoves began tobeproduced view oftheenvironment, especially with regard to use, particularly for cooking, from thepointof Ghana hasviewedtheissueofhouseholdenergy Source: + cooking 4.1.4. Ahibenso CoalpotProgramme + Fig. 6. reference

Programmes onhousehold Regionaldifferences in cookingspacesinGhana (3) . the dependence of households, catering services promotion programme toreduce deforestation and the MinistryofEnergy introduced anationalLPG deforestation intheAfrican region. In1989, Ghana has had one of the highest levels of Mass disseminationofthestove beganin1992. the mostappropriate for the Ghanaianmarket. been tested, theAhibensocoalpot was chosenas viable improved charcoal stove modelshad Programme ofthe World Bank. After several with theEnergy SectorManagementAssistance by theNationalEnergy Board incollaboration The programme was plannedandimplemented the demand for wood and slow deforestation. National LPGpromotion programme 12 Use for cooking 13 Opportunities for Transition to Clean Household Energy in Ghana reverted totraditional fuels, particularly charcoal. the LPGsupply, andmany domesticconsumers users. Consequently, there were shortagesin of the demand of commercial and domestic Oil refinery, was abletomeetonly afraction refinery andstorage facility for LPG, the Tema distribution was inadequate. The onenational in Ghana, theinfrastructure for greater LPG increasing thedemandandconsumption ofLPG Although thisprogramme was successful in and prisons. installation toeducational institutions, hospitals was laterextended toprovide free cylinders and LPG distribution and delivery. The programme free LPGcylinders tothepublicandimproved and small-scale food sellers onwood. Itprovided low flame. many dishesrequire long cooking timesover a the staple foods eaten in Ghana. For example, technologies must be well suited to preparing biomass cookstoves. The designofcleanstove More than96companies inGhanamanufacture and supportfor policy development. professionals, supporttostove manufacturers campaigns for community members and health improved cookstoves, including awareness-raising programmes topromote biomassfuelusein for CleanCookstoves andFuels organizes standards for cookstoves. The GhanaAlliance and IndustrialResearch) andtodevelop national institutions (for example, the Centre for Scientific biomass cookstoves incollaboration withresearch The Government has worked to promote improved Cookstoves’ CountryAction Plan. as catalyst for theGlobalAlliance for Clean Sustainable Energy for All Initiative andserved Plan oftheUnitedNationSecretary General’s prioritized intervention inthecountry’s Action Promotion of cleanercooking solutionswas a transport sector. over one third ofall LPGconsumption was inthe it cost lessthangasoline;accordingly, by 1998, transport sector. Owingtothesubsidyfor LPG, The programme had an unexpected benefit for the National Action Plans Global Alliance for CleanCookstoves Sustainable Energy for All andthe of LPGasasubstitutefor charcoal andfirewood. LPG Promotion Programme toensure wideruse In 1990, theGovernment introduced theNational through LPGsubsidiesandelectrification. has encouraged cleanhouseholdenergy primarily country actionplans. Since then, theGovernment All Initiative andtheGlobalAlliance’s cleancooking during development ofthe SustainableEnergy for The linkbetweenhealth andHAPbecame anissue and efficiencyofthesectorwithinGhana. It will extend itsactivitiestoincrease theregulation management for sustainablecharcoal production. various partners tointroduce asystem ofwoodlot Government onenergy matters, isworkingwith renewable energy industriesandadvisesthe regulator ofGhana’selectricity, natural gasand The Energy Commission, whichisthetechnical Project, which startedin1990to substitute National Liquefied Petroleum Gas Promotion The rural programme isanextension ofGhana’s with arural LPGprogramme in2014. The subsidywas discontinued in2013andreplaced Ghana’s Rural LPGProgramme Different improved stove andclean fuel modelsare demonstrated. Credit: HeatherAdair-Rohani  the censusfindings are presented here. showed a decrease in nationaluse of kerosene; however, the sample size of the survey was muchsmaller thanthat ofthe census, and thus 1 Source: + lighting source for about 15% of all households in portable lightingdevices oftenserve asthemain of Ghana. Battery-operated torches andother to thenationalgridislowest inthenorthern belt in rural households (40%). this source isgreater inurbanareas (84%)than about 65%ofall householdsinGhana The nationalgridisthemainsource oflightingfor stakeholders toimplementtheprogramme. The Ministry of Petroleum coordinates various 2014 tomainstream LPGuseintorural households. The Rural LPGProgramme was launchedinearly and thereliance onbiomassfuelishigher. rural areas, where themajorityofGhanaianslive programme, LPGisalsobeingintroduced inpoor had littleimpactinrural areas. Underthenewer focused mainly onurbanareas andtherefore more than50000mT in2000–theprogramme 5000 megatonnes (mT) per annum in 1989 to of LPG consumed nationwide – from a littleover had some success in terms of increased tonnage Although the earlier nationalLPG programme and environmental advantages over other fuels. businesses. LPG was promoted ashaving health LPG for woodinhouses, schoolsandsmall 4.2.1. 4.2 Flashlight battery15.7% The GhanaLiving Standards Survey Round 6(conductedin 2013), whichprovides updated statisticsfrom the2010national census, + Fig. 7. Kerosene 17.8% reference

Lighting fuel Household energy usefor lighting Primary lightingfuelsusedinhouseholds inGhana Primary Gas 0.2% Solar 0.2% (3) . 1 In rural areas, access Generator 0.7% (2) . Useof Candles 0.8% Electricity 64.2% cylinders provided through theprogramme. and nodataare available onthenumberofLPG systematic monitoringandevaluation strategy, At present, theRural LPGProgramme hasno the beneficiaries. intended beneficiaries(i.e. households)were not as afuel, andthesubsidywas scrapped, asthe commercial vehicles andtaxisstartedusingLPG initially subsidizedfor domesticuse. Then, To increase LPG use in rural areas, LPG was vendors intheirdistricts. are responsible for procuring LPG from local cylinders are distributedfor free, andresidents about 40districts. Ineachdistrict, 2000–4000LPG however, theprogramme hadbeenextended to introduced only in the northern district; by 2016, At itsinception, theRural LPGProgramme was urban homes, 0.3%inrural homes). very few households(0.2%nationally, 0.1%in Solar energy isusedasa source oflightingby and easternregions. national population, especially inthenorthern kerosene, whichisusedby closeto18%ofthe The third mostcommon source oflightingis to lighttheirhomes. rural areas, where 30%ofhouseholdsusetorches Ghana (Figs 7 and 8). This figure is even higher in

