The findings from our 2013-2014 project in Guangxi (see below) indicated that if rural Chinese households currently boiling their drinking water in pots heated with solid-fuels (which produce hazardous air pollution) switched to using electric kettles, there could be significant gains in access to microbiologically safe drinking water, and accompanying reductions in household air pollution (HAP). Exposure to HAP is linked to a number of negative health impacts, and rural HAP contributes significantly to China’s overall air pollution burden. Households currently purchasing bottled water (which we found to be frequently contaminated), or not treating their water at all, could also benefit from a switch to electric kettles.
Because the majority of rural Chinese households boil their drinking water every day, increased electric kettle use could have a significant impact on improving the health, livelihoods, and environmental health, of hundreds of millions of rural Chinese. To promote such a change in water treatment practices, the NCRWSTG and UCB developed a simple and scalable strategy for promoting the use of electric kettles in poor rural areas. However, before this or a similar program might be recommended for use at a wider scale, we sought to evaluate whether a Rural Electric Kettle Promotion Program would increase electric kettle adoption and provide concomitant improvements to drinking water quality, reduced air pollution, and other benefits. The NCRWST invited Dr. Alasdair Cohen and the Berkeley team to work with them and their China CDC partners to rigorously evaluate and quantify the potential benefits, and understand the feasibility, of such a program.
Our Guangxi research revealed that households in the lowest income groups (and female-headed households in particular) tend to be more likely to boil with metal pots and hazardous fuels. For such households then, the cost of an electric kettle and/or the associated increase in electricity consumption may be a barrier to would-be adoption. Taking this into consideration, we designed a cluster-randomized impact evaluation design to measure rates of electric kettle adoption in a group that received promotional messaging and free electric kettles (450 poverty-classified households) and in a control group (450 poverty-classified households).
After extensive enumerator training, the project began at the end of 2017 and will be completed later this year (2019). We collected a range of data in order to compare rates of electric kettle adoption and use (based on observed data and data from electricity use meters), drinking water quality, and exposure to HAP (using real-time PM2.5 monitoring in a subset of households), as well as other outcomes related to health. At this writing, the primary phase of data collection is essentially completed and we are preparing to use qualitative methods to better understand HWT preferences and related behaviors and beliefs in the two groups.
Our study was pre-registered on the Chinese Clinical Trials Register (ChiCTR-IOR-17013373) and ClinicalTrials.gov (Identifier: NCT03376152).