2016/63 Supported by K NKONW A A WELDEGDEG E OL N ONTOET E S ESREI R E ISE S F OFRO R P R&A C T HTEH E NEENREGRYG Y ETX ITCREA C T I V E S G L O B A L P R A C T I C E THE BOTTOM LINE The Lao Cookstove Experience: In the Lao People’s Democratic Republic household air pollution Redefining Health through Cleaner Energy Solutions from the incomplete combustion of solid fuels is the top health risk, costing some 3.5 percent What is the problem? Although the Lao PDR reported high annual increases in access to nonsolid cooking fuels between 1990 and 2010 (figure 1), almost of GDP in lost productivity. To Although cleaner cookstoves can dramatically 96 percent of the Lao population, most of which lives in rural areas, increase access to modern improve health in Lao PDR, especially among still uses solid biomass such as firewood and charcoal for cooking. cooking and heating solutions in East Asia, the World Bank women and children, the use of solid fuels This is due to the high costs of both nonsolid fuels and electricity remains widespread (World Bank 2013). The rate of access to nonsolid fuels in the country introduced a Clean Stove remains no more than 4 percent, one of the lowest in the world Initiative in 2012. Pilot projects Worldwide, more than 2.8 billion people continue to use wood, char- (figure 2). were begun in China, Indonesia, coal, and other solid fuels to meet their cooking and heating needs. Household air pollution from cooking over open fires or on crude and Mongolia, as well as Lao Household air pollution resulting from the incomplete combustion of wood-burning cookstoves is the top health-risk factor in the country PDR. One of the first challenges those fuels is linked to more than 4 million premature deaths each (figure 3). It is estimated by the World Health Organization (Global was the need to bring all relevant year (Lim and others 2012). Cleaner-burning nonsolid fuels can save Burden of Disease Study 2010) to cost 3.5 percent of GDP in lost ministries and stakeholders on many lives. productivity. board to help recognize the In East Asia and the Pacific, the share of the population with The burden of disease from biomass smoke falls on women and urgency of the problem and the access to nonsolid fuel for cooking rose from 33 percent (534 children disproportionately, because in nearly all Lao households magnitude of suffering that was million people) in 1990 to approximately 52 percent (1 billion people) women are responsible for daily meal preparation and children join occurring as a result of household in 2010 (Portale and de Wit 2014). During this period, 477 million them in the kitchen and often around the fire. air pollution. The other was to link people gained access to nonsolid fuel, while the region’s population The transition to electricity for household cooking has faltered the health situation with the need expanded by 350 million.1 despite the steady expansion of electricity service in the country. for a clean energy solution. Despite this gain, the challenge of access to nonsolid fuel Although more than 90 percent of the Lao population has access remains significant in most countries of the region, including the to electricity, the great majority (almost 96 percent) continue to use Rutu Dave is an energy Lao People’s Democratic Republic. Across the region, more than 357 firewood and some charcoal for cooking. Between 1995 and 2005, specialist and task team million people still live without access to nonsolid fuels, and less than leader of the Lao Clean the use of electricity as the primary cooking fuel actually declined half the population has access to nonsolid fuels in nearly half the among urban households, from 10.4 percent to just 3.8 percent, Stove Initiative in the countries. as the retail tariff was steadily raised for cost-recovery purposes. Energy and Extractives Global Practice at the World Bank. Previously, the electricity tariff was significantly lower than the overall 1. Globally, the absolute number of people with access to nonsolid fuels increased by 1.6 billion between 1990 and 2010, but Rema N. Balasundaram the global population over the period grew by the same amount (World Bank 2014). Hence the global increase in the share of is a consultant and writer. the population with access to nonsolid fuels was only modest. LW63-fin-logo.indd 1 6/12/17 6:52 PM 2 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s Figure 1. Annual growth in access to nonsolid cooking fuels in East Asia and the Pacific, 1990–2010 15 Annual incremental population growth “Like electricity, nonsolid 10 Annual incremental access growth Annual growth in access (%) 3 population (million) fuels such as liquefied petroleum gas (LPG) remain 5 2 annual growth in access (%) largely unaffordable for the 1 rural poor and thus are not 0 0 widely used.” China Indonesia Philippines Vietnam Thailand Myanmar Malaysia Korea, Dem. Cambodia Papua New Guinea Lao PDR Mongolia Timor- Leste Fiji Solomon Islands People’s -1 Rep. -5 -2 -3 -4 cost of production (i.e., generation, transmission, and distribution) What can be done? and urban households took advantage of the low tariff rates (World Bank 2013). By 2005, only 8 percent of urban households in Vientiane Since 2012, the World Bank’s Clean Stove Initiative used electricity as their main cooking fuel, 14 percentage points less has been introducing cleaner cooking solutions than a decade earlier. To increase access to modern cooking and heating solutions, the Like electricity, nonsolid fuels such as liquefied petroleum gas World Bank introduced the East Asia and Pacific Clean Stove Initiative (LPG) remain largely unaffordable for the rural poor and thus are (CSI) in 2012. Four countries in the region—China, Indonesia, Lao not widely used. LPG is imported, and the distribution network is PDR, and Mongolia—embraced the initiative and agreed to conduct expected to remain limited, with access greater in major cities along pilot studies using the results-based financing model. This model the border with Thailand and Vietnam. is designed to mobilize and sustain private-sector participation in Firewood, by contrast, is readily available in rural areas of Laos, scaling up access to clean stoves by disbursing public subsidies and its use is culturally ingrained. For example, cooking fires also against demonstrated results. provide heat for the home and repel insects. They are widely used for In response to the WHO finding that household air pollution drying food. caused by the burning of biomass was the leading risk factor for Given the high prices of LPG and electricity, combined with the premature deaths in Laos, the nation’s government resolved to take abundance of readily available firewood in rural areas, it is likely that action. One of the first challenges was the need to have all relevant fuelwood will continue to be a major household cooking fuel for ministries and stakeholders recognize the urgency of the problem the foreseeable future unless cleaner alternatives (both stoves and and the magnitude of suffering that was occurring as a result of fuels) and solutions can be provided at affordable prices. household air pollution. Another was to link the health situation with the need for a clean energy solution. LW63-fin-logo.indd 2 6/12/17 6:52 PM 3 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s Figure 2. Access to nonsolid fuel in countries of East Asia and the Pacific, 2010 Palau 100 Samoa 0 Malaysia 100 Palau 0 “The rate of access to Tuvalu 81 Tuvalu 0 nonsolid fuels in the Thailand 74 Malaysia 0 country remains no Marshall Islands 68 Marshall Islands 0 more than 4 percent, Tonga 0 Fiji 63 one of the lowest in the Micronesia 0 Micronesia 59 world.” Kiribati 0 Tonga 57 Samoa 0.1 China 54 Vanuatu 0.2 Kiribati 54 Fiji 0.3 Philippines 50 Solomon Islands 0.5 Samoa 47 Timor-Leste 1.0 Indonesia 45 Mongolia 2.0 Vietnam 44 Papua New Guinea 5.0 Mongolia 28 Lao PDR 6.0 Papua New Guinea 27 Cambodia 12.6 Vanuatu 16 Thailand 18.1 Cambodia 11 Korea, Dem. People's Rep. 22.2 Solomon Islands 10 Myanmar 44.0 Korea, Dem. People's Rep. 9 Philippines 46.2 Myanmar 8 Vietnam 49.4 Timor-Leste 8 Indonesia 131.3 Lao PDR 4 China 612.8 LW63-fin-logo.indd 3 6/12/17 6:52 PM 4 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s Figure 3. Burden of disease in Lao PDR attributable to 15 leading risk factors, 2010 The colored portion of each bar represents the specific diseases attributable to that risk factor, while bar size represents the percentage of DALYs linked to specific risk factors. “To coordinate its Household air pollution participation in the CSI, Smoking the government of the Lao Dietary risks War and disaster Intentional injuries PDR convened, in 2012, a High blood pressure Unintentional injuries Transport injuries high-level interministerial Childhood underweight Other non-communicable Musculoskeletal disorders taskforce to oversee the Alcohol use Diabetes/urogenital/blood/endocrinological Mental and behavioral disorders nation’s multisectoral Suboptimal breastfeeding Neurological disorders Digestive diseases Lao Clean Stove Initiative Ambient PM pollution Cirrhosis Project, which is based on High fasting plasma glucose Chronic repiratory diseases Cardio and circulatory diseases the premise that technical Cancer Occupational risks Other communicable solutions to address the Nutritional deficiencies Iron deficiency Neonatal disorders challenge of indoor air Maternal disorders Physical inactivity NTD and malaria pollution can be delivered Diarrhea/LRI/other infectious High body-mass index HIV/AIDS and tuberculosis to households through High total cholesterol a coordinated program Drug use of testing, certification, 0 1 2 3 4 5 6 7 8 9 promotion, and results- % DALYs attributable to risk factors based financing.” Source: Institute for Health Metrics and Evaluation (2010). Note: DALYS = disability-adjusted life years. To coordinate its participation in the CSI, the government of the the most advanced type of biomass-burning stoves, which emit little Lao PDR convened, in 