14 Household energy use for lighting 15 Opportunities for Transition to Clean Household Energy in Ghana Source: + + Fig. 8. reference Geographical fuelsusedfor distributionofprimary lightingby householdsinGhana (3) . Source: + businesses, reducing salesby over 5%in2014(7). Electrical outages have a significant impact on still lacked access toelectricityin2012. made notableprogress, about7million people an electricitysupply (Fig. 9). Although Ghanahas A numberofvillages inGhanastill do nothave Source: . technologies Clean fuelsand technologies Polluting fuelsand . + Fig. 9. Table 5. reference reference Villages inGhanawithoutelectricity Mainsource oflightinginhouseholds Ghana(percentage ofhouseholds) (3) (2) . . Other Generator Electricity Solar energy LPG lamp Crop residue Firewood Torch Candle Kerosene Fuel type All Ghana 64,2 15,7 17,8 0,2 0,7 0,2 0,2 0,1 0,2 0,8 technical support. the Government provided additionalfinancialand national gridconnections. Inthesecommunities, commitment by installing low-voltage polesfor voltage networkandthathadalready shown located withinareasonable distance ofamedium- national electrification schemein communities help electrification programme” toaccelerate the In 1990, Ghana instituted a complementary “self- rural electrification programme. fund established to support introduction of the collected were paidintoanationalelectrification electrification levy was instituted, and thelevies instituted to replace the 1970policy. A national In 1989, anational electrification scheme was and increasing economic activityinrural areas. as ameansofreducing urban–rural inequalities Ghana in 1970 to bring electrification torural areas A rural electrification programme was initiated in lighting andelectrification 4.2.2. Self-Help Electrification Programme National Electrification Scheme All Urban

Programmes onhousehold 83,8 0,2 0,6 0,1 0,1 0,1 5,5 1,1 8,4 0 Urban: Accra 87,1 0,2 0,6 0,1 0,1 0,1 3,9 1,9 5,9 0 All Rural 39,5 28,6 29,5 0,3 0,7 0,3 0,2 0,1 0,4 0,3 16 Household energy use for lighting 17 Opportunities for Transition to Clean Household Energy in Ghana distribution ofelectricitythroughout thecountry. entail enhancingthegeneration, transmission and in every partofthecountry by 2020. This will goal ofmakingelectricityaccessible topeople Electrical Company of Ghana, withtheultimate intheoperating areas ofthe in 26 districts about 59000newcustomers in530communities is toextend electricity power linestoconnect The aimofthepresent electrification scheme household burns for some time. An analysis of Teaching Hospitalhasbeencollecting dataon are generally scarce, however, theKomfo Anokye studies onthesafety ofindividual energy sources of clean household energy in Ghana. Data from fuels andtechnologiesare abarriertotheuptake Perceptions of the risks of different household the northernareas, although nodataare available There is reportedly limited demand for heating in 4.4 4.3 Perceptions ofsafety ofhouseholdenergy Household energy usefor heating flames from LPGinthesechildren from solid fuel was almost double that caused by and the number of burns caused by fire or flames the mostcommonly affectedgroup (Fig. 10) scalds, andchildren lessthan10years oldwere open fires were themain causes ofburnsand data onburncases from 2009–2013, showed that fuels used. to quantifytheextent ofhouseholdheatingor Soot from useofthestove hasblackened thewalls. A traditional biomasscookstove outsideahome. Credit: HeatherAdair-Rohani (9) .  (8) , module, LPGbottlingplantswill besitedaway from distribution atLPGbottlingplants(10,11). Inthis including useofarecirculation modelof has therefore mandatedregulatory measures, a significant riskof explosions. TheGovernment use ofLPG(includingfaulty cylinders) can incur and technologies, like LPG. Inaddition, improper and thegreater safety of cleanhouseholdfuels children for burnsfrom householdenergy sources further raised inthecommunity abouttheriskof These datasuggestthatawareness shouldbe Source: + Scalds 225 + Fig. 10. Chemical 17 reference Electrical 13 EtiologyofburnsatKomfo Anokye Teaching Hospital, 2009–2013 (8) . Stevens -Johnsonsyndrome11 Candles 0.8% ﬂame 221 Open ﬁre/ of theirproficiency inmeetingthe required safety will be classified into low or high risk on the basis households through retail outlets. Existingstations cylinders tobedistributedconsumers and and will procure, brand, maintainandfill empty congested commercial andpopulationcentres only, withimproved safety standards. found tobelow riskwill supply gasfor vehicles cylinder retail and distribution outlets, and those found tobehighriskwill beconverted intofilled standards in continual riskassessments. Those 18 Perceptions of safety of household energy 19 Opportunities for Transition to Clean Household Energy in Ghana and coordination Stakeholder organization 5 development, amongothers. The key roles and related to environment, health andsocial Household energy useisacross-cutting issue, • • sector incollaboration withotherinstitutions: are beingorhave beenimplementedby thehealth and MinistryofEnergy. The following programmes programmes oftheMinistry of theEnvironment ensure health protection withinthepoliciesand address HAP; however, the sector is working to There are currently nohealth sectorpolicies to conducting research. committees and with academic institutions in with otherministriesthrough interministerial of theMinistryHealth. This unitcollaborates Health UnitoftheGhanaHealth Service, anagency addressed by theOccupational andEnvironmental Since 1998, theairpollution agendahasbeen of thehighburden ofdiseaseattributedtoHAP. consider HAPacritical health problem, inview The Government ofGhanaanditsMinistryHealth 5.1.1. 5.1 cooking environments. (especially thoseunder5years) outofsmoky and charcoal indoors andkeeping children of vehicles, avoiding cooking withfirewood change attitudeswithregard toregular servicing in educational materialsand for advocacy to links with air quality. The results were used Data collected over 1 year were analysed for infections amongchildren under5years old(13) Study ontheoccurrence ofacuterespiratory reported by outpatient departments in Accra (12). quality parameters and respiratory diseases Determination oftheassociationsbetweenair

