KNOWLEDGE ON HOUSEHOLD AIR POLLUTION

AMONG FAMILIES OF SOLID FUEL USERS

SANGITA SUBEDI
PU Registration No.2011-1-42-0033

In partial fulfillment of the requirements for the

Degree of Bachelor in Science in Nursing (B.sc Nursing)

A Research Report Submitted to

B.sc Nursing Programme
School of Health and Allied Sciences
Pokhara University
Lekhnath-12, Kaski, Nepal
2015
 APPROVAL SHEET

It is approved that Ms. Sangita Subedi has prepared the research entitled,
‘‘Knowledge on Household Air Pollution Among Solid Fuel Users”. This research
has been prepared for the partial fulfillment of the requirements for the degree of
Bachelor of Science in Nursing (B.Sc Nursing) and forwarded for final evaluation.

........................................

Ms. Manju Kaphle

Supervisor and Lecturer
School of Health and Allied Sciences
Pokhara University
Date………………….

........................................
Ms.Rojana Dhakal
(Programme co-ordinator )
B.sc Nursing programme,
School of Health and Allied Sciences
Pokhara University
Date……………………

........................................

Mr. Sudarshan Subedi

( Acting Director)
School of Health and Allied Sciences
Pokhara University
Date: ………………..

This research topic has been accepted not accepted

ii
 DECLARATION

To the best of my knowledge and belief, I declare that this report entitled
“Knowledge on Household Air Pollution Among Families of Solid Fuel Users” is
the result of my own research and contains no material previously published by any
other person except where due acknowledgement has been made. This research report
contains no material, which has been accepted for the awards of any other degree or
diploma in any University.

Signature:
Name: Sangita Subedi
PU Regd No. 2011-1-42-0033
Date: June, 2015

iii
 ABSTRACT

Background: The quality of air inside houses, public buildings, where residents
spend a large part of their life time, is an essential determinant of healthy life and
well-being. Globally, almost three billion people rely on solid fuels and coal as their
primary source of domestic energy. Solid fuels accounts for more than one-half of the
domestic energy requirement in many developing countries.

Objective: To explore the knowledge on house hold air pollution among the families
of solid fuel users.

Methods: The descriptive cross sectional study design was adopted to find out
knowledge on household air pollution among solid fuel users of Lekhnath 15, Kaski
for 1st two weeks of time period on the month of may 2015. Structured interview
schedule was used. Non-probability sampling technique was used. The sample size
was of 50 respondents. The collected data was analyzed on SPSS version 16.0.

Results: The study revealed more than half (62%) of the respondents used cooking
stove without chimney. Most of the respondents (82%) have knowledge on effects of
solid fuels. And the main sources of information for knowledge on household air
pollution were radio (92%) and television (88%) respectively. Majority (88%) of the
respondents said that, smoke from cooking fuel is the contributing factor for
household air pollution. The major health problem related to household air pollution
was respiratory problem and eye problem (92% and 94%) respectively. The group of
people affected by household air pollution is elderly and female. Majority (60.00%) of
the respondents had high level knowledge whereas around one fifth (19.00%) had
moderate level knowledge and only few (02.00%) respondents had low level
knowledge on household air pollution

Conclusion: The study showed that majority of the respondents had high knowledge
on Household air pollution.

Key Words: Knowledge, Household, Air Pollutiuon, Solid Fuel Users

iv
v
 ACKNOWLEDGEMENT

This research report has been completed with the support, guidance and co-operation
from many people. In fact it wouldn’t have been possible to meet this target without
their help and assistance and it may therefore be unfaithful if I miss to mention any
one of them.
I would like to express my sincere gratitude, who is an asset and I am privileged to
have opportunity to express to Pokhara University, School of Health and Allied
Science for providing an opportunity to conduct this study as a partial fulfillment of
B.Sc.Nursing program.
I would like to extend thoughtful appreciation to my research supervisor Ms. Manju
Kaphle for her precious inspiration, guidance constant, valuable suggestions, timely
support and meticulous editing of mistakes.
I would like express sincere gratitude to Bachelor of Science Nursing Program
coordinator Ms. Rojana Dhakal for her inspiring guidance, constant encouragement
and support which made the study a fruitful and successful one.
I would like to express heartfelt gratitude to the entire faculty member Ms. Shanti
Khadka, Ms. Gaura Gurung, Ms. Nirmala Neupane, for their constructive
suggestions and support during the course of the study.
I heartly express my gratitude to Ward Secretory and people in Lekhnath 15 for
their help and cooperation. Likewise, I would like to acknowledge all the respondents
without whose co-operation this study would not be achievable.
My sincere gratitude to all the library staff of Central Library of Pokhara
University, Pokhara Nursing Campus; for permitting to utilize their library
facilities.
My special thanks go to my sister, Ms Swastika Subedi for her support and
encouragement at various stage during the study. I would like to acknowledge to all
well wishers, colleagues and parents who have directly or indirectly helped me in the
successful completion of this study.

Sangita Subedi

v
 Table of Content
APPROVAL SHEET ............................................................................................................... i
DECLARATION ................................................................................................................... iii
ABSTRACT ............................................................................................................................ iv
ACKNOWLEDGEMENT ..................................................................................................... v
CHAPTER I .............................................................................................................................1
INTRODUCTION...................................................................................................................1
1.1Background of the Study ..............................................................................................1
1.3Significance of the Study ..............................................................................................3
1.4 Objectives of the Study ................................................................................................3
1.4.1 General Objective ......................................................................................................3
1.4.2 Specific Objectives ...................................................................................................3
1.5 Research Question ........................................................................................................3
1.6 Variables of Study .......................................................................................................4
1.6.1 Independent Variables ..................................................................................................4
1.6.2 Dependent Variables .....................................................................................................4
1.7 Conceptual Framework ..............................................................................................5
1.8 Operational definition ................................................................................................6
CHAPTER II............................................................................................................................7
REVIEW OF LITERATURE ............................................................................................7
2.1 Introduction .......................................................................................................................7
2.2 Review of related literature......................................................................................7
2.3 Summary of Literature Review .....................................................................................13
CHAPTER III ........................................................................................................................14
METHODOLOGY............................................................................................................14
3.1 Research Design: ............................................................................................................14
3.2 Research Setting..............................................................................................................14
3.3 Study Population .............................................................................................................14
3.4 Sample size ......................................................................................................................14
3.5 Sampling Technique .......................................................................................................15
3.6 Inclusion Criteria ............................................................................................................15
3.9 Research Instrument .......................................................................................................15
3.10 Validity and Reliability of instruments ..............................................................15

vi
 3.11 Data Collection Plan .............................................................................................16
3.12 Data Analysis Plan ................................................................................................16
CHAPTER IV ........................................................................................................................17
RESULTS...............................................................................................................................17
CHAPTER V .........................................................................................................................23
DISCUSSION, CONCLUSION AND RECOMMENDATION ....................................23
5.1 Discussion ....................................................................................................................23
5.2 Conclusion ...................................................................................................................25
5.3 Limitation.....................................................................................................................25
5.4 Implication ...................................................................................................................25
5.5 Recommendation ........................................................................................................26
ANNEXURE-I: OFFICIAL LETTER………………………………………………………… . ………………….I
ANNEXURE II : CONSENT FORM ..................................................................................III
ANNEXURE –III ................................................................................................................... V
ANNEXURE IV .................................................................................................................XIII

vii
 LIST OF TABLES
Table 1 Socio demographic characteristics……………………………………...… 19