2012, a high-level interministerial taskforce or none of the particulate matter associated with inferior stoves to oversee the nation’s multisectoral Lao Clean Stove Initiative or open fires. Fine particulate matter (PM2.5) is an air pollutant that Project, which is based on the premise that technical solutions to threatens human health when levels in the air are high. PM2.5 are tiny address the challenge of indoor air pollution already exist and can be particles that reduce visibility and cause the air to appear hazy when delivered to households through a coordinated program of testing, levels are elevated. certification, promotion, and results-based financing. The options for The interministerial taskforce was established by the Ministry of clean cooking include electricity, gas, or forced-draft gasifier stoves, Energy and Mines and its Institute of Renewable Energy Promotion LW63-fin-logo.indd 4 6/12/17 6:52 PM 5 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s (IREP), which served as the CSI focal point and coordinating agency. collaboration to improve the health and economic well-being of the The role of the task force was to ensure that CSI policy and strategic rural poor. In January 2014, the interministerial taskforce authorized directives were aligned with the country’s Renewable Energy and sponsored a detailed assessment of the practicability and Development Strategy and other national policies. The taskforce cost-effectiveness of introducing best-in-class low-emission stoves included the Ministry of Health, the Ministry of Science and into households in the poorest rural communities of Lao PDR. The “The Laos Cookstoves and Technology (with its Renewable Energy and New Materials Institute), assessment was completed in June 2015. Owing to time constraints, Health Initiative brought and the national university’s faculty of engineering, which helped the study was limited in sample size and geographic and seasonal establish the first national cookstove testing laboratory. The role of representation and only able to examine short-term pollution and the Ministry of Energy and the laboratory was to assist the government in establishing cook- fuel-use effects from the new stove (less than a month after intro- Mines and the Ministry of stove testing protocols to ensure that standards and methods were duction). Most health benefits, however, require long-term reduction Health together in a unique uniformly applied throughout the country. in air pollution, which was not directly measured by the study. collaboration to improve The early phases of the Lao CSI also included a high-level Findings indicate that: policy dialogue and advisory support from the World Bank and the • When introduced and promoted, the stoves were readily taken the health and economic Asia Sustainable and Alternative Energy (ASTAE) program. Initial up by the villagers and apparently used for nearly all cooking in well-being of the rural financing was provided by a World Bank trust fund for infrastructure. the first weeks. poor.” ASTAE worked to replicate the cookstove and biodigester programs • When used exclusively, the cookstove reduced average kitchen developed earlier in Cambodia (ASTAE 2013), with specific adaptions pollution levels by a factor of four compared with traditional open to suit Lao traditions. biomass stoves. The project began in 2012 with a stocktaking, field survey, stakeholder consultations, and two consultation workshops. The • When used exclusively, it reduced fuel consumption per person field survey, conducted in the city of Vientiane and the provinces of by about 40 percent. Bolikhamsi, Khammouane, and Vientiane, had two parts: (i) a survey • When used exclusively, it reduced cooks’ exposure to air of household cooking fuel use conducted in periurban and rural pollution (the most important metric for health) by about 40 areas, and (ii) a market survey of biomass cookstoves and the supply percent. chain. A subsequent phase that began in 2013 provided technical The study also states that if this performance were maintained assistance in several areas including: for three years with 75 percent long-term adoption and usage, • Capacity building in construction and use of the improved dissemination to 25,000 households in similar Lao villages would traditional clay-based cookstove reduce premature deaths by about 22 percent and disability-adjusted life years (DALYs) by about 1,200 in this population, with about half of • Establishment of a cookstove testing laboratory at the national the mortality benefit accruing from decreased child pneumonia and university the rest from reduction in adult chronic diseases. (about 70 percent • Development of the first national cookstove standards (June of the reduced DALYs would be in children).2 Assuming different 2015), and lifetimes and/or usage rates would alter these estimates (World Bank • An assessment of the program’s impact on health and 2015a and 2015b). associated results-based financing. The Laos Cookstoves and Health Initiative brought the Ministry 2. DALYs are used by health and development entities globally to measure the burden of disease from a disease or risk factor and as the metric to evaluate and compare the effectiveness of health-related interventions, for example in terms of of Energy and Mines and the Ministry of Health together in a unique dollars per averted DALY. LW63-fin-logo.indd 5 6/12/17 6:52 PM 6 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s What are the distinguishing features of the on biomass for cooking live in developing Asia. WHO estimates that Lao Clean Stove Project? 