Ministry ofHealth Government agencies . • of cleanhouseholdenergy are presented below. programmes ofsomestakeholders intheprovision for Clean Cookstoves. All policies related to Development Programme and the Global Alliance with technical supportfrom theUnitedNations Action Plan, which was launched in May 2013 is theGhanaSustainable Energy for All (SE4ALL) Ghana’s workingdocument onhouseholdenergy policies topromote householdenergy. Currently, agencies. The Ministry ofEnergy isresponsible for Energy and implemented through directorates and programmes are ledmainly by theMinistryof Ghana’s householdenergy policiesand study inKassena-Nankana District. in aninterdisciplinary randomized intervention Ghana attheNavrongo Health Research Centre climate and cooking technologies innorthern Platform; and research on emissions, air quality, Research Centre’s Environmental Health Research function amongchildren by theKintampoHealth as low birthweight, pneumoniaandpulmonary of theeffectsHAPonhealth outcomes such Ghana Health Service, includinganassessment The health sectorsupportsresearch withinthe 5.1.2. Alliance for CleanCookstoves andtheUnited Health Service in2016, sponsored by Global its effectsonhealth was organized by theGhana Training ofhealthpersonnel 2017 topilot-test materialsonHAPandhealth. Another course was organized by WHO in May States Agencyfor InternationalDevelopment.

Ministry ofEnergy . Acourse onHAPand LPG. Inthearea ofhouseholdenergy, theNPA is including transport andindustrialfuels and distributionofrefined petroleum products, refining ofcrudeoilandthesale, marketing is responsible for regulating importationand The National Petroleum Authority (NPA) on energy matters. energy industriesandadvises theGovernment of Ghana’selectricity, natural gasandrenewable Ghana. The Commissionisthetechnical regulator manage anddevelop useofenergy resources in Commission Act, 1997(Act 541)toregulate, set upby anAct ofParliament, theEnergy environment thatencourages thedistribution of technologies inGhanaand tocreate amarket manufacture and distribution of clean energy enable theprivate sectortoparticipateinthe based solutions. The aimoftheproject is to clean energy through establishment ofmarket- Appropriate MitigationActions on access to the national coordinating agency for Nationally to sustainable development. The Ministry is also technology activitiesandtheenvironment related leads, coordinates andregulates science and Among other responsibilities, the Ministry the Annex. They are describedbelow andinmore detailin the promotion ofaccess tohouseholdenergy. plans have beenorare beingimplementedfor Several sectorpolicies, masterplansandaction directive oftheMinistry. responsible for planstosupportany LPGpolicy The Energy Commission The key implementingagenciesare: • • • impact objectives for immediateactionare: indicators for Ghana SE4ALL. The three high- household energy contribute toachievingthe Science, Technology andInnovation 5.1.3. access tomodernenergy for cooking. (such asgenerating income); and access tomodernenergy for productive uses power solutionsfor remote communities; provision ofoff-grid, renewable energy-based

Ministry ofEnvironment, . The Commission was .NPA The fuel. One of the six thematic areas of the Graduate piped toacookstove for useasacleancooking released during anaerobic digestion, and this is viable market. Biogasdigesters capture thegas and hospitalswiththegoalofestablishinga digesters inpublicboarding schools, prisons agency for aprogramme toinstall 200biogas household energy, the Agency is the coordinating air pollution monitoringandtraining. Intermsof emissions and for initiatives such as ambient is responsible for regulating environmental is theEnvironmental Protection Agency Environment, Science, Technology andInnovation One ofthe expected tobedistributedinGhanathisway. good for health) and250 000LPGcookstoves are efficiency than traditional optionsbut probably not million energy cookstoves (stoves with greater fuel by anappropriate financingmodel. Aboutone clean energy technologies to users, supported policy totheGovernment ontrade andtoformulate The role ofthisMinistryistoprovide advice on use ofbiomassfuel. emissions from deforestation through sustainable been implementingtheREDD+strategy toreduce related tothem. Since 2012, the Commission has those resources andcoordination ofpolicies resources, conservation and management of the regulation ofuseforest andwildlife an agency of the Ministry, is responsible for mineral resources. The Forestry Commission, wildlife, aswell as efficient managementofits management anduseofGhana’slands, forest and This Ministryismandatedtoensure thesustainable production andtheuseof improved stoves. effects of wood use as fuel, sustainable charcoal management”, whichhasaparticularfocus onthe Entry Medical Programme is“Energy resources Industry 5.1.5. Natural Resources 5.1.4.

Ministry of Trade and Ministry ofLandand agencies oftheMinistry , which 20 Government agencies 21 Opportunities for Transition to Clean Household Energy in Ghana work ofISO’s Technical Committee285, which a labelling system for cookstoves, in line with the ISO 22991. Itispreparing asetofstandards and gas cylinders toascertain theirconformity with various testsonrandom samplesofimported and tubing. The Standards Authority conducts LPG andGSISO13341for valving, regulators standard GSISO22991for gascylinders for the InternationalStandards Organization’s (ISO) national standards. The Authority hasadopted to ensure system certification and to develop Ministry of Trade andIndustrywithamandate Ghana Standards Authority trade andindustry. and development ofdomesticandinternational and implementpoliciesfor thepromotion, growth external andinternalresources and planningand preparing budgets, mobilizingandallocating The MinistryofFinance isthekey ministryin such asalcohol, for cooking. of sustainableproduction anduseof biofuels, agro-processing. Other opportunities include use use for irrigation, post-harvest infrastructure and on renewable energy includesactivitiessuchas and windare particularinterests. Current work Renewable power derived from biomass, the sun and research andtechnologyfor agribusiness. This Ministryfocuses onsustainableagriculture indoor emissions, fuelefficiencyandsafety). attributes ofcookstoves (i.e. overall emissions, is preparing standards for various performance 5.1.7. Agriculture 5.1.6.

