Household fuel consumption, indoor air pollution, and respiratory health infections among children in Pakistan

Abstract Household energy use for cooking constitutes a significant portion of energy consumption in Pakistan. The use of unclean fuels releases harmful pollutants, increasing the risk of respiratory infections, which are a leading cause of mortality among children under five worldwide. This study assesses the impact of household fuel use on respiratory infections in children under five in Pakistan. This cross-sectional study utilized data from the Pakistan Demographic and Health Survey. The population included children less than five years of age. Logistic regression models were applied to assess the relationship between household energy type and respiratory infections, adjusting for confounding factors such as wealth status, maternal tobacco use, place of residence, and maternal education. The findings revealed that children in households using clean energy fuels had lower odds of respiratory infections (odds ratio [OR]: 0.70; 95% CI: 0.60–0.80). Having a separate kitchen was associated with reduced odds (OR: 0.80; 95% CI: 0.68–0.94), while children from the wealthiest households were significantly less likely to develop respiratory infections (OR: 0.54; 95% CI: 0.44–0.66). Conversely, maternal tobacco use increased the odds of respiratory infections in children (OR: 1.65; 95% CI: 1.34–2.04). Regional differences, urban vs. rural residence, and maternal education also emerged as important determinants. This study highlights the critical public health importance of promoting clean energy sources for cooking, improving kitchen design, discouraging maternal tobacco use, and addressing socioeconomic disparities to reduce respiratory infections among children in Pakistan. Policymakers should prioritize accessible clean energy solutions and targeted health interventions to improve child health outcomes.