600,000 premature deaths annually are related to cooking using biomass in East Asia alone. The gender dimension of that sobering The project is a cross-sectoral, gender-attuned, fact should be noted, given that cooking-related indoor air pollution and innovative effort to improve health through disproportionately affects women and children. Early measures of “Early measures of the cleaner cooking the project included addressing gender issues in the use of ener- project included addressing gy-related products and services by integrating a gender-sensitive Cross-sectoral collaboration. Coordination and cooperation approach into both the needs identification (demand) and the gender issues in the use were built into project design at inception, with the decision by design-related response (supply) phases. The measures also included of energy-related products the national government to carry out a stakeholder consultation identifying gender-sensitive energy-related needs of women in Lao and services by integrating when the Clean Stove Project was initiated. In October 2012 the PDR. government agreed that an interministerial CSI task force should a gender- sensitive Many households in Lao PDR exhibit concentrations of partic- be established by the Ministry of Energy and Mines and its Institute approach into both the ulate matter and nitrogen dioxide that are much higher than the of Renewable Energy Promotion (IREP), which would serve as guidelines of the World Health Organization (World Bank 2013, citing needs identification the CSI focal point and coordinating agency. The role of the task Mengersen and others 2007; Lao Department of Statistics 2009; and (demand) and the design- force was to ensure that CSI policy and strategic directives were LWU 2001). The World Bank (2013) confirmed a strong link between aligned with national policy and the country’s Renewable Energy related response (supply) higher concentrations of indoor air pollution and respiratory illnesses Development Strategy. The World Bank worked with the government phases. The measures in women and children, with the link particularly strong for women. in a unique partnership that recognized the commitment of the line also included identifying The incidence of virtually all health outcomes considered in the ministries and their individual ministerial missions and mandate, study was more than triple for women living in dwellings with higher gender-sensitive energy- with the overall goal of moving the cookstove story from fuel and charcoal to cleaner and more efficient energy models. Thus the concentrations of nitrogen dioxide. A health survey conducted as related needs of women in collaborative mode of functioning was set at the government and part of the project revealed that nearly half of women spent one Lao PDR.” to three hours each day in the cooking area, while nearly a quarter line ministry level. Another dimension was the recognition and role of the Ministry of Science and Technology and its Renewable Energy spent more than six hours there. Nearly three-fourths of children and New Materials Institute, along with the Faculty of Engineering spent more than five hours each day in the cooking area, while 17 at the national university, to help establish the first national cook- percent spent more than five hours close to the fire. Based on the stove testing laboratory. The role of the laboratory is to assist the survey results, the study concluded that the more time women and government in establishing cookstove testing protocols to ensure children spend close to the fire, the higher their risk of contracting that standards and methods are uniformly applied throughout the respiratory illnesses (e.g., cold, fever, runny nose, stinging or watery country. The Ministry of Energy and Mines played the coordinating eyes, coughing, itchy rash or eczema, bronchitis, and pneumonia). role. Cooperation was played out with the integration and inclusion The most recent Lao Expenditure and Consumption Survey of donors both bilateral and multilateral, including the World Bank, (LECS), conducted in 2007–08, confirms that women spend twice as nongovernmental organizations, and the private sector. much time as men collecting firewood (an average of 12 minutes ver- The gender dimension. Close attention to the gender sus 6 minutes per day) (Lao Department of Statistics 2009). The study dimensions of the project were ensured from