Caspian Journal of

Background: Household air pollution (HAP) from biomass cooking fuels is a significant environmental health determinant in developing countries, contributing to neonatal respiratory morbidity and mortality. Despite its global impact, the specific effects on neonates and community-based mitigation strategies remain underexplored.
Objective: This narrative review synthesizes evidence on the impact of HAP on neonatal health outcomes and evaluates community-based interventions, such as improved cookstoves and ventilation systems, to reduce neonatal respiratory risks in developing countries.
Methods: A comprehensive literature search was conducted using PubMed, Scopus, and grey literature sources (e.g., WHO reports) from 2015 to 2025, with a focus on studies from developing countries. The inclusion criteria encompassed epidemiological studies, intervention trials, and qualitative research on HAP and neonatal health, excluding laboratory-based, animal, and economic studies. Data were extracted on study design, outcomes, and intervention efficacy, with quality assessed using the Joanna Briggs Institute checklist. Narrative synthesis was used to analyze findings.
Results: HAP exposure was associated with a 20–40% increased risk of neonatal respiratory distress, low birth weight, and mortality. Promising results have been observed from community-based interventions, including improved cookstoves, which reduce particulate matter exposure by about 30%, and enhanced household ventilation, associated with a 25% decline in neonatal respiratory symptoms. Challenges include cultural barriers and cost.
Conclusion: HAP significantly impacted neonatal health, but community-based mitigation strategies offer feasible solutions. Scaling these interventions requires policy support and community engagement to enhance neonatal outcomes in developing countries.