Table 2 Knowledge on types of stoves and harm of solid fuels…………………... 20

Table 3 Knowledge on effects of solid fuels and source of information…………... 21

Table 4 Knowledge on contributing factors, health effects and

prevention of household air pollution………………………………………….. 22

Table 5 Knowledge level of respondents……………………………………….. 23

viii
 LIST OF FIGURES

Figure 1: Conceptual framework on knowledge on household air pollution……….5

ix
 CHAPTER I

INTRODUCTION

1.1Background of the Study

The quality of air inside houses, public buildings, where residents spend a large
part of their life time, is an essential determinant of healthy life and well-
being. Globally, almost three billion people rely on solid fuels (wood,
charcoal, crop residues and cow dung) and coal as their primary source of
domestic energy. Solid fuels accounts for more than one-half of the domestic
energy requirement in many developing countries.1
The health consequences of solid fuel use have been well documented. In a global
assessment of avoidable health risks published in 2002, the World Health
Organization (WHO) reported that in the year 2000 about 1.6 million people had died
from indoor air pollution2. In a subsequent 2009 report, the WHO raised the estimate
to 2.0 million deaths. The indoor smoke from solid fuels is the 10th leading cause of
avoidable deaths worldwide. It is the second most important environmental cause of
disease after contaminated waterborne diseases. In developing countries, indoor
smoke is responsible for an estimated 3.7% of the overall disease burden,
making it the most lethal killer after malnutrition, unsafe sex and lack of safe water
and sanitation. In rural areas, unlike urban areas, chullah is mainly used for cooking
purposes, which increases the chances of house hold air pollution.3
Around the world more than one-third of the population relies on solid fuels for their
household energy needs. These fuels have been burnt over the centuries when people
started cooking and found them as a source that caught fire and acted as fuel for it.
Stoves were created later for safer and speedier cooking and according to how each
biomass fuel could be utilized. These stoves as not being efficient enough poorly
burnt the fuel and people cooking inside the living room in poorly ventilated
conditions have been facing major problems that in turn relate to burning of biomass

1
fuels The smoke resulting from incomplete combustion contains a range of health
deteriorating substances that, at varying concentrations, can pose a serious threat to
human health, especially women and younger children. There is sufficient evidence
linking smoke from solid fuel use with acute infection of lower respiratory tract,
chronic obstructive pulmonary disease including chronic heart disease, eye problems,
skin problems and lung cancer (WHO 2008). It has been reported that chronic
nutritional deficiencies including anemia and stunted growth in children with constant
smoke exposure figured out 94% of the population of respondents in Nepal using
biomass fuels in which increased the particulate matter in the kitchen three times of
those using better fuels life, liquefied petroleum gas and biogas.4

Nepal is characterized by large number of beautiful landscape having diverse

topographical, geographical and physiographical situation. Most of the people live in
the rural and semi urban or peri urban area. Biomass is the major sources of energy in
this area. The overall energy consumption of Nepal is largely dominated by the use of
traditional non commercial forms of energy such as fuel wood, agricultural residues
and animal waste. The share of traditional biomass resources is 87%.5

1.2 Rationale of the study

Air pollution, particularly house hold air pollution being a critical issue plays pivotal
role in deteriorating health of the people and burning of solid fuels and biomass
adversely affects health of the people. House hold air pollution is a common cause of
morbidity and mortality especially in resource-poor communities. A significant source
of house hold air pollution is the burning of fuels such as solid fuels in stoves.7 Over
3 billion people worldwide cook in their homes with solid fuels. Cooking with this
source of fuel exposes people to the toxic fumes which contain dangerous particulate
matter, carbon monoxide, nitrogen oxides, formaldehyde, benzene, polycyclic
aromatic hydrocarbons and other toxic pollutants from the fire wood smoke.1 In
most of the developing countries like Nepal the particulates released during cooking
are responsible for up to 780/1000 deaths resulting from lung diseases, ischemic heart
disease and cardiovascular diseases combined.1
In Nepal, different health problems are caused due to house hold air pollution. Till
now, no documented research has been conducted to assess the health impacts of
house hold air pollution among solid fuel users of Kaski district. Thus the researcher

2
felt the need to assess the health impact of household air pollution among solid fuel
users.
Hence this study on knowledge on indoor air pollution is carried out to identify the
knowledge on health impact of household air pollution in Lekhnath 15, Kaski. If
people who use solid fuels for cooking purpose have knowledge about the impacts of
fire smokes and house hold air pollution then they can further prevent the impacts of
indoor air pollution by substituting the solid fuels to bio gas or other fuels for cooking
purpose. The domestic smoke exposure increases the risk of a range of common and
serious diseases. Further, association of exposure with chronic bronchitis and chronic
obstructive lung disease is quite well established in recent researches.6

1.3 Significance of the Study

The study finding might be helpful to all the health personnel, as well as nursing
students of various levels to understand the knowledge level of community people on
health impacts of household air pollution. It helps to provide baseline data for further
researcher. It is beneficial for health care planner and environmental worker for
developing new programme regarding the improvement of physical health of solid
fuel users and for the prevention of health impacts of household air pollution.

1.4 Objectives of the Study

1.4.1 General Objective

To explore the knowledge on house hold air pollution among the families of solid fuel
users.

1.4.2 Specific Objectives

• To identify the contributing factors for household air pollution.

• To assess the effects of solid fuel users on household air pollution.
• To find out the preventive measures of household air pollution.

1.5 Research Question

What is the existing knowledge on household air pollution among the solid fuel
users of Lekhnath 15, Kaski?

3
1.6 Variables of Study

1.6.1 Independent Variables

Economic status

Cultural variables

Family income

Family size

Educational level

1.6.2 Dependent Variables

Knowledge on house hold air pollution.

4
1.7 Conceptual Framework

Independent Variables Dependent Variable Outcome

Economic
status
Prevention from
Cultural Knowledge on different
variables household health impacts
air pollution of household
Family
air pollution
income

Family size

Educational
level

Figure: Conceptual framework on knowledge on household air pollution

5
1.8 Operational definition

Knowledge: Facts, information, acquired by a person through experience or

education; the theoretical or practical understanding of household air pollution, its
contributing factors, effects of use of solid fuels.