inception, given the also found that women walk longer distances to collect firewood. role of the woman in the use of the stove and provision of food for A CSI survey found that in 98 percent of the households surveyed, the rural and urban household. The project took into account the women were responsible for daily meal preparation. In both rural and fact that more than 70 percent of the 2.3 billion people who still rely peri-urban areas, women who cook for family members are typically LW63-fin-logo.indd 6 6/12/17 6:52 PM 7 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s about 38 years old and spend about 2.25 hours each day on meal a larger proportion of households in a village adopt cleaner-burning preparation, indicating that this group is especially vulnerable to stoves. Pollution exposures, although substantially improved, did exposure to indoor air pollution. not come down to WHO guidelines or typical national standards for Financing. The CSI program’s results-based financing (RBF) pollution. framework has three building blocks: (i) certification of cookstoves The project now faces a set of challenges related to scaling up for cleanliness and efficiency, (ii) incentives for the adoption of the RBF model based on aDALYs—that is, in operationalizing the certified stoves, and (iii) a monitoring and verification system. These financing elements of the aDALY market, finding buyers, and generat- building blocks are supported by two pillars: (i) institutional strength- ing aDALYs in a financially sustainable manner. Another challenge is ening and capacity building of key market players and (ii) public in working with donors to distribute the clean cookstoves so that the awareness campaigns to help stimulate household demand (Zhang health benefits can trickle down to the community. and Adams 2015; ASTAE 2014; ASTAE and ESMAP 2014). These challenges are being addressed through multisectoral 2014 saw the commencement and financing of a pilot program engagement and forward-looking strategies. Early on, the team to see if the Lao PDR’s high rate of lost healthy life years—expressed recognized the need to bring in multiple actors at the country level. as DALYs—could be reduced through a clean cookstove scheme Coordination and work on the ground involved a number of donors. based on RBF. The basic concept involves verifying and monetizing The cookstove initiative is supported in multiple ways by multilateral the health benefits derived by women and children from the use of and bilateral donor agencies and the national government entities advanced cookstoves in the household and then compensating the described earlier. stove provider whose products made the DALY reductions possible. The Pilot Study on Impact of Air Pollution has been completed The first stage of the pilot RBF scheme began with controlled (World Bank 2015b). As part of Phase II the team is discussing several cooking tests and trials using high-efficiency wood-burning cook- options with the government of Lao PDR and key stakeholders. stoves in Vientiane and Savannakhet. The studies helped assess Topics include: (i) an in-depth assessment of stove use focusing on a households’ willingness to pay for improved cookstoves and clean cookstove performance, quality, and user acceptance; (ii) tech- identified the most common cooking techniques used in Lao PDR. nical and policy support for the interministerial task force, particularly These initial findings are expected to inform the next stage of pilot its committee on clean cookstove standards; and (iii) introducing new surveys that will incrementally introduce the concept of improved clean cookstoves, especially wood-burning stoves, in rural, urban, health outcomes using the “averted DALY” (aDALY) as a tool for the and peri-urban areas in the north, where firewood remains the sale and distribution of the Clean Cooking Stove Prototype (Smith cooking fuel used by the vast majority of households. Additionally, and others 2015). efforts are ongoing to build a financing modality that uses the aDALY to support the sale and distribution of the clean cookstove prototype. What have we learned? The project recognizes the need to use a multi-pronged approach across four key drivers that are precursors to successful Valuable lessons emerged from the early phases cooking stove interventions: awareness raising in the targeted of the project population; studying markets and preferences; reviewing available The project studied the impact of household air pollution in technologies and standards (Ekouevi 2013) and innovative financing 72 households from three villages (Houaymouange, Vangkhonkham, measures. On the consumer side, the key constraints to the adoption and Aho) in the rural Xonboury District of Savannakhet Province. of cleaner cooking practices are absence of information, lack of The study found that the use of the cleaner cooking stove failed to awareness, and the overlap between traditional cooking practices contribute in large measure to the improvement in the environment, and other household needs and customs (such as heating, drying thereby suggesting that a greater health benefit is likely to accrue if food, repelling insects, and preserving housing materials). The latter LW63-fin-logo.indd 7 6/12/17 6:52 PM 8 T h e L ao C oo k sto v e E x perie n ce : R ede f i n i n g Healt h t h ro u g h C lea n er E n erg y S ol u tio n s points to the need for research and development on cookstoves that Mengersen, K., L. Morawska, H. Wang, F. Tayphasavanh, K. MAKE FURTHER fit local cooking traditions and requirements. The use of promotional Darasavong, and N. Holmes. 