Incomplete transitions to clean household energy reinforce gender inequality by lowering women’s respiratory health and household labour productivity

•Household biomass burning affects women’s respiratory health and household labour productivity disproportionately.•Partially adopting clean cooking gas does not provide respiratory health or substantial time saving benefits.•Switch from traditional to ICS with chimneys improves respiratory health but this may be short-term.•Complete transition to cooking gas reduces gender inequality by improving women’s respiratory health and saving time and effort spent on biomass. India has over 800 million people without access to clean cooking fuel. A well-known, but under-researched aspect of poor access to clean energy is its cost on woman’s health and well being. Here we use the nationally representative India Human Development Survey, tracking the same set of households from 2005 to 2011, to quantify the gender-related health and time-saving benefits of a shift in a household’s fuel and stove use patterns. We show that across India, the predicted probabilities of cough in non-smoking women are 30%-60% higher than non-smoking men in solid-fuel using households, but that a complete transition from solid fuels to liquefied petroleum gas (LPG) for cooking reduces this gap to only 3%. Exclusive use of LPG is also accompanied by reduced cooking time (~37 min) and less time for collecting fuels (~24 min) in rural households, together saving up to an hour in demands on women’s labour each day. We also find electrification reduces the probability of developing cough by about 35–50% in non-smoking men and women across both rural and urban households, and help close the gap between men and women in rural households. Despite clean energy being a long-held policy goal of Indian governments, between 2005 and 2011, only 9% of households made a complete transition to clean energy, and 16.4% made a partial transition. We suggest that government efforts in India, and elsewhere, should focus on improving affordability, supply and reliability of clean fuels in enabling a complete household energy transition and help address key issues in gender inequality.