The knowledge will be assessed in terms of Bloom’s cuts of point where knowledge
level will be scored according to the following: 8

High Level = above 80%

Moderate Level = 60-80%

Low Level = less than 60%.

House hold Air Pollution: Any harmful contaminants in the air inside the house due
to pollutants from things such as gases and particles from solid fuels are known as
House hold air pollution.

Solid fuels: Solid fuels can be defined as the various types of solid material that are
used as fuel to produce energy and provide heating, usually released through
combustion.
Solid fuel users: Solid fuel users can be defined as the people who use various types
of solid material to produce energy and provide heating, usually through combustion.

6
 CHAPTER II

REVIEW OF LITERATURE

2.1 Introduction

Review of literature is a key step in research process. Review of Literature refers to an

extensive, exhaustive and systematic examination of publications relevant to the
research project. Review of literature is defined as a broad, comprehensive in depth,
systematic and critical review of scholarity publications, unpublished scholarly print
materials, audiovisual materials and personal communications.

The purpose of the literature review is to generate idea regarding the research topic, to
be oriented about what is already known, develop idea regarding research
methodology and for becoming aware of the difficulties faced by previous researcher.
In order to find out the appropriate literature (research article, study report, journal,
text book, etc) the researcher has visited the different library. Besides, relevant web
pages have also browsed. Therefore literature has been reviewed and cited here to find
out the knowledge on indoor air pollution among fire wood users.

2.2 Review of related literature

The area selected for sampling was the Uchalli Wetlands Complex which in the
Northwest of Khushab district in Pakistan. The age of 19-95 were interviewed with a
majority of males, houses in the area were mainly of stone blocks and majority males
in the area worked in the city. Combined family system was prevalent in the area
(80%) with about 42% of the population having no formal education. A wide variety
of stoves were observed in the area with wives having a major decision (69%) in fuel
choice which mainly depended on the cheapness and availability of the fuel. The
cooking being mostly done (79.8%) outside in summers and indoors in winters.
Majority of the respondents (94.7%) were aware that liquid petroleum gas and natural

7
gas are better ways of reducing pollution and decreasing the incidence of diseases
which included using dry wood, proper ventilation and many others.9

One month field work on Improved cooking stove (ICS) was conducted in the
Dadagaun, ward no.4 of Jhaukhel, Bhaktapur. Community awareness program was
launched and people were encouraged to use ICS as an alternative to Traditional
Cooking Stove. More than 80% houses’ kitchens of that area were installed with ICS.
After installation of ICS there was reduction in fuel wood consumption and indoor air
pollution. As there was reduction in the time spent inside kitchen for women, it
favored the scope for them to be engaged in other income generating activities and
help in raising their living standard.10

The study conducted about the relationship between the urban and rural environment
condition. There was 58% in the urban and 94% rural household were using solid
fuel in the Pakistan. The study investigated variations in indoor and outdoor
concentrations of particulate matter while activities for three different micro-
environments in Pakistan. The study concluded that there was high level of
concentration of particulate matter in the kitchen because of the using solid fuel for
the cooking than the living area. So the women had to spend mostly time in the
kitchen so she faced greatest exposure.11

The study about the air pollution associated health benefits of interferences to reduce
indoor air pollution cooking heating with solid fuels were estimated in South and
South- east Asia, Africa, and the Americas using widespread cost- helpfulness
method. Two major health results with indoor air pollution are attended, namely
severe lower breathing pollutions in young children under five years of age and
chronic disruptive lung disease in adults over twenty. While providing approach to
cleaner fuels has a larger health impact on the population than improved stoves, there
is much health benefit associated with improved stove use. Expanded stoves were also
much more price than cleanser fuels, oil, or paraffin, is more cost- active than watery
gas , since fuel is cheaper than liquefied petroleum gas.12

The inhabitants which is depending on biomass fuel in the Pakistan is 94% in the
countryside areas and 60% in the city areas. Some common infection and such warn
diseases evaluated in the dwelling of Sabour village. There 50.3% family member had

8
Chronic Obstructive Pulmonary disease. 12.7% family member had Respiratory
Infection. 9.6% had asthma and 6.4 respondent’s family member had lungs cancer.
Majority of woman of village depend on biomass fuel because of for reasons poverty,
lack of knowledge level, facility of natural gas is not accessible and easily availability
of biomass fuel. Effected population is considered trouble on the society that area
cannot development properly.13

The study was conducted in the Ethiopia. This study explained the women awareness
about health problem related to the indoor air pollution caused by the use of biomass
fuel for the cooking. There were 80% population lived in the rural areas and using
biomass fuel for the cooking. Women are often cooking indoor in non-ventilated
areas. They have less awareness about the health although the women interviewed did
consider some fuels as cleaner than others. There was respiratory disease more two
three time than the urban areas or the middle class family which were not using
biomass fuel for cooking.14

The research was conducted at Bolivia in 2002. Study was about indoor air pollution
and human health. The data was collected in 448 families. 70 % of questionnaires
were filled by women, 10% husband and wife, 8% daughter, 12% by husbands. In
52% of the residents, the kitchens were located inside the houses in the ground floor.
The rest, 36%, were independent structures separated from the house. 15

The indoor pollutant which caused by the use of the biomass fuel. The Tobacco
smoke was the highlighted as the indoors pollutant in the both scientific journal by the
international and the government originations. It was significant effect of the indoor
pollutant in the Pakistan. It is because of the use of biomass fuel for the cooking
mostly in the rural Areas it contributes in the poor indoor quality by the smoke of
biomass fuel. It need be country wide awareness to the public by the advocacy
campaign which was association with the air pollution and ill health the development
and adaptation of the improve cooking stove is most suitable choice for the population
according to the current socioeconomic conditions of the country. Thus it needs to be
exploring further biogas as a fuel. 17

In China, studies have been performed to evaluate the impact of outdoor air pollution
and solid fuel smoke exposure on COPD; and most studies have focused on the role

9
of air pollution in acutely triggering symptoms and exacerbations. Few studies have
examined the role of air pollution in inducing path physiological changes that
characterize COPD. Evidence showed that outdoor air pollution affects lung function
in both children and adults and triggers exacerbations of COPD symptoms. Hence
outdoor air pollution may be considered a risk factor for COPD mortality. However,
evidence to date has been suggestive that chronic exposure to outdoor air pollution
increases the prevalence and incidence of COPD. Cross-sectional studies showed
biomass smoke exposure is a risk factor for COPD. A long-term retrospective study
and a long-term prospective cohort study showed that biomass smoke exposure
reduction with a decreased risk of COPD.18