2007. “Investigation of Indoor Air CONNECTIONS campaigns that targeted messages for both the stove users and Pollution and Relationship to Housing Characteristics and Health other household members was also key to ensuring adoption of Effects Observed by Occupants in Lao PDR.” Executive Summary, Live Wire 2014/7. the methods. Measures for scaling up are being built in a larger Project for World Health Organization, International Laboratory for “Understanding the and broader context to allow for measurable impact on health of Air Quality and Health and Queensland University of Technology. Differences Between the population as a whole. Plans for these continue to be thought Portale, E., and J. de Wit. 2014. “Tracking Progress Toward Providing Cookstoves,” by Koffi Ekouevi, through. Sustainable Energy for All in East Asia and the Pacific.” Live Kate Kennedy, and Ruchi Soni. Wire 2014/28, World Bank, Washington, DC. http://hdl.handle. References net/10986/20255 Live Wire 2014/8. “Tracking Smith, K. R., A. Pillarisetti, L. D. Hill, D. Charron, S. Delapena, C. Access to Nonsolid Fuel ASTAE (Asia Sustainable and Alternative Energy Program). 2013. Garland, and D. Pennise. 2015. “Proposed Methodology: for Cooking,” by Sudeshna “Clean Stove Initiative Forum Proceedings.” Phnom Penh, Quantification of a Saleable Health Product (aDALYs) from Ghosh Banerjee, Elisa Portale, Cambodia, March 18. East Asia and Pacific Clean Stove Initiative Household Cooking Interventions.” Household Energy, Climate, Heather Adair-Rohani, and Series, World Bank, Washington, DC. and Health Research Group, School of Public Health, University Sophie Bonjour. ­———. 2014. Annual Status Report FY 2013. Washington, DC: World of California at Berkeley, and Berkeley Air Monitoring Group. Bank. Berkeley, CA, USA. December. Live Wire 2014/28. “Tracking ASTAE and ESMAP (Energy Sector Management Assistance Program). World Bank. 2013. “Pathways to Cleaner Household Cooking in Lao Progress Toward Providing Annual Report 2014. Washington, DC: World Bank. PDR: An Intervention Strategy.” Washington, DC. May. Sustainable Energy for All in Ekouevi, K. 2013. “Scaling Up Clean Cooking Solutions: The Context, ­­———. 2014. Global Tracking Framework. Sustainable Energy East Asia and the Pacific,” by Status, Barriers, and Key Drivers.” International Finance for All. Report 85415. Washington, DC: World Bank. http:// Elisa Portale and Joeri de Wit. Corporation, Washington, DC. documents.worldbank.org/curated/en/2014/01/19164902/ Institute for Health Metrics and Evaluation. 2010. “Global Burden of Live Wire 2015/46. “Results- global-tracking-framework. Disease Profile for Laos.” Seattle, Washington, USA. Based Financing to Promote ­­ ———. 2015a. Project Appraisal Document, Lao PDR, Health and Lao Department of Statistics. 2009. “The Households of Lao PDR, Clean Stoves: Initial Lessons Nutrition Program. June. Social and Economic Indicators Survey Results on Expenditure from Pilots in China and ­­ ———. 2015b. “Air Pollution and Impact Analysis of a Pilot Stove and Consumption of Households 2007/2008 (LECS 4).” Vientiane: Indonesia,” by Yabei Zhang Intervention.” Final Report to the Ministry of Health and Clean Ministry of Planning and Investment, Department of Statistics. and Norma Adams. Stove Initiative of the Lao PDR. July. Lim, S. S., and many others. 2012. “A Comparative Risk Assessment World Bank and IEA (International Energy Agency). 2015. Progress of Burden of Disease and Injury Attributable to 67 Risk Factors Live Wire 2015/62. “Toward toward Sustainable Energy 2015: Global Tracking Framework and Risk Factor Clusters in 21 Regions, 1990–2010: A Systematic Universal Access to Clean Report. Washington, DC: World Bank. Analysis for the Global Burden of Disease Study 2010.” Lancet Cooking and Heating: Early Zhang, Y., and N. Adams. 2015. “Results-Based Financing to Promote 380 (9859): 2224–60. Lessons from the East Asia Clean Stoves: Initial Lessons from Pilots in China and Indonesia.” LWU (Lao Women’s Union). 2001. “Fuel for Life: Women, Men, and the and Pacific Clean Stove Live Wire 2015/46. World Bank, Washington, DC. http://hdl.handle. Fuelwood Cycle in the Lao PDR.” Vientiane: Lao Women’s Union Initiative,” by Yabei Zhang and net/10986/22114. Gender Resource Information and Development Center (LWU Norma Adams. GRID Center). This note was peer-reviewed by Besnik Hyseni. LW63-fin-logo.indd 8 6/12/17 6:52 PM