Ministry ofFinance Ministry ofFood and is an agency of the including HAPinnationalmedium-termplans. development plans. Interest hasbeenshown in development policyframework andmedium-term policy andstrategy. Itprepares anational advises the President on development planning The National Development Planning Commission socioeconomic effects. of the environment and not necessarily health or to viewhouseholdenergy from thepointofview implementing fiscal policies. The Ministrytends their benefits for womenandchildren and for men. clean household fuels and technologies because of This Ministrycould beanimportantadvocate for education, income-generation andotheractivities. firewood, resulting inmore opportunities for time thatwouldotherwisebeusedincollecting exposure toharmfulsmoke. Itwouldalsofree health, safety and livelihoods by reducing their clean cookstoves, could greatly benefittheir safe, efficient household energy, particularly and technologiesinthehome, anduseofclean, disproportionately affected by polluting fuels and preparing meals. Consequently, they are traditionally responsible for collecting firewood disability. InGhana, womenandchildren are children, vulnerable peopleandthosewitha survival, socialprotection anddevelopment of gender equalityandequitypromote the and SocialProtection istocoordinate andensure The mandateoftheMinistryGender, Children 5.1.9. Planning Commission 5.1.8. Children andSocialProtection

Ministry ofGender, National Development adoption ofcleancooking solutions. awareness aboutHAPandencouraging the is anAmbassadorfor theAlliance andisraising lady of Ghana, Mrs Hadjia Samira Bawumia, Alliance alsosupportsresearch. The second cookstoves in Ghana, a country in which the These activitieswill encourage theuseofcleaner • • • cooking solutions. InGhana, theAlliance is: global market for clean, efficienthousehold private andnon-profit partners tocreate a thriving the environment. The Alliance works withpublic, improve livelihoods, empower womenandprotect by theUnitedNationsFoundation tosave lives, The Alliance isapublic–private partnership hosted Cookstove 5.2.1. examples) 5.2 labelling andmoderntestingcentres. helping to develop local policies, standardization, about theadvantages ofcleancookstoves and educating studentsandhealth professionals building the capacity of local stove manufacturers,

Global Alliance for Clean Nongovernmental organizations (selected cooking fuelsandtechnologies. The organization community abouttheimportance ofefficient, clean and knowledge oflocal actors andthebroader and consumers. It strengthens the awareness facilitate access tofinance for stove manufacturers and performance of local cookstoves andto of cookstove users in Ghana and thedurability understanding of the needs and preferences is tosupporttheAlliance by creating better implementing partneroftheAlliance. Itsaim This nongovernmental organization isalocal as agentsofchangefor cleancooking inGhana. of cleancooking andbuildtheircapacity toserve provide aplatform toeducate girlsonthebenefits of changeintheworld. The Associationcould and leadwhilealsoempowering themtobeagents opportunities for girls and young women to grow The objective oftheAssociationistoprovide clean cooking. policy andclimatechangeprogramme goalsfor also supportstheGovernment’s renewable energy Cookstoves andFuels 5.2.2. Association 5.2.3.

Ghana Alliance for Clean Ghana GirlGuides 22 Nongovernmental organizations (selected examples) 23 Opportunities for Transition to Clean Household Energy in Ghana livelihoods and access basic services. Up to connections they require to improve their stakeholders withthetools, knowledge and Netherlands. It equips communities and local SNV is the development organization of The so thatitismore operational andfinancially sector, by strengthening theAlliance’s secretariat to provide strategic supporttothecleancooking Clean Cookstoves and Fuels haslaunchedaproject and incollaboration withtheGhanaAlliance for In termsofhouseholdenergy, SNV through EnDev quality requirements. providing local producers with specifications and and adoptionoflarge-scale improved stoves by to minimize some of the barriers to production and parboilingof cookstoves for fishsmoking, with local stove builders to make three improved initiatives toimprove access toenergy includework technology, the Thiaroye technique(14). OtherSNV with researchers todevelop amore efficient Organization of the United Nations (FAO) worked health risks, SNV and the Food and Agriculture into the environment and food. To mitigate such high levels ofpolyaromatic hydrocarbons emitted risks toproducers andconsumers because ofthe kiln, although fastand economic, presents health important export for Ghana. The Chorkor Smoker preparing smoked fish, alocal stapleandan and Chorkor fishsmokingstoves are used for coastal area ofGhana, about 120000traditional According to research conducted by the SNV in the cassava, brewing local beerorsmokingfish. for income-generating uses, such as for roasting now, SNV hasprimarily focused on cookstoves Organisation (SNV) 5.3.1. (selected examples) 5.3

Netherlands Development Bilateral andmultilateral organizations pita , shea andrice. The aimis gari processing on cleanfuelsortechnologiesthat protect health. has beenonmore efficient cookstoves ratherthan To date, muchofthework of theseorganizations in Ghana. analysing thepenetration ofdifferent cookstoves cookstove and household energy actors and sustainable, organizing annual forums for local for programme implementers and policy-makers. a project for translating research intoevidence the health impactsofhouseholdenergy through supported training of health professionals on civilian foreign aid. With theAlliance, USAID has USAID isresponsible primarily for administering through grid extension or renewable energy (16). in micro-, small andmedium-sizedenterprises primarily for electrification for productive uses development” programme in Ghana have been Interventions withintheGIZ“energising sustainable economic development (15). has focused onagriculture, governance and In Ghana, GIZ, theGermandevelopment agency, international cooperation for over 30years. Ghana hasbeenapartnercountry for German Internationale Zusammenarbeit 5.3.2. International Development 5.3.3. (GIZ)