Smoke from both coal and biomass contains substantial amounts of carcinogens,
including benzo[a]pyrene, 1,2 butadiene and benzene. A consistent body of evidence,
particularly from China, has shown that women exposed to smoke from coal fires in
the home have an elevated risk of lung cancer in the range 2-6. This effect has not
been demonstrated among populations using biomass, but the presence of carcinogens
in the smoke suggests that the risk may be present. Synergistic health impact between
use of coal for domestic heating and passive smoking from environmental tobacco
smoke has also been noted.19

Asthma Fewer than 10 studies from developing countries examining the association
between solid fuel smoke and asthma (mainly in children) have been published .
Again, outcome definitions have not been well standardised, exposure has not been
measured and confounding has not been dealt with in some studies. Evidence so far is
inconsistent in both industrialized and developing countries; however, taken together
with studies of environmental tobacco smoke and ambient pollution, the evidence is
suggestive that wood smoke pollution may exacerbate and/or trigger asthma in
sensitised people.20 There have been three published studies to date examining the
association with tuberculosis. An analysis of data from 200,000 Indian adults as part
of the Indian National Family Health Survey (1992-93) found that persons living in
households burning biomass reported tuberculosis more frequently compared to
persons using cleaner fuels, Although large, this study relied on self-reported
tuberculosis. The other studies used clinically defined tuberculosis and found
consistent results. More research is needed to fully understand the nature of this

10
relationship. Such an association, if proven, may be due to reduced resistance to
infection as shown in laboratory experiments with animals exposed to wood smoke.21

One study has been reported from a developing country. This found an association
between perinatal mortality (still births and deaths in the first week of life) and
exposure to indoor air pollution, with an odds ratio of 1.5 adjusted for a wide range of
factors, although exposure was not assessed directly. Although this finding is of
marginal statistical significance, there is also some supportive evidence from outdoor
air pollution studies.22

One study of the effects of fuel use on birth weight in a developing country has been
published. This study, conducted in Guatemala, found that birth weight was 63 grams
lower for babies born in households using wood versus those using cleaner fuels. This
estimate was adjusted for confounding but exposure was not assessed directly.23

Eye Irritation and Cataract Eye irritation (sore, red eyes and tears) from smoke is
widely reported, but there is also preliminary evidence that it may be associated with
blindness. A hospital-based case-control study in Delhi comparing liquid petroleum
gas with solid fuel use found adjusted odds ratio of 0.62 for cataracts (LPG use had
lower risk).19 Animal studies report that biomass smoke damages the lens and
evidence from environmental tobacco smoke is also supportive.24

In the study done in 74 healthy asymptomatic women divided into two age matched
groups of 37 each. Pulmonary function tests were assessed by computerized
spirometry and statistical comparisons done on women using solid fuel (study group)
and women using other sources of fuel (LPG/ electric stove) for cooking (control
group). The pulmonary function test results showed significant reduction in forced
expiratory lung volumes like Forced Vital Capacity , Forced Expiratory Volume in 1
second, Forced Expiratory Flow between 25-75% and Forced Expiratory Volume
percentage (FEV1%) in biomass fuel users as compared to those not exposed to
biomass fuel smoke. The results of this study suggest that solid fuel smoke may
produce definite impairment in lung function, especially with regard to the smaller
airways.25

11
One hundred sixty nonsmoking women were included in the study. Demographic data
and information about symptoms and other environmental exposures were collected.
All women underwent spirometry and those with COPD also had their lung volumes
measured.The COPD group had greater exposure in years to wood smoke (p = 0.043),
greater length of rural residence (p = 0.042) and the same length of passive smoking
(p = 0.297) and farm work (p = 0.985). Cough (69.8%), sputum (55.8%) and
wheezing (67.4%) predominated in the COPD group (p < 0.001) compared to those
without COPD (40.2%, 27.4%, 33, 3%, respectively). The COPD patients had mild to
moderate obstructive disturbance and normal lung volumes, except that the residual
volume and total lung capacity ratio (RV/TLC) > 0.40 in 45%, which correlated
negatively with forced expiratory volume in one second and FEV1/vital forced
capacity ratio (FEV1/FVC).Women with prolonged exposure to wood smoke had
predominantly mild to moderate COPD. Those without COPD had a high prevalence
of chronic respiratory symptoms, justifying clinical and spirometric monitoring.26

The study was carried out to assess the level of awareness about household air
pollution in urban Indian population and to identify factors that influence this
awareness. A total of 754 subjects including 489 asthmatic patients and 265 control
subjects were recruited in the study. Result is 98.8% of the total subjects were not
able to score more than 25 marks. Out of 754 subjects 485 patients and 260 controls
could not pass the test. There was no difference between males and females regarding
the knowledge about house hold air pollution. Highly educated subjects were
associated with more awareness compared to less educated subjects but the difference
was statistically not significant. Age-wise distribution showed that young adults and
adults had more knowledge compared to older people but this difference was also not
statistically significant.27

In the study is about the indoor pollutant which caused by the use of the biomass fuel.
The Tobacco smoke was the highlighted as the indoors pollutant in the both scientific
journal by the international and the government originations. It was significant effect
of the indoor pollutant in the Pakistan. it is because of the use of biomass fuel for the
cooking mostly in the rural Areas it contributes in the poor indoor quality by the
smoke of biomass fuel28

12
The indoor air pollution was the major concern with the health in both developed and
developing countries. But the condition was worse in the developing countries the
developed countries. Biomass fuel was based on plant and animal waste material
which was burn incompletely by the human. It mostly used for the cooking purpose as
a fuel. It included wood, Coal, Agricultural residues and dung. It was estimated that
about 3 billion population of the world were depended on the biomass fuel. 2.4 were
using coal and mostly used in the china. there were regional variation in the use of
biomass fuel only 20% biomass fueled used in the Europe and majority were about
80% were used in the central Asia, sub Saharan Africa and south Asia.. Social and
economic development was necessary requirement for the access of modern energy.
The majority population of the world had not yet access to the modern energy.
Because lack of availability of energy and due to low economic status. 29

2.3 Summary of Literature Review

Many of the respiratory diseases and many other complications that result from indoor
air pollution are unpredictable and can affect the health of all family members of solid
fuel users. Having no knowledge on household air pollution leads to different health
problems. Household air pollution remains a significant global health threat that
needs to be addressed. The literature indicates ambient air pollution levels and
personal exposure levels from cooking with solid fuels are dramatically high.
Although the literature is growing, there is currently a number of information on
impacts on health, and even less on the impacts on the economic well-being of the
family. Awareness and knowledge regarding house hold air pollution causing
different health problems is still grossly inadequate in developing countries. The
studies in literature review highlights the urgent need for strategies to increase
awareness and knowledge about house hold air pollution hazards and possible
preventive measures among the general population of developing countries in order to
prevent chronic disease.

13
 CHAPTER III

METHODOLOGY

This section deals with methodology which was adopted for the study. This chapter
includes research design approach, setting of the study population, sampling
technique, sample criteria, instruments and development of tool, data collecting
procedure and data analysis procedure.

