Clean cooking and cook stove interventions in Africa: a scoping review of exposure contrasts and future steps

In Africa, solid biomass fuels are widely used for household cooking, heating, and lighting, generating hazardous levels of household air pollution (HAP), including fine particulate matter (PM₂.₅), black carbon (BC), and carbon monoxide (CO). Inhalation of these pollutants is associated with adverse health outcomes. Women of childbearing age and young children experience the highest exposures due to their disproportionate time spent cooking and performing household activities. To mitigate these risks, interventions such as cleaner fuels and improved cook stove technologies have been promoted. However, evidence on their effectiveness in reducing pollutant exposure and improving health outcomes in African households remains fragmented, highlighting the need for a scoping review focused on the African context, where reliance on solid fuels is particularly high. To synthesize existing evidence and identify knowledge gaps through a scoping review of cleaner fuel and modified cook stove interventions in African households, examining changes in PM₂.₅, BC, and CO concentrations in cooking areas and/or personal exposures compared with traditional cooking methods. This review was prospectively registered with the Open Science Framework ( https://osf.io/thwsf/ ). We conducted a systematic search of Medline (PubMed), Web of Science, and CAB Abstracts. Eligible studies were intervention studies conducted in Africa that reported pre- and post-intervention household air pollution measurements. Study selection and data extraction followed JBI and PRISMA-ScR guidelines, using Colandr. The review mapped available evidence on reductions in household air pollution associated with cleaner fuel and cookstove interventions. Key gaps were identified, including limited assessment of pollutants beyond PM₂.₅, BC, and CO; inconsistent use of personal exposure measurements; uneven geographic representation across African regions; and scarce evidence on long-term effectiveness or direct links between interventions and health outcomes. This scoping review provides a comprehensive synthesis of evidence on clean cooking interventions in Africa and highlights critical research gaps. Addressing these gaps is essential to guide effective interventions, inform policy, and reduce household air pollution exposures among vulnerable populations.