Deutsche Gesellschaft für United StatesAgencyfor Inside ashopforrefilling cylinders in Accra, anoldnewspaper article warns that cylinders shouldnotbeusedformore than10years. Credit: HeatherAdair-Rohani  24 Bilateral and multilateral organizations (selected examples) 25 Opportunities for Transition to Clean Household Energy in Ghana Social interventions 6 capacity and willingness to achieve equity. programmes are inplace can indicate acountry’s to vulnerable populations. Thus, knowing which be an effective channel for transferring resources programmes. Socialwelfare programmes can Ghana has a number of social intervention attending publicnurseries and primaryschools. and prepared by local caterers for children meal each day made from locally grown foodstuffs The Programme provides onehot, nutritious production in poorer communities (18,19). school enrolment andincreasing local food reducing hungerandmalnutrition, increasing Ministry ofSocialProtection isapilotproject for The GhanaSchoolFeeding Programme ofthe basic household consumption and nutrition, The objectives oftheprogramme are toimprove people andvulnerable pregnant women(17). people withsevere disabilities, extremely poor old)withoutproductive capacity, (> 65 years including young children (< 5 years old), the elderly and mostvulnerable populationsinGhana, poverty andimprove thelives ofthepoorest Children andSocialProtection, works toreduce (LEAP) programme, ledby theMinistryofGender, The Livelihood Empowerment AgainstPoverty 6.2 6.1 Ghana SchoolFeeding Programme Livelihood Empowerment AgainstPoverty increase access tohealth care services, increase programmes are describedbelow. Selected examples of social intervention be integrated. for the adoption of clean household energy could populations, additionalobjectives andincentives As suchprogrammes are targeted tospecific in thecommunity for cleancooking. reduce HAP and encourage local chefs to advocate use ofcleanerfuelsfor food preparation could used for preparing meals. Institutionalizingthe Currently, firewood is the fuel most commonly by amultidisciplinary team. institutions, isimplementedin all 216districts all children inpublic pre-primary andprimary The Programme, whichreaches nearly 40%of populations atthemostriskfrom HAP. making cleanhouseholdenergy available tothe districts of Ghana and could be a usefulentry to populations. LEAPhasgrown tocover all 216 members in the above-mentioned vulnerable in extreme poverty andthosewithoneormore social cash grants are provided tohouseholds beneficiary households. To meet these objectives, facilitate access toservices like welfare among school enrolment, attendance andretention and platform for accessing health, environment and overseen by Ghana Health Services, is a versatile The Health Information Exchange, whichis to contact withover 80%ofall pregnant women primary health care benefits. Thispolicyhasled childbirth, postnatalvisits, newborncare andother Enrolment includes six antenatal visits, care during Health Insurance Schemepremium andother fees. subsidies toall pregnant womenfor theNational care topregnant womenandnewborns The GhanaHealth Service provides free health 6.3 sharing system andotherdatasources 6.4 Health andenvironment information Free MaternalHealth Services Initiative Community members inspectanewlyconstructedcookstove thatisdesignedtooperate wtih greater fuelefficiency(althoughemissionsmaynotachievesafelevelsforhealth). Living Standards Survey, theDemographic and and energy data sources in Ghana include the related datafrom various sectors. Other health in all health facilitiesinGhana. would becollaboration withmidwives, whowork energy, andonemeansofreaching thispopulation pregnant womenaboutaccess tocleanhousehold malaria control. There isnoprogramme toinform nets toalmostall pregnant women in Ghanafor has alsobeenusedtodeliver insecticide-treated and theirnewbornsinthecountry. The system Credit: HeatherAdair-Rohani  26 Free Maternal Health Services Initiative 27 Opportunities for Transition to Clean Household Energy in Ghana overcome geographical and financial challenges of LPG in rural areas. It is currently working to fully insection4.1.2. Itsaimistoincrease use The Ghanarural LPGprogramme isdescribed Although thesedataare infrequently collected, for general dataonmorbidityandmortality. and otherpartners includingGhanaHealth Service Health Survey andtheGhanaStatistical Service 6.5 GhanaRural LPGProgramme approaches toovercome thesebarriers. also provides opportunitiestotestinnovative of householdsinaccessing LPG. The programme all programmes. of HAPaspartmonitoringandevaluation of they could beusedinmodelling thehealth impact An LPGtankisweighedbefore being sold. Credit: HeatherAdair-Rohani  Discussion 7 the only ethanolproducer in Ghana, recently and increase fuelcosts for households. Caltech, produced locally, which may limititsavailability downstream. Currently, mostethanol is not of biofuelsfaces challenges bothupstream and options inGhana. Asfor LPG, thewidescale adoption ethanol andbiogasare othercleanrenewable fuel Barriers touse of other clean fuels: activity for community members. stations andalsoprovide anincome-generating the accessibility ofLPGinareas withfew filling delivery (e.g. by tricycle) could alsoenhance in communities. Innovative approaches for LPG areas wouldfacilitateaccess toanduseofLPG Increasing thenumberoffilling stationsinrural there are freely available biomassfuelsnearby. less likely touseLPGregularly, particularly if long distances to refill theirLPGcylinders, they are filling stations. Ifhouseholdmembers must travel particularly inrural areas, includetheavailability of Other barriers towiderscale adoptionofLPG, use ofLPG, thecost shouldbereduced. to useLPGregularly for cooking. To encourage play acritical role inthewillingness ofhouseholds use ofLPG: Financial andgeographical barriers toincreasing of charcoal. sale of ethanol, could facilitate the phasing out household energy use, suchasproduction and production oralternative sources ofincome from income. Findingmore efficient methodsofcharcoal of peoplewhorely oncharcoal production for charcoal value chainmay affectthelivelihoods of crop failure. Thus, anything thataffectsthe who consider itaform ofinsurance incase source ofadditionalincome for Ghana’sfarmers, available. The production ofcharcoal isoftena (e.g. electricity, LPG and ethanol) are readily used for cooking, even whencleaneralternatives Charcoal production: energy 7.1 Barriers toadoptionofcleanhousehold The cost ofLPGandthecylinder Charcoal isstill commonly Biofuels like household maintenance of biogas digesters, supply cleancooking fuelandelectricity;however, Over 100biogasdigesters installed across Ghana Biogas has hadmixed success inGhana(20). also present barriers towideruseofethanol. The availability ofstoves andcultural practices fraction of the 70 million litres currently imported. This output, however, represents only a small 3 million litres ofethanolannually from cassava. opened a facility with a capacity of producing facilities. Inaddition, thedataonburninjuries are minor injuriesthatare notreported tohealth not sufficiently detailed, anditdoesnotinclude register inGhana, thedescriptions ofburnsare Injuries from burns: and cylinderreplacement. to adhere toascheduleofmaintenance, repair of thecylinders toLPGcompanies andobligethem A potentialsolutionwouldbetotransfer ownership a cylinder, they may nothave themeanstodo so. household members consider itistimetoreplace usable condition. Anotherproblem isthatwhen difficult toensure thatthey are keptinsafe and are theproperty of individuals, anditistherefore In thecurrent system inGhana, LPGcylinders and storage ofLPGinthehome. provide training for consumers onthesafe use users’ perception ofitssafety. The NPA could of LPG explosions in homes but also increase introduced. This could notonly reduce thenumber as inothercountries, suchasBrazil, could be that requires asafety valve onall LPGcylinders, enacted andenforced. For example, aregulation that adequately cover thisindustryshouldbe the perceived riskofexplosions, regulations by many householdstobeanunsafe fuel. To reduce Perceptions ofthesafety ofLPG: of thiscleanfuel. and otherproblems have limitedwideradoption investment costs, insufficient availablewaste Although there isaninjury LPGisperceived 28 Barriers to adoption of clean household energy 29 Opportunities for Transition to Clean Household Energy in Ghana morbidity andmortality. There is, however, limited problem inGhanaandleadstohighrates of household energy sources isawidespread energy andhealth: Lack ofawareness oflinks between household the sources offires. Service, whichsupportsthecollection ofdataon in partnership withtheGhanaNationalFire LPG for cooking and lighting. This could be done with householduseofbiomass, kerosene and and causes ofburns, includingthoseassociated sector isrequired, whichrecords theseverity structured injury register coordinated by the health not representative ofthewholecountry. Amore points of the Libreville Declaration (21). One of Environment in2012toimplementthe11action jointly by theMinisters ofHealth andofthe strategic alliance”. A committee was established and health issuesina“health andenvironment governance structures tointegrate environmental it was recommended that the country address To fill thesegaps inthelegislative framework, • • • • identified included: between health andtheenvironment. The needs sustainability andfor strengthening thelinks policy optionswere identified for environmental adjustments