3.1 Research Design:

The descriptive cross sectional study design was adopted to find out health impacts of
house hold air pollution among solid fuel users.

3.2 Research Setting

There are 18 wards in Lekhnath municipality. The selected area for study was
Lekhnath 15. People in that area were from different religion, different ethnic group,
different cultural variation and with different socio economic status, where the
number of solid fuel users was high. The people with different socio-demographic
characteristics were available here. So, the researcher selected this community
purposively due to the fulfillment of sample criteria.

3.3 Study Population

The Study Population was the peoples of Lekhnath 15 of Lekhnath municipality,

Kaski. The total population of Lekhnath 15 is 1940

3.4 Sample size

Sample size was fifty.

14
3.5 Sampling Technique

Non-probablity sampling technique was used.

3.6 Inclusion Criteria

All the families in Lekhnath 15 who use solid fuels for cooking purpose were
included. Those families who were available and willing to participate were included
in the study.

3.9 Research Instrument

Structured interview schedule was used. The research instrument was divided into two
parts.

Part I: Socio demographics

This part consist of 7 question related to socio-demographic data: Age, Gender,

Ethnicity, Religion, Educational level, occupation, family income and family size.

Part II: Knowledge on House hold Air Pollution

This part consist of 17 questions related to knowledge on House hold air pollution
and solid fuel, its contributing factors, and preventive measures.

3.10 Validity and Reliability of instruments

Validity of the instrument was established by developing the instruments on the basis
of literature review, seeking the opinion of subject experts, peer discussion and
research advisor. The questionnaire was prepared in English language and translated
in Nepali Language so that the community people can understand easily. Reliability
was established by pre-testing the instrument on 10% of the total sample size ie.5
families who use solid fuels for cooking purpose. Data collected from pre-test was not
included in the study report. After pre-test, according to the need of study, required
modification was done in data collection questionnaires.

15
3.11 Data Collection Plan

Data was collected after getting approval from Pokhara University. Written
permission from Pokhara University was taken and consent was taken from each
respondents. Objectives was clearly explained to the respondents before each
interview. Data will be collected by interview. Respondents were forced to participate
in the study. Privacy and confidentiality was maintained.

3.12 Data Analysis Plan

After collection of data, checking, compiling and editing was done manually on the
same day of data collection. The collected data was coded and entered in SPSS
V.16.0. Descriptive data was analyzed by using mean, frequency and percentage.

Ethical Consideration

Before data collection objective of the study was well explained. Approval was taken
from concerned authority. Written consent was taken from all respondents for
interview. Anonymity and confidentiality was maintained and use only for study
purpose. Nobody were forced to participate in the study; those who show
unwillingness were excluded.

16
 CHAPTER IV

RESULTS

This chapter deals with the analysis and interpretation of the data collected from the
respondents. All the obtained data were analyzed according to research question and
objectives by using descriptive statistics such as mean, standard deviation, frequency
and percentage through table.

Table 1 shows the demographic characteristics of respondents. Table 2 illustrates

types of fuel used daily, reasons to use solid fuels, types of cooking stove used, and
cooking stove good for health and fuel harmful for health. Table 3 reveals knowledge
on effects of solid fuels, contributing factors of household air pollution and source of
information. Table 4 illustrates knowledge on health effects of household air
pollution, group of people affected, and knowledge on prevention of household air
pollution. Table 5 shows knowledge level of Respondents on Household air Pollution

17
 Table 1

Socio demographic Characteristics of the Respondents n= 50

Variables Frequency Percentage

Age
25-45 27 54.0
45-65 23 46.0
Ethnicity
Brahmin 23 46.0
Chhetri 07 14.0
Janajati 04 08.0
Dalit 16 32.0
Religion
Hindu 49 98.0
Christian 01 02.0
0ccupation
Teachers 01 02.0
**Others 49 98.0
Educational status
Illiterate 26 52.0
Primary 16 32.0
Secondary 08 16.0
Type of family
Nuclear 39 78.0
Joint 11 22.0
Minimum: 28years, Maximum: 59years, Mean ± S.D: 44.86±7.61
**Housewife, labor and business.

Table 1 shows that the mean age of respondents was 44.86±7.61. More than half (54%) of
respondents belong to age group 25-45 years. All the respondents were female. In terms of
ethnicity, nearly half (46%) of respondents were Brahmin. Others Most (98.00% and 98.67%)
of the respondents were Hindu and Housewife respectively. About half (52%) of the
respondents were illiterate and 78% of respondents lives in nuclear family.

18
 Table 2

Knowledge on Types of Stove and Harm of Solid Fuels

n=50
Characteristics Frequency Percentage

Reasons to use solid fuels

Cheaper than other 21 42.0
Utilization of fire wood 29 58.0
Types of cooking stoves used
With chimney 19 38.0
Without chimney 31 62.0
Cooking stove good for health
With chimney 48 96.0
Without chimney 02 04.0
Fuel harmful for health
LP gas 05 10.0
Solid fuels 45 90.0

Table 2 illustrates that the main reason for choosing solid fuels was utilization of fire woods
(58%). More than half (62%) of the respondents used cooking stove without chimney. Most
of the respondents (96%) choose with chimney as good cooking stove. And 90% of
respondents said that, solid fuels are harmful for health.

19
 Table 3

Knowledge on Effects of Solid Fuels and Source of Information

n=50

Characteristics Frequency Percentage

Effects of solid fuels*

Effect on health 41 82.0
Consume long time 13 26.0
Risk of fire 32 64.0
Accident 10 20.0
Source of information*
School 06 12.0
Radio 46 92.0
Television 44 88.0
Newspaper 03 06.0
Others** 21 42.0
*multiple response, **friends, community people and other source of information

Table 3 reveals that most of the respondents (82%) have knowledge on effects of solid
fuels and choose effect on health. And the main source of information for knowledge
on household air pollution is school and radio (92%) and television (88%)
respectively.

20
 Table 4
Knowledge on Contributing Factors, Health Effects and Prevention of
Household Air Pollution
n=50
Characteristics Frequency Percentage

Contributing factors*
Smoke from cooking fuels 44 88.0
Dust produced inside the house 38 76.0
Use of mosquito coils and insecticides 23 46.0
Smoke from cigarette 24 48.0
Health effects*
Respiratory problems 46 92.0
Cardiovascular problems 32 64.0
Eye problems 47 94.0
Skin problems 23 46.0
Others 04 08.0
Group of people affected
Elderly 16 32.0
Female 34 68.0
Prevention*
By substituting solid fuels with safer one 41 82.0
By improving the structure of cooking stove 28 56.0
By reducing other household air pollution 18 36.0

*multiple responses
Table 4 illustrates that, majority (88%) of the respondents said that, smoke from
cooking fuel is the contributing factor for household air pollution. The major health
problem related to household air pollution were respiratory problem and eye problem
(92% and 94%) respectively. The group of people affected by household air pollution
is elderly and female. Majority (68%) of the respondents choose female as the most
affected group. And all of the respondents said that the effects of household air
pollution can be prevented by substituting solid fuels with safer one (82%), by
improving the structure of cooking stove (56%) and by reducing other household air
pollution (36%).

