Introduction

Indoor Air Pollution (IAP), especially smoke generated from burning solid biomass fuel in kitchens, is a major environmental health issue in Nepal. Some 85 per cent of Nepalese households are dependent on biomass fuels for cooking energy (CBS, 2004). Biomass fuels such as animal dung, crop residues and wood, which are considered the most polluting fuels, lie at the bottom of the energy ladder, and are used mostly by very poor people. In Nepal these fuels are typically burnt in open fires or poorly functioning stoves and more often with inadequate ventilation creating a dangerous cocktail of hundreds of pollutants to which women and young children are exposed on a daily basis. According to WHO (2007a, based on) estimates, IAP from solid fuel burning was responsible for the deaths of 7,500 people, 204,400 Disability-Adjusted Life Years (DALY) loss and 2.7 per cent of the national burden of diseases in Nepal 2002 data. According to NDHS 2006, Acute Respiratory Infection (ARI) has contributed to 23 per cent of the total deaths in the year 2006 among children below five years of age. In Nepal, Acute Lower Respiratory Infections (ALRI), Chronic Obstructive Pulmonary Disease (COPD) and Tuberculosis are among the top 10 causes of death. There is strong evidence to suggest the role of IAP in the occurrence of such illnesses. Responses to such illnesses so far have focused on treatment rather than on prevention.