Insights into household air pollution: A systematic scoping review on perceptions of solid biomass fuel use in South Asian countries.

Introduction: Over half of the world's population cooks using solid fuels, which poses serious health hazards, making women and children more vulnerable to household air pollution (HAP). Despite progress towards universal access to cleaner fuels, 47% of families continue to use fossil fuels. Objectives: This review aimed to understand the perceptions of solid fuel users in South Asian countries regarding the use of solid fuel for lighting, heating, and cooking. Materials and Methods: The perceptions of solid fuel users were categorized into six key domains derived from the Social Ecological Model (SEM): (a) Community, Family, and Health, (b) Home, Space, Place, and Roles, (c) Cultural and Cooking Practices, (d) Environment, and (e) Practice and Policy Development. This scoping assessment was conducted using the PRISMA-ScR guideline, and finally twenty-four articles were selected from four databases: Scopus, Web of Science, Science Direct, and PubMed. The result was categorized under six key domains based on the SEM. Results: The review revealed inconsistencies and a research gap in HAP perceptions. Participants prioritized household security over ventilation and short-term health over the long-term benefits of treatment. Women and children, experiencing higher HAP exposure rates than men, had less decision-making authority over the use of solid fuels, highlighting a socio-demographic gender gap. Community norms and cultural traditions play a crucial role in policy and practice. Conclusion: Further research and locally-based, community-led interventions are necessary to bridge these gaps and minimize the global burden of illness related to HAP. Addressing the identified gaps and disconnects is crucial to decreasing the global illness burden linked to HAP.