21
 Table 5
Knowledge level of Respondents on Household air Pollution

n = 50

Knowledge Level of Respondents Frequency Percentage

High Level (>80%) 01 60.0

Moderate Level (60-80%) 19 38.0

Low Level (<60%) 30 02.0

Mean ± S.D: 20.420 ± 6.154,

Table 5 illustrates that the level of knowledge was assessed and categorized as high
level, moderate level and low level. The mean score of the respondents was 20.420 ±
6.154. Majority (60.00%) of the respondents had high level knowledge whereas
around one fifth(19.00%) had moderate level knowledge and only few (02.00%)
respondents had low level knowledge on household air pollution.

22
 CHAPTER V

DISCUSSION, CONCLUSION AND RECOMMENDATION

This chapter deals with discussion, conclusion and recommendation of the study.
Discussion section presents all the findings in comparison with those of the other
studies and conclusion are drawn from each of the findings. Recommendation gives
direction to future researcher and suggestion for improving present study for
generalizations.

5.1 Discussion

This study was conducted to assess the knowledge on household air pollution among
solid fuel users of Lekhnathn15. The findings of the study revealed that more than
half (54%) of the respondents were of age group 25-45years whereas near to half
(46%) of respondents were of age group 45-65years. All of the respondents were
female. . In terms of ethnicity, nearly half (46%) of respondents were Brahmin.
Likewise most (98.00% and 98.67%) of the respondents were Hindu and Housewife
respectively. About half (52%) of the respondents were illiterate and 78% of
respondents lives in nuclear family.

In this study, all of the people use solid fuels for cooking purpose. This result is
almost similar to the result of study done in Ethiopia, on women awareness about
health problem related to the indoor air pollution. Where 80% of people use biomass
fuel for cooking purpose.

In this study, near to half (42%) of the respondents use solid fuels because it cheaper
than other fuel and more than half (58%) of the respondents use solid fuels for the
utilization of fire wood. In village area, use of solid fuels might be due to easy
availability of fire wood and its cost effective than others.

In this study majority (62%) of the respondents use cooking stove without chimney
and two fifth (38%) of the respondents use cooking stove with chimney. However
most (96%) of the respondents select cooking stove with chimney as harmless

23
cooking stove. This study shows the respondents have knowledge but it’s not
applicable in practical life, this might be due to to easy availability of fire wood and
its cost effectiveness.

This study shows majority (90%) of the respondents select solid fuels as the harmful
cooking fuel. Most (82%) of them choose effects on health as the harmful effects of
solid fuel. Althouth they use solid fuels for cooking purpose.

In this study, the major source of information for the knowledge regarding solid fuels
and household air pollution are television (88%) and radio (92%) respectively.

This study shows the important contributing factor for household air pollution is
smoke from solid fuels (88%). Likewise about half (48%) of the respondents choose
smoke from cigarette is also a causative factor for household air pollution. It is
opposing to the study done in Pakistan, as it says the tobacco smoke was highlighted
as the indoor air pollutant. Smoking inside the house only cause household air
pollution but smoking in public places may harm the outer environment, but it may
not harm the indoor air quality. The study in Pakistan also supports the preventive
measure of effects of household air pollution by substituting solid fuels with other
safer fuels like Biogas.27

In this study, majority (92%) of the respondents and their family have respiratory
problems due to household air pollution. This findings were supportive to the study
conducted in Sabour village, Pakistan on health impacts of indoor air pollution due to
biomass fuel. There 50.3% family member had Chronic Obstructive Pulmonary
disease. 12.7% family member had Respiratory Infection. 9.6% had asthma and 6.4
respondent’s family member had lungs cancer who were non smoker and all the
respondents use solid fuels for cooking purpose.12

In this study, 94% of respondents and their family have eye problem due to smoke
from solid fuels. The hospital-based case-control study in Delhi comparing liquid
petroleum gas (LPG) with solid fuel use findings is supportive for this study. Where
the adjusted odds ratio of 0.62 for cataracts (LPG use had lower risk and solid fuel
users had higher risk).23

24
This study shows the majority (68%) of the people affected by household air pollution
are female. It might be due to the involvement of majority of female group in
household activities including cooking.

In this study, all of the respondents said that the effects of household air pollution can
be prevented. The household air pollution can be prevented by substituting solid fuels
with safer one (82%), by improving the structure of cooking stove (56%) and by
reducing other household air pollution (36%).
In this study, more than half (60%) of the respondents have low level of knowledge
on household air pollution. This is supportive to the results seen in the study of Indian
urban population conducted to assess the level of awareness about household air
pollution and to identify factors that influence this awareness.26 There are no fruitful
association between socio-demographic status and knowledge level of the
respondents.

5.2 Conclusion

The results of the study showed that majority of the respondents had poor knowledge
on Household air pollution. There was a significant lack of knowledge about
Household air pollution. Association between socio-demographic factors and
knowledge on household air pollution is not significant.

5.3 Limitation

The study was confined to only the peoples using solid fuels in Lekhnath
Municipality 15, so the result cannot be generalized.

The data collection time was two weeks only.

5.4 Implication

The study finding will be helpful to the other researcher to identify the knowledge on
Household air pollution among solid fuel users.

The findings of this study will be useful as a source of reference for the students or to
conduct such research in large scale.

25
5.5 Recommendation

Knowledge on Household air pollution will change with time and place. So, it should
be assessed from time to time in a population and should be acted according to need
of that society.

School, television and radio are the main source of information, more information on
Household air pollution should be delivered through it.

Further, qualitative research is needed to address the problems related to household

air pollution.

