Learning from (): Putting Community Engagement at the Centre of Air Quality Improvement Initiatives William Avis (University of Birmingham)

Gabriel Okello (African Centre for Clean Air).

Air pollution is a global environmental health threat, contributing to an estimated 3-7 million deaths per year globally. Whilst various types of air pollution exist, particulate matter (PM) air pollution contributes the most to the global burden of disease. The effects of air pollution on human health are well documented in a range of epidemiological studies; exposure increases the risk of lung cancer, heart disease, bronchitis and other cardiorespiratory conditions. Evidence has also recently emerged highlighting links between air pollution and cognitive decline. Whilst air pollution is considered to impact on all groups, particularly when exposed over prolonged periods of time, some groups are considered to be more susceptible than others. These include the young and the old, those who work in jobs where exposure is high or where people occupy particularly polluted locations. Low income groups are often considered more vulnerable than others given dependency on polluting fuels for heating, lighting and cooking as well as increased susceptibility as a result of income related factors.

Over the last two years ASAP-East Africa researchers have been undertaking a series of projects in the Namuwongo area of Kampala focussed on understanding exposure to indoor air pollution as well as identifying opportunities and challenges for household transitions to cleaner fuels. Namuwongo is located in the Wabigalo informal settlement which encompasses an area of approximately 41.9 acres and has a population of around 36,000. As a result of its location, residents of Namuwongo must cope with location related hazards including floods, exposure to dumpsites, busy roads, power lines, open drains, and industrial hazards. Residents in these areas are also subject to evictions, crime, community violence and riots. Indoor air pollution is also of concern with many households dependent on charcoal for cooking.

Comparison of 24-h mean PM2.5 kitchen In February 2020 the University of concentrations in households in Namuwongo Birmingham alongside partners from () according to fuel type Kampala Capital City Authority, , the African Centre for Clean Air, 450 400 ACTogether and EASE Women’s collective 350 co-convened a community dialogue to 300 provide feedback on Household Air 250 Pollution and Household Fuel Transition 200 concentrations studies that community members had

150 2.5 100 been engaged in and to provide an

50 opportunity for the community to reflect h PM h

- 0 on findings and advise on next steps. 24 Charcoal Charcoal & Briquettes Indeed, a theme of these projects was the Briquettes only need for the community to be active Fuel type participants in, rather than passive recipients of research.

The community dialogue provided an opportunity to solicit feedback from community members on these projects and to share knowledge of air pollution. It also provided an opportunity to bring together a multi-stakeholder platform that allowed government officials, academic researchers, civil society groups and local enterprises to engage with community groups in honest and open dialogue to identify strategies for collective action on indoor air pollution.

The event provide an opportunity to Engagement activity plotting perceived household air establish feedback loops between the pollution levels during cooking periods. participating organisations and the local community. This was considered central to enhancing the capability, accountability and responsiveness of all stakeholders.

Capability: Consultation and dialogue between government, academia and citizens can improve public understanding of and support for policies and interventions. It also encourages and provides an opportunity for citizen ownership of efforts to tackle the issue of household air pollution. Without the support of the public, implementers may be hampered in their capability to get things done.

Accountability: Access to information is vital for enabling citizens to monitor and hold government, researchers and civil society groups to account for their actions. Far too often researchers and implementers fail to provide opportunities for the community to shape their work.

Responsiveness: An informed and active community strengthens the demand for action and for implementers and researchers to be accountable. Communication and open dialogue encourages responsiveness to citizens’ demands and can result in better public services or action on issues such as household air pollution.

These events were based on an acknowledgment that solutions to the challenge of household air pollution are complex and multifaceted. Indeed, knowledge comes in many different forms and we must guard against notions of epistemological primacy and recognise that the community should always be active participants in research or implementation processes. They enrich the outcomes, and facilitate the application of findings and development of solutions.

Historically air quality interventions have been developed in abstract from the context in which they are to be deployed with implementers often failing to account for perceptions of affordability (perceived or not), accessibility of solutions and familiarity with alternative fuel sources. Cultural determinants of fuel use have also often been ignored.

By undertaking sustained community engagement and facilitating processes whereby community residents are able to critically appraise research and implementation activities, stakeholders can ensure a focus on practical action. Such dialogue must be based on trust and sustained over time to build lasting partnerships that cross disciplinary, sectoral and stakeholder boundaries and foster shared understanding.