were conducted for Ghana. Several assessment andananalysis ofprioritiesandpolicy National prioritization: identified several meanstoaddress theproblem. household energy shouldbeaddressed andhave recognize thattheriskassociatedwithpolluting The Government and its development partners household energy 7.2 and plansfor clean householdenergy. evaluation ofnationalframeworks, strategies related totheenvironment andhealth; and a more multidisciplinary approach toissues and plans; relevant regulatory frameworks, strategies update nationalpolicies; adequate financial resources to formulate or Opportunities for introducing clean HAPduetouseofpolluting In 2010, a needs programmes related tohouseholdenergy. should have agreater role insettingpoliciesand stakeholders alsosuggestedthatthehealth sector was required to tacklethe burden ofHAP. Other Energy acknowledged thatstronger collaboration Philanthropies, the Ministers of Health and of Disease Control and Prevention and Bloomberg visit by WHO, theUnitedStatesCenters for Inadequate coordination: disease, stroke andadverse pregnancy outcomes. to non-respiratory health outcomes such as heart professionals. This isparticularly truewithregard solid fueluseinthehome, even amongmedical awareness ofthehealth risks ofkerosene and issue. Itwill beimportanttofundthisinitiative. been madetoaddress HAPasahouseholdenergy needs assessments, littleconcerted efforthas identified asapriorityinGhana’ssituationand been unabletotake action. Although HAPwas funding supportfor theinitiative, sothatithas and health issues. There has, however, beenno for all stakeholders workingonenvironment up asystem for sharing data and information the main activities of the committee was to set A stackofwood forfuelingcookingfires. Credit:Karin Troncoso Duringacountry  could convene anintersectoral workinggroup The Ministry of Health and the health services energy policies and programmes is required. rigorous monitoring and evaluation of household Monitor andevaluate nationalprogrammes: Ghana Standards Authority. being prepared by theEnergy Commissionand fuel efficiency of the stove. A labelling system is benefits health by reduced emissionsandthe labelling wouldclearly indicate whetherthestove for indoorairquality(23). The standards and the emissionrate targets ofthe WHO guidelines in ahealth benefit, they shouldbealignedwith safety. Inorder thatemissionstandards result performance for fuelefficiency, emissionsand standardized toensure thatthey have therequisite Standardization: climate change. meeting Ghana’s commitments to mitigating household fuelwouldtherefore beasteptowards the near-term effectontheclimate. Useofclean emissions ofmethaneandsignificantly reduced stoves have already resulted inareduction in towards cleaneroptionslike LPGandelectric (such askerosene andinefficientbiomassstoves) of climate-forcing pollutants like blackcarbon current shiftfrom fuelsthatemithighvolumes sector, and the reduction expected from the traditional biomass use to LPG in theresidential for Ghana in 2014 already cited shifts from for climate. The national greenhouse gas inventory ethanol andLPGwouldhave significant benefits cleaner fuelsandtechnologieslike solarlamps, commercial and agricultural sectors. Shiftingto the residential sector exceeded that from the CO2, CH4andN2Ofrom fuelcombustion in For example, in2012, thetotalemissionsof uncertain, is likely to be substantial (22). of inefficienthouseholdenergy use, although important consideration, asthetotalimpact household energy usetoclimatechangeisan Mitigate climatechange: 7.3 accelerating thetransition Recommendations tothehealth sectorfor Cleancookstoves shouldbe The contribution of More be widely usedinGhanatocomplement LPG. required onothercleanalternatives thatcould use, such as ethanol gels. Further research is affordable, reliable and convenient for household and livelihoods, particularly ifthesolutionsare of polluting householdenergy systems onhealth biomass stoves, could also reduce the impacts Clean transitional options, such as highly efficient that wouldencourage long-term useofLPG. understanding ofthesocialandcultural factors LPG, including better distribution models and way toincrease thesupply andadoptionof Increase clean fueluse: monitoring system. intersectoral nationalhouseholdenergy andhealth energy andhealth survey questions) for arobust, adapting tools (e.g. WHO’s harmonized household that wouldberesponsible for developing and Credit: GettyImages/AFP/Ato Kwamena Dadzie 2007. The incident occurred asagastanker View ofadestroyed housenearthesiteof a gasexplosion thatwounded130people in Ghana’ssecondlargest city, Kumasi, in was discharging LPGatafilling station. Effortsare under  30 Recommendations to the health sector for accelerating the transition 31 Opportunities for Transition to Clean Household Energy in Ghana between householdfuelsandhealth should Wider communication: throughout thehealth community. ensure that training is broadly disseminated various health disciplines to act as trainers would Furthermore, using“champions” identified in clean householdenergy toprotect health. professionals andempower themto“prescribe” energy usewill buildknowledge amonghealth materials onthehealth impactsofhousehold health professionals: Raise awareness andbuildcapacity among Training and reference Awareness ofthelink agencies could alsoresult inbroader cooperation. the benefits of clean home energy in government clean householdenergy. Increasing awareness of use onhealth andonlivelihoods andthebenefitsof understanding of the impacts of household energy members and the community should have a good (such asenergy andtheenvironment), household clean householdenergy. People inothersectors behaviour andattitudesnecessary for adoptionof stakeholders, tobringaboutthechangesin should be prepared, in consultation with local A set of targeted communication materials also beraised beyond thehealth community. recommendations Conclusions and 8 • • • • Assessment, monitoringandevaluation • • • • Convening andcoordination household energy infour areas. sustained useof clean fuels and technologies for The health sectorcould encourage adoptionand project tobeevaluated. Identify aperi-urbancleanfueldemonstration incidents. energy-associated disease, injuries and Assess capacity for surveillance ofhousehold energy andconduct health impactassessments. Draw upscenarios for policyonhousehold and health. monitoring nationalhouseholdenergy use working group todesigna robust system for Establish andsupportan interministerial a policyfor cleanhouseholdenergy. Convene leaders inhealth andenergy topromote and health. recommendations abouthouseholdfuels Review current policies inall sectors, andmake technologies responsible. household energy use, includingthefuelsand country to monitor burns associated with Establish injuryregistries across the and energy sectors. Strengthen collaboration betweenthehealth • • • Policy advocacy • • • Communication and education • • use, make LPGcost-competitive withcharcoal In order tomeetthenational target for LPG Support thePresidential initiative onLPG. household energy. Promote adoptionof WHO standards for clean raising. Evaluate theimpactoftraining andawareness- fuels onhealth for Government leaders andstaff. Raise awareness abouttheeffectsofhousehold sector on the effects of household fuels on health. Prepare campaigns andtraining inthehealth to replace candles andtorches. use ofkerosene, andextend thenationalgrid upper eastandwestregions todecrease Promote useofrenewable electricityinthe through regulation andenforcement. sectors toworktogetherimprove safety LPG could offer an opportunity for multiple Government willingness to improve access to be variably filled andare easily transportable. smaller volume, lightweightcylinders thatcan Modify theregulatory framework for LPGtoallow urban centres. by introducing subsidies, especially around 32 Conclusions and recommendations 33 Opportunities for Transition to Clean Household Energy in Ghana References 9 2. 1. 8. 7. 6. 5. 4. 3. Trauma. 2016;4:21. in Ghana:any cluesfor prevention? Burns studies ofburnpatients inaburncenter R, Farhat B, Turkson Eetal. Epidemiological Agbenorku P, AboahK, AkpalooJ, Amankwa 6 March 2018). WEO2014_AfricaEnergyOutlook.pdf, accessed publications/freepublications/publication/ Energy Agency;2014(https://www.iea.org/ African energy outlook. Paris: International pdf, accessed 6March 2018). gh/docfiles/glss6/GLSS6_ Main%20Report. Service, 2014(http://www. statsghana.gov. main report. Accra: GhanaStatistical Ghana livingstandards survey round 6, accessed 5March 2018). ghdx.healthdata.org/gbd-results-tool, Health MetricsandEvaluation; 2016(http:// GBD results tool. Seattle(WA): Institutefor accessed 5March 2018). burden_disease/estimates/en/index1.html, 2017 (http://www.who.int/healthinfo/global_ 2015. Geneva: World Health Organization; disease burden and mortality estimatesfor Health statisticsandinformation systems, catalog/51, accessed 5March 2018). www.statsghana.gov.gh/nada/ index.php/ Ghana Statistical Service; 2013(http:// 2010 population and housing census. Accra: accessed 1July 2017). main.BODHOUSEHOLDAIRDTHS?lang=en, 2015 (http://apps.who.int/gho/data/node. repository. Geneva: World Health Organization; in 2012. Global Health Observatory data Household airpollution attributabledeaths Syst. 2013;3 production inGhana. JSustainableBioenergy Assessment offeedstock optionsfor biofuels Kemausuor F, OppongAkowuah J, Ofori E. (2) . doi:10.4236/jsbs.2013.32017. 11. 10. 9. 17. 16. 15. 14. 13. 12.