26
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3. Polsky D. Caroline L. The health consequences of indoor air pollution: A

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8. Yimer M, Abera B, Mulu W, Bezabi B. Knowledge, attitude and practices of
high risk populations on louse- borne relapsing fever in Bahir Dar city, north-
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2015from:http://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.2014
0201.13.pdf

9. Nepal, M., Nepal, A., and Grimsrud, K, Energy Sector Synopsis Report, 2010,”
Water and Energy Commission Secretariat, 2010. Retrieved on 16th April 2015
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10. Nasir, Z. A., & Ali, Z. (2010). Characteristics of indoor/outdoor particulate

pollution in urban and rural residential environment of Pakistan. Indoor Air
2010. Retrieved on 29th march 2015 from
www.ncbi.nlm.nih.gov/pubmed/20028432
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11. Mehta, S., & Shahpar, C. (2004). The health benefits of interventions to
reduce indoor air pollution from solid fuel use: A cost-effectiveness analysis.
Energy for Sustainable Development. Retrieved on 23rd April 2015 from
http://www.ncbi.nlm.nih.gov/books/NBK11760

12. Qasim, M., Usman, M., Anees, M., & Bashir, A. Indoor Particulate Pollutant
(Biomass Fuel) Epidemiology and Socio Environmental Impact and
Assessment of Awareness Level among Women 2013. Retrieved on 29th
march 2015 from http://idosi.org/aejaes/jaes13(11)13/11.pdf

13. Edelstein, M., Pitchforth, E., Asres, G., Silverman, M., & Kulkarni, N.
Awareness of health effects of cooking smoke among women in the Gondar
Region of Ethiopia: A Pilot Survey. International Health and Human Rights,
8(July) 2008. Retrieved on 15th April 2015 from
http://www.biomedcentral.com/1472-698X/8/10

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14. Mariana, N. & Sims, J. The Kitchen Journey, form black holes to Open
Spaces. Lund University Sweden 2009. Retrieved on 12nd April 2015 from
http://issuu.com/naintara/docs/evntment.

15. Polsky D. Caroline L. The health consequences of indoor air pollution: A

review of the solution and challenges. World Lp gas association2013.
Retrieved on June 13, 2015 from
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socioeconomic-impact-of-switching-to-lp-gas-for-cooking.pdf

16. Gouping H. Zhong N. Pixin R. Journal of Thoracic Disease, United Nation

Library of Medicine, National Institute of Health, JThoracicDis. Jan 2015,
Retrieved on 17th April 2015 from www.ncbi,n/m.nib.gov/pmc
articles/pmc4311081

17. Daigler GE, Markello SJ, Cummings KM. The effect of indoor air pollutants
on otitis media and asthma in children 101,2007. Retrieved on 29th March
2015 from http://www.ncbi.nlm.nih.gov/pubmed/2000018

18. Bruce N, Perez-Padilla R, Alablak R. Indoor air pollution in developing

countries: a major environmental and public health challenge. WHO Bulletin,
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19. Pintos J, Franco EL, Kowalski LP, Oliveira BV, Curado MP. Use of wood
stoves and risk of cancers of the upper aero-digestive tract: a case-control
study. International Journal of Epidemiology, December 2008. Retrieved on
17th April 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377187

20. Mavalankar DV, Trivedi CR, Gray RH. Levels and risk factors for perinatal
mortality in Ahmedabad, India. WHO Bulletin, 2006. Retrieved on 29th March
2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3511893

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21. Boy E, Bruce N, Delgado H. Birthweight and exposure to kitchen wood
smoke during pregnancy. Environmental Health Perspectives, 2006. Retrieved
on 3rd April 2015 from http://www.ncbi.nlm.nih.gov/pubmed/11781172

22. Mohan M, Sperduto R, Angra S, Milton R et al. India-US case control study of
age-related cataracts. Archives of Opthalmology, 2009. Retrieved on 16th
April 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1723947

23. Clin J. Diagn R. Altered Lung Function Test in Asymptomatic Women Using
Biomass Fuel for Cooking, Journal of Clinical Diagnostic Research, oct 2014
ISSN 0973-709X. Retrieved on 16th April 2015from,
www.ncbi.n/m.n,h.gov/pmc4253149

24. Moreira MA, Barbosa MA, Jardim JR, Querioz MC, Inacio LU, Chronic
obstructive pulmonary disease in women exposed to wood stove smoke,
NCBI, 2013. Retrieved on 16th April 2015 from
www.ncbi.n/m.nih.gov/pubmed/24211014

25. De Koning HW, Smith KR, Last JM , Biomass fuel combustion and health,
NCBI, 2013. Retrived on 17th April, from
www.ncbi.n/m.nih.gov/pmc/articles/pmc2536350

26. Niphadkar VN, Rangnekar K, Tulaskar P, Deo S, Mahadik S, Kakade MK,

Poor Awareness and Knowledge about Indoor Air Pollution in the Urban
Population of Mumbai, India, June 2009. Retrieved on 17th April 2015 from
http://archive-org-2013.com/org/j/2013-11-05_3138642_9/Journal-of-The-
Association-of-Physicians-of-India

27. Colbeck, I. Nasir, Z. A. Department of Biological Sciences, Interdisciplinary

Centre for Environment and Society, University of Essex, Colchester 2010.
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28. Zafar. F., Ambreen, K., Kadir, M. M. Nalini, S. Situational Analysis of
Household Energy and Biomass Use and Associated Health Burden of Indoor
Air Pollution and Mitigation Efforts in Pakistan. S, Int. J. Environ. Res.,
Public Health, 2010. Retrieved on 29th March 2015 from
http://www.ajmse.leena-luna.co.jp/AJMSEPDFs/Vol.3(2)/AJMSE2014(3.2-
08).pdf

31
 ANNEXURE–I
OFFICIAL LETTER

I
II
 ANNEXURE II
CONSENT FORM

Research Title: “Knowledge on Household Air Pollution Among Solid fuel Users”

Namaskar, my name is Sangita Subedi studying in Pokhara University as a student of

B.Sc. Nursing 4th year, 3rd batch. This research study is carried out for the partial
fulfillment of the requirement of Bachelor of Science in Nursing Program. The
objective of this study is to identify knowledge on household air pollution among
solid fuel users. Your participation in this survey is very important and is completely
voluntary. I assure that your personal information and answers will remain
confidential and will be used for study purpose only. I would like to request for
valuable support by answering the questions ask in interview. Your co-operation will
be very much helpful to give the final structure of this study. I am looking forward for
your kind cooperation.

Thank -you!

Would you like to participate as a respondent in this research study?

Yes No

If yes, please do signature ……………………

III
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IV
 ANNEXURE –III

Pokhara University

Faculty of Science and Technology

School of Health and Allied Sciences

B. Sc. Nursing Programme

Lekhnath-12, Kaski

Structured Questionnaire for the assessment of knowledge on house hold air pollution.

