Exploring the multi-sectoral links between cooking and health in rural Malawi using Photovoice

Rural Malawians are part of a 3 billion worldwide population exposed to toxic pollution and ill-health through cooking on open fires or inefficient cookstoves using biomass fuels. This burden is a significant challenge to health systems in low income countries.  The Cooking and Pneumonia Study (CAPS) was a village-level randomised controlled trial of an advanced cookstove intervention recently completed in Malawi.

CAPS provided a unique opportunity to gain understanding about the social and cultural factors that may hinder or encourage use of advanced cookstoves and to explore gendered household dynamics and decision making in this context. A total of 50 participants from 5 representative CAPS villages participated in a Photovoice study in 2016. Images about cooking were collected over 5 days and discussed in village-level focus groups and in interviews.


This methodology facilitated an in-depth exploration of every-day priorities and decision making. The complexity of gendered household and community roles was illustrated through image collection and discussion and led to the development of a ‘picture’ of the socio-cultural context of adoption of the cookstove intervention. The expertise and autonomy of the photographers was also promoted.

Submitted by:
Jane Ardrey

Mice for Lunch

Family life is important in Chikhwawa and extended families may share food, cooking and childcare duties. Grandparents care for their grandchildren and children care for their siblings. Using large pots to cook shared meals can be difficult with cookstoves and this may lead to reversion to open fire cooking.

Photographer: Falesi Laiti

Mice for Lunch

The staple food in Chikhwawa is nsima, made from maize meal and is eaten with ‘relish’ which is often just vegetables, sometimes beans or dried fish, but uncommonly meat. Field mice are common at sometimes of year and are a good source of free, protein rich relish.

Photographer: Enelesi Paulo

Family preparing a meal on an open fire

Although women and older girls are the main cooks in villages households, open fire cooking, as shown in the background here, is part of everyday life and impacts on everyone. Infants are particularly vulnerable to toxic air pollution and this has also been linked with low birthweight.

Photographer: Margret Falakeza

Maize is life

Most people in Chikhwawa grow maize for their own consumption and sometimes for sale. Crops are generally rain-fed only and climate change has led to both floods and droughts resulting in severe food shortage and loss of income. A good crop is something to be proud of and provides security.

Photographer: Aines Banda

‘We are the champions!’

Football is a popular village activity which highlights gendered household roles. There is an expectation that girls will stay closer to home to help while boys usually have more free time for other activities. A lack of shoes is no barrier to dreams of being the next Mo Saleh.
Photographer: Mary Kennedy