Date of Award

Spring 1-1-2016

Document Type


Degree Name

Doctor of Philosophy (PhD)

First Advisor

Karl G. Linden

Second Advisor

Sherri Cook


Public health interventions which aim to address contaminated drinking water and indoor air pollution in developing countries may help to reduce the burden from two of the leading causes of death, diarrhea and pneumonia. Interventions which distribute and promote household water filters may reduce diarrheal disease through improving water quality, while improved cookstove interventions may reduce indoor air pollution, a leading cause of pneumonia. Beyond health impact, water filter and cookstove interventions may provide livelihood and environmental impacts which can contribute to the overall suitability and sustainability of an intervention. Household water filtration has the potential to both reduce fuelwood consumption and provide time savings by no longer needing to boil water before drinking. Similarly, improved cookstoves have the potential to reduce fuelwood purchasing and collecting, while providing environmental benefits both locally and globally.

This research describes a public health intervention where water filters and improved cookstoves were distributed in rural Rwanda. The intervention is examined from the pilot phase to a scale up of over 100,000 households, examining adoption rates and behaviors while performing a cost benefit analysis to determine if the program provided sufficient benefits to outweigh program costs. High uptake and sustained adoption was measured from the pilot phase through the large-scale program with over 90% measured adoption rates. However, exclusive use of both technologies was identified as a concern in providing health impact. The program was estimated to be highly beneficial with benefits providing over six times the cost of the program. Fuel savings from the cookstove were found to be the most dominant contributor to the positive benefit to cost ratio.

An additional sub-study was conducted to analyze environmental, economic and social sustainability metrics of locally made and imported cookstoves. Both were found to contribute significantly but by different means. The imported stove tended to provide higher benefits from an environmental perspective while the locally made stove provided many social benefits. Economic sustainability was mixed based on wood procurement scenarios. Overall a hybrid approach is likely to provide the most sustainable benefits.