Code No:

PART I
Date:
(SOCIO-DEMOGRAPHIC INFORMATION)

1. Age (in years) …………..

1.Sex
a. Male
b. Female
2.Ethnicity
a. Brahmin
b. Chhetri
c. Janajati
d. Dalit
3. Religion
a. Hindu
b. Buddhist
c. Christian
d. Muslim

V
 4. Occupation
a. Farmer
b. Teacher
c. Service
d. Others (house wife, labor, business)
5. Education
a. Illiterate
b. Primary
c. Secondary
d. Higher
6. Total family income in year……………..
7. Family structure
a. Nuclear
b. Joint

PART II
(KNOWLEDGE ON HOUSE HOLD AIR POLLUTION)
1. Which types of fuel can be used daily in house?*Multiple response
a. Bio gas
b. LP gas
c. Solid fuels
d. Others (charcoal, cowdung)
2. Which type of fuel you used daily?*Multiple response
a. Fire wood
b. Charcoal
c. Cow dung
d. Others
3. What are the effects of solid fuels?*Multiple response
a. Effects on health
b. Consume more time
c. Risk of fire
d. Risk of accidents

VI
4. Why you use solid fuels for cooking purpose?*Multiple response
a. Large family size
b. For warmth
c. Cheaper than other
d. Utilization of fire woods
5. What type of cooking stove is used?
a. With chimney
b. Without chimney
c. Both
6. Which type of cooking stove is good for health?
a. With chimney
b. Without chimney
7. What do you mean by household air pollution?
a. Pollution from dust and smoke produced inside the house
b. Pollution from sun rays
c. Pollution from wind and storm
d. Pollution from impure water
8. What are the contributing factors for house hold air pollution?* Multiple
response
a. Smoke from fire wood
b. Dust produced inside the house
c. Use of mosquito coil and insecticides
d. Smoke from cigarette
9. What is the source of information for house hold air pollution?* Multiple response
a. School
b. Radio
c. Television
d. Newspaper
e. Others
10. Which type of fuel is harmful for health?
a. Bio-gas
b. LP gas
c. Solid fuels
d. Others
VII
11. what are the effects of house hold air pollution?* Multiple response
a. Respiratory problems
b. Cardiovascular problems
c. Eye problems
d. Skin problems
e. Others
12. Have any health problems related to household air pollution in your family?
a. Yes
b. No
13. If yes then, what type of health problem related to household air pollution, in
your family have?* Multiple response
a. Respiratory problems
b. Cardiovascular problems
c. Eye problems
d. Skin problems
e. Others
14. Which group of people is mostly affected by household air polluiton?
a. Elderly
b. Children
c. Male
d. Female
15. Can you prevent the effects of house hold air pollution?
a. Yes
b. No
16. How can we prevent those effects of household air pollution?* Multiple
response
a. By substituting solid fuels with safer one
b. By improving the structure of cooking stoves
c. By reducing the other house hold air pollution

VIII
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IX
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v_ w]/} ;do vr{ x'g]
u_ cfunfuL x'g ;S5
3_ b'3{6gf x'g ;S5
$= lsg tkfO{Fn] 7f]; OGwg k|of]u ug'{x'G5 <
s_ 7"nf] kl/jf/ ePsf]n]
v_ tftf]sf] nfuL
u_ c? eGbf ;:tf] eP/
3_ bfp/fsf] pkof]u
%= tkfO{Fsf] 3/df s:tf] k|sf/sf] r'Nxf]sf] k|of]u ug'{x'G5 <
s_ lrDgL ePsf]
v_ lrDgL gePsf]
u_ b'a}

X
 ^= s'g k|sf/sf] r'Nxf] :jf:Yosf nfuL /fd|f] x'G5 <
s_ lrDgL ePsf]
v_ lrDgL gePsf]
&= tkfO{n] 3/leqsf] jftfj/0f k|b'if0f eGgfn] s] a'‰g'x'G5 <
s_ 3/df pTkfbg x'g] w'nf] / w'jfFaf6 x'g] k|b'if0f
v_ 3fdsf] ls/0faf6 x'g] k|b'if0f
u_ xfjfx'/Laf6 x'g] k|b'if0f
3_ b'lift kfgLaf6 x'g] k|b'if0f

*= 3/ leq x'g] jftfj/0f k|b'if0fsf sf/s tTjx? s] s] x'g < -ax'pQ/Lo k|Zg_
s_ OGwgsf] w'jfF
v_ 3/af6 lg:s]sf] w'nf]
u_ nfdv'6\6] dfg]{ w'k, ls6gf;s cf}ifwL
3_ r'/f]6sf] w'jfF

(= tkfO{n] 3/leq x'g] jftfj/0f k|b'if0fsf af/]df sxfFaf6 yfxf kfpg'eof] < -ax'pQ/Lo k|Zg_
s_ ljBfno
v_ /]l8of]
u_ l6=eL=
3_ kqklqsf
ª_ cGo
!)= :jf:Yosf b[i6Lsf]0fn] tnsf dWo] s'g OGwg xfgLsf/s x'G5 <
s_ jfof] UofF; -uf]j/ UofF;_
v_ Pn\=kL= UofF;
u_ 7f]; OGwg
3_ cGo
!!= 3/leqsf] k|b'if0fsf c;/x? s] s] x'g < -ax'pQ/Lo k|Zg_
s_ Zjf; k|Zjf;df ;d:of
v_ d'6' tyf /Qm;+rf/ ;DaGwL ;d:of
u_ cfFvfdf ;d:of
3_ 5fnfdf ;d:of
ª_ cGo

XI
!@= tkfO{Fsf] kl/jf/df 3/leqsf] jftfj/0f k|b'if0fn] ubf{ x'g] s'g} k|sf/sf] :jf:Yo ;d:of 5 <
s_ 5
v_ 5}g
!#= obL 5 eg], tkfO{sf] kl/jf/df 3/leqsf] k|b'if0fn] ubf{ x'g] s:tf :jf:Yo ;d:of 5g\ < -
ax'pQ/Lo k|Zg_
s_ Zjf; k|Zjf;df ;d:of
v_ d'6' tyf /Qm;+rf/ ;DaGwL ;d:of
u_ cfFvfdf ;d:of
3_ 5fnfdf ;d:of
ª_ cGo
!$= 3/leqsf] k|b'if0fn] s'g ;d"xsf JolQmnfO{ a9L c;/ u5{ <
s_ j[4j[4f
v_ s]6fs]6L
u_ k'?if
3_ dlxnf
!%= s] tkfO{Fn] oL ;d:ofx? /f]syfd ug{ ;Sg'x'G5 <
s_ ;lsG5
v_ ;lsFb}g
!^= 3/leqsf] k|b'if0faf6 x'g] ;d:ofx? s;/L /f]syfd ug{ ;lsG5 < -ax'pQ/Lo k|Zg_
s_ 7f]; OGwgsf] ;6\6fdf cGo ;'/lIft OGwg k|of]u u/]/ .
v_ ;'wf/LPsf] r'Nxf] k|of]u u/]/ .
u_ cGo 3/]n' jftfj/0f k|b'if0fsf sf/0fx? sd u/]/ .
;xof]usf] nflu wGoafb

XII
 ANNEXURE IV

WORK PLAN

Date April May

Activities 12 19 26 3 10 17 24

Identification and finalization of

topic/problem

Topic presentation

Review of literature

Proposal development

Development of tools

Pretesting and correcting

Data collection

Data management and entry

Data analysis

Report preparation and presentation

Report Submission

XIII