Background: Three billion individuals worldwide rely on biomass fuel (crops, dung, wood) for cooking and heating, mostly in the developing world. Incomplete combustion of these biomass fuels in inefficient cookstoves leads to high levels of household air pollution (HAP). Health conditions resulting from HAP are responsible for approximately 1.6 million premature deaths each year. Of the diseases associated with HAP exposure, lower respiratory infections (LRIs) are the leading cause of death for children under five worldwide. There is a great need to understand the etiology of HAP-associated LRIs to inform health interventions and to improve treatments. Ultimately, however, the only way to prevent the disease burden from HAP is to stop exposure. Policies and programs to promote the use of clean fuels for cooking are a pivotal prevention strategy. Methods: All three studies draw from an established cohort in Ghana. The Ghana Randomized Air Pollution and Health Study (GRAPHS), was a cookstove intervention trial in Kintampo, Ghana. Participants were randomized to a more efficient biomass cookstove arm, a liquefied petroleum gas (LPG) stove arm, or the traditional cookstove arm (baseline). The principal outcome of GRAPHS was childhood pneumonia. The first chapter utilizes banked nasal swabs from GRAPHS to assess the relationship between HAP exposures and a panel of known respiratory pathogens. In the second chapter we leverage data on stove use during GRAPHS, and then follow a sub cohort 6 months prior to and 6 months after the GRAPHS termination date. We employ a novel construct, suspended use, to understand the factors associated with people stopping LPG use. The third chapter tests a new randomized intervention on a subset of the GRAPHS participants. We provide free cookstoves, and allocate participants to one of four arms: a behavior change intervention, an intervention where LPG fuel is directly delivered to their home, a dual intervention of behavior change and fuel delivery, or a control arm. We track their stove use to identify the most effective intervention on sustained use. Results: In Chapter 1, we find that the traditional cookstove users had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p<0.0001, n = 260). This difference was driven by increased bacterial (p<0.0001) rather than viral species presence (non-significant). Adjusted exposure-response analyses, however, produced null results. Chapter 2 identifies several factors associated with reduced or suspended LPG use of intervention cookstoves, including: experience of burns, types of food made, and access to biomass fuels. Finally, in Chapter 3 results show increased use for all three intervention arms, the largest for the direct delivery arm with an increased weekly use of 4.7 minutes per week (p<0.001). Conclusions: Transition away from traditional biomass stoves is projected to curb the health effects of HAP by mitigating exposure, but the full benefits of newer clean cookstove technologies can only be realized if use of these new stoves is absolute and sustained. This work enhances our understanding of the etiology of HAP-associated pneumonia, the drivers of clean cookstove suspension, and informs policies designed to promote clean cookstove sustained use, thus reducing the burden of disease associated with exposure. We recommend future use of the suspended use paradigm in research to inform future household energy interventions. Additionally, we encourage policymakers to incorporate health behavior change theory and approaches in cookstove intervention and promotion efforts.

This thesis comprises three chapters on topics in development economics. The first chapter studies access to maternal healthcare in markets with vertically differentiated public and private providers. The second chapter studies the efficacy of induction stoves in reducing indoor air pollution in rural households when faced with erratic power supply. Finally, the third chapter studies the role of financial incentives in correcting disparities in sex ratios. All three chapters study the context of India but are representative of important development issues in low-income countries. The first chapter titled "Equilibrium Effects of Subsidizing Public Services" studies one of India's largest welfare schemes Janani Suraksha Yojana (JSY) that incentivized pregnant women in India to access institutional maternal care at public hospitals. We argue that governments can make complementary investments to improve welfare gains from large scale policies. JSY did not improve health outcomes despite a substantial increase in the take-up of institutional care. We document three equilibrium responses that explain this policy failure. First, JSY led to a mismatch of risk across health facilities -- high-risk mothers sorted out of highest quality care at private facilities. Second, in line with the literature, public sector quality deteriorated as a result of congestion. This resulted in lower quality care for both marginal as well as infra-marginal patients at public hospitals. We show that only mothers with high socio-economic status adapted to the worsening quality of care at public hospitals by sorting into more expensive private hospitals. Third, despite increased competition, private hospitals maintained high prices, crowding out riskier and poorer mothers. We do not find evidence that private hospitals improved healthcare quality to justify higher prices. The second chapter titled "Electric Stoves as a Solution for Household Air Pollution" is an interdisciplinary field-based research study that studies the role of reliable electricity in inducing rural Indian households to switch away from dirty cooking fuels towards a clean cooking technology, induction cookstoves, thereby reducing the exposure to high levels of indoor air pollution. We collected minute-by-minute data on electricity availability, electric induction stove use, and kitchen and outdoor particulate pollution in a sample of rural Indian households for one year. Using within household-month variation generated by unpredictable outages, we estimate the effects of electricity availability and electric induction stove use on kitchen PM2.5 concentration at each hour of the day. Electricity availability reduces kitchen PM2.5 by up to 50 ??/?3, which is between 10 and 20 percent of peak concentrations during cooking hours. Induction stove use instrumented by electricity availability reduces PM2.5 in kitchens by 200-450 ??/?3 during cooking hours. The final chapter titled "Can Large-Scale Conditional Cash Transfers Resolve the Fertility-Sex Ratio Trade-off? Evidence from India" studies a large-scale conditional cash transfer (CCT) scheme Ladli Laxmi Yojana that offered cash incentives to households upon the birth of girl children. The policy also offered substantial incentive for investing in girls' education. In my evaluation of the Ladli Laxmi Yojana in Madhya Pradesh, India. I find that financial incentives aimed at the girl child increased average fertility by about 0.15 children per household (on baseline average of 0.93 children) children per household and improved sex-ratio by 3%. This points to the well known fertility-sex ratio trade-off. Moreover, these effects are quite opposite to a similar CCT scheme in Haryana (Anukriti, 2018) suggesting context dependence of such policies.