gh/news/cylinder-re-circulation-module, Petroleum Authority; 2017(www.npa.gov. Cylinder re-circulation module. Accra: National accessed 5March 2018). following-gas-explosion- at-atomic-junction/, new-government- regulatory-measures- presidency.gov.gh/index.php/2017/10/12/ Accra: The Presidency; 2017(http:// following gas explosion at Atomic Junction. New Government regulatory measures, Ghana. 2015;4:5–10. Kumasi: atenyear review. Postgrad MedJ Adu E, Koranteng A. Burninjuriesin 5 March 2018). leap.gov.gh/about-us/ objectives/, accessed (LEAP) objectives. Accra: LEAP;2018(http:// Livelihood Empowerment Against Poverty content/Ghana, accessed 6March 2018). Development; 2018(https://endev.info/ Ghana. Energy situation. Accra: Energising html, accessed 5March 2018). 2018 (https://www.giz.de/en/worldwide/324. für InternationaleZusammenarbeit GmbH; Ghana. Eschborn: Deutsche Gesellschaft org/3/a-i4174e.pdf, accessed 5March 2018). the UnitedNations;2015(http://www.fao. Rome: Food andAgriculture Organization of Thiaroye processing technique(FTT–Thiaroye). Guide for developing and using the FAO– Health Unit, GhanaHealth Service; 2008. report. Accra: Occupational andEnvironmental preschool children inAccra, 2008. Study Prevalence ofrespiratory diseasesin Agency; 2006. Health Service, Environmental Protection and Environmental Health Unit, Ghana Accra. Study report. Accra: Occupational diseases reported in out-patient facilitiesin The impactofairqualitychangesonrespiratory accessed 25May 2018). 20. 19. 18.

