Relationship between cooking fuels and health among under-5 children in Malawi: a nationwide time-trend survey from 2000 to 2016

Fuels are substances used to produce energy and are categorized as primitive (e.g., firewood, agricultural waste, and cow dung); transitional (e.g., charcoal, coal, and kerosene); and advanced (e.g., electricity, biofuels, and liquid petroleum gas) (van der Kroon et al., 2013). Primitive fuels are less efficient and emit more pollutants compared to transitional and advanced fuels (Meried, 2021). The choice of cooking fuels is influenced by several factors, such as accessibility, efficiency, cleanliness, and cost (Puzzolo et al., 2019). Poor people and rich people use significantly different energy sources. For instance, poor people residing in remote areas would easily access naturally occurring fuels, such as firewood, agricultural waste, and animal dung. As their economic status improves, access to fuels that require a well-established supply system (such as electricity, liquid petroleum gas, biogas, and kerosene) is enabled. This transformation is accompanied by a switch from polluting fuels to efficient fuels.