Identifying the role of Civil Society Organizations in shaping Indigenous Mexican women’s health literacy, gender empowerment, and use of improved cookstoves

Abstract Background While large-scale interventions have addressed household air pollution through the implementation of improved cookstoves (ICSs), the impact of small-scale interventions led by Civil Society Organizations (CSOs), particularly when combined with participatory methods, remains underexplored. This study examines the intersection of gender, health, social structures, and empowerment to better understand the downstream effects of CSO-led initiatives. Methods This three-phase participatory study (2019–2024) with Indigenous women in Mexico involved co-designing ICSs, conducting in-depth interviews with 14 participants, and analyzing secondary de-identified data. Interviews explored perceptions of CSO activities and ICS use across five thematic domains. Secondary data analysis consisted of iterative inductive and deductive coding. Results Findings show that CSO engagement significantly influenced participants’ perspectives. Participants described the barriers to access quality health care. They experienced an increased health literacy particularly regarding the respiratory risks of open-fire stoves. They also developed language and attitudes reflecting increased gendered equity and empowerment. Conclusions This study demonstrates that promoting Indigenous women's rights to health and gender equity through CSO interventions empowered female participants to advocate for themselves, value their labor, understand women's rights, improve their health, and strengthen social and economic networks, fostering solidarity and reducing gender inequities. The collaborative methodology frames the process of stove design and usage as a conversation between local actors, practitioners, and scholars. Findings highlight the importance of integrating technology and local culture to address gender inequities and promote sustainable health improvements in marginalized communities.