RETT EnergyRETT Commission;undated(http:// technology – What works for Ghana?Accra: Ahiataku-Togobo W, Owusu-ObengPY. Biogas programme, accessed 5March 2018). org/programme/ghana-schoolfeeding- Programme; 2018(http://socialprotection. City (NY):UnitedNationsDevelopment Ghana SchoolFeeding Programme. New York expenditure-review, accessed 5 March 2018). Social-protection-assessment-and-public- curated/en/776791491300371576/Ghana- 2016 (http://documents.worldbank.org/ review. Washington DC: World BankGroup; protection assessmentandpublicexpenditure Marques JS, Honorati M. Ghana –social 23. 22. 21.

Health Organization; 2014. household fuelcombustion. Geneva: World WHO guidelinesfor indoorairquality: March 2018). pdf/nir1_to_bur1_ghana.pdf, accessed 6 parties/biennial_update_reports/ application/ int/files/national_reports/non-annex_i_ Government of Ghana; 2015 (http://unfccc. 2014 nationalcarbon accounting. Accra: National greenhouse gasinventory report: Caribbean, andPacific Group ofStates;2012. The Libreville Declaration. Brussels: African, accessed 6March 2018). What%20works%20 for%20Ghana.pdf, energycom.gov. gh/files/Biogas%20-%20 34 References 35 Opportunities for Transition to Clean Household Energy in Ghana Annex LPG-related regulations inGhana A • that hasbeenenactedislistedbelow: (see Appendix 3 oftheNPA Act 691). Legislation transport, refining), pricingandmarket monitoring licensing (e.g. importation, exportation, shipment, out theseregulations, whichincludeprovisions on Petroleum Authority (NPA) (2005, Act 691) sets LPG inGhana. The Act that established the National Various regulations govern thesupply anduseof • • • • • 1724). These regulations require that a fire Fire Precaution (Premises) Regulations, 2003 importation ofusedLPGcylinders intoGhana. 1693). This subsidiarylegislationprohibits the of UsedLPGCylinders) Instrument, 2001 Export andImport(Prohibition ofImportation respect ofsuchundertakings. environmental impactassessmentprovided in the Environmental Protection Agencyand an as well asstorage facilities, beregistered with products and construction relating to products, that undertakingsinvolving refined petroleum 1999 Environmental Assessment Regulations, yet available. are to be prescribed by regulations that are not The procedure andmannerfor securingapermit a development permitfrom thelocal authority. district. The installation ofLPGfacilitiesrequires to grant permitsfor sitingLPGfacilitiesina of Act 462mandatesdistrict planningauthorities Local Government Act, 1993 is renewable every 6months, isrequired. fitting in vehicles. In addition, a sticker, which registration inrespect ofsuitabilityLPG for examination, issueofacertificate and LPG invehicles andrequires, amongothers, 1592). This instrumentregulates theuseof Road Traffic (UseofLPG)Regulation including LPGandisenforced by theNPA. governs thepricingofpetroleum products Instrument (L.I). 2186, Appendix4). This regulation Petroleum pricing formula regulations (LI1652). These regulations stipulate (Act 462). Section49 (Legislative , 1994 (LI (LI (LI • • • established toconduct LPGrefilling activities operators ofLPG filling plantswhoare already LPG filling plants in the country. It also assists as aguidetoinvestors whointendtosetup Code ofStandard onLPG. Service Council. fire warning systems determined by theFire of practice onmeansof escape, firefighting and Fire Service is authorized to enforce the code protection service contractors, and the Ghana for the classification and registration of fire includes aprovision for settingguidelines and useofLPGfacilities. The regulation certificate beobtained for theestablishment cylinder specifications. threads (Appendix 7). Appendix 8 provides to valving both for taperandparallel screw routine for inspectionandpreparation prior cylinders andfire extinguishers. Itdefinesthe but excludes breathing apparatus, diving gas combinations connected to screw threads to cylinders. Itappliestoall valves andcylinder to befollowed whenconnecting cylindervalves This standard specifiestheessentialprocedures gas cylinders –fittingof valves togascylinders). Ghana Standard ISO13341:1997(Transportable temperatures (Appendix6). up toandincluding150L, exposed toambient welded steelLPGcylinders ofwater capacity at manufacture oftransportable refillable and workmanship, procedures and testing requirements for material, design, construction This internationalstandard specifiesminimum petroleum gas(LPG) refillable welded steel cylinders forliquefied ISO 22991(onGascylinders –transportable Plants inGhana, 2010). and Operation ofLiquefied Petroleum GasFilling (Appendix 5, Guidelinesfor theEstablishment in asafe, environmentally friendly manner –Designandconstruction). This documentserves

 Rural Ghanaian students study with the help of a kerosene lantern in the evening. Credit: Taylor Weidman/ LightRocket via Getty Images

For further information please contact:

Department of Public Health, Environmental and Social Determinants of Health Climate and other Determinants of Health Avenue Appia 20 World Health Organization 1211 Geneva 27 Switzerland http://www.who.int/airpollution/en/

ISBN 978-92-4-151402-6