Friday, March 28, 2014

Organization of Environmental Health Services: Directorate/ Department of Environmental Health and Sanitation

Environmental Health services play a pivotal role in health service delivery and concentrate on preventive and promotive health aspects which are vital for alleviation of current pressures on curative health services. Over the years, many definitions have been ascribed to Environmental Health. The World Health organization defines Environmental Health as the control of factors in man’s physical environment which exercises, or may exercise, a deleterious effect on his physical development, health or survival. Environmental health has been defined recently as comprising those aspects of human health, including quality of life, which are determined by physical, biological, chemical, social and psychological factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing these factors that can potentially affect adversely, the health of present and future generations. Environmental health programmes are organized community efforts to monitor and modify man- environment relationships in the interest of better health.

Some of the functions of Environmental Health include:
sanitation of the environment, inspection of premises, control of communicable diseases, disposal of wastes (i.e., garbage, general sewage and gaseous wastes including such special wastes like toxic and hazardous substances) potable water supply, good and sanitary housing condition, food sanitation, personal hygiene pests and rodents control, air pollution control, control o noise pollution, etc.

Environmental health plays a major role in disease prevention, control and the sustenance of environmental integrity. Therefore, as a broad concept in public health, it is ‘the science and art of preventing disease, prolonging life and promoting health through organized efforts of society. The outcome of environmental health activities is the prevention, detection and control of environmental hazards which affect human health.

The Goal of Environmental Health services
To improve the status of the environment in order to reduce environmental risk and promote healthy living.
Core Functions
Environmental Health Practitioners in Nigeria are appointed or employed under the Federal, State and Local Governments. However, the majority of the Officers are employed under the services of the Local Government Authority who has the primary responsibilities for the grassroots populace. In recent time, a few Environmental Health Officers have been employed in the Organized private sector (multinational petro-chemical industries) and consulting outfits. They are also employed in the military and
paramilitary formations. They carry out duties as specified in the Public Health Laws, Sanitation Law and Edicts, Food, Drugs and Chemical substances provisions among others. The Department of Environmental Health and Sanitation a leading role in the prevention and control of preventable diseases. The following are core functions of the Environmental Health Officers, which also constitute special areas (components).
The components of Environmental Health include:
i.             Waste management;
ii.          Food hygiene and control;
iii.        Pest and vector control;
iv.         Environmental health control of housing and sanitation;
v.           Epidmiological investigation and control;
vi.         Air quality management; occupational health and safety; water resources management and sanitation; noise control;
vii.       Protection of recreational environment; radiation control and health; control of frontiers, air and sea ports and border crossing;
viii.     Pollution control and abatement;
ix.         Educational activities (health promotion and education);
x.           Promotion and enforcement of environmental health quality standards;
xi.         Collaborative efforts to study the effects of environmental hazards (research);
xii.       Environmental health impact assessment (EHIA);
xiii.     Environmental and Public Health Laboratory Services;
xiv.     Disposal of the Dead (human and animals).
xv.       School Health Services (Sanitation)

In the Ministries of Health and Environment, the Directorate of Environmental Health Services (DEHS) is one of the oldest in the Public Health sector.
The Directorate of Environmental Health irrespective of its level of operations, should comprise the following divisions, namely:
1. Division of Environmental Sanitation;
2. Division of Environmental Health Data Management;
3. Division of Pollution Control;
4. Division of International Health & Port Health Services;
5. Division of Occupational Health and Safety;
6. Division of Environmental Health Education and Promotion;
7. Division of Epidemiology of Communicable and Non- Communicable Diseases;
8. Division of Emergencies and Response;
9. Division of Food Safety and Hygiene.

1. Division of Environmental Sanitation
i. Formulation and implementation of policies on health, hygiene and sanitation
ii. Maintenance of urban and rural sanitation;
iii. Maintenance of sanitation of dwellings, markets, public places, abattoirs, camps, exhibition grounds, park and informal settlements;
iv. Prevention and control of nuisances in the environment;
v. Promotion and co-ordination research on appropriate alternatives in sanitation and use of new technologies;
vi. Collaboration roles of partners and other stake-holders involved in implementing environmental sanitation and hygiene activities;
vii. Enforcement of Environmental Health Standards and Regulations
viii. Review of Environmental Health legislation;
ix. Promotion of waste analysis and segregation at source and safe re-use of wastes;
x. Promotion of safe disposal of wastes;
xi. Promotion and coordination of public-private sector partnerships in waste management;
xii. Development of guidelines/SOP on the management of Hospital/medical and electronic wastes;
xiii. Co-ordination of Integrated Pests and Vectors Management Activities;
xiv. Monitoring of activities of private sector pests and vector control service providers;
xvi.       Ensuring the safe handling and use of pesticides within the community.
xvii. Identification and mapping of ecological breeding sites of pests and vectors.
xviii. Ensuring continuous training and re-training of EHOs in the ecology, physiology of pests, etc.;
xix. While-on-the-job training and capacity building for control of insect pests, rodents and other vermin of Public Health Importance;
xx. Participate in planning of layouts, processing of building sites and plans.
xxi. Ensuring compliance with approved building plans as it affects health and safety issues;
xxii. Issuance of certificates of fitness for habitations and certificates of fitness for continued habitation or continued use of building and premises;
xxiii. Inspection of water packaging premises.

2. Division of Environmental Health Data Management
i. Participate in periodic monitoring, surveillance and evaluation of programmes in the directorate;
ii. Coordinate collection, collation, analysis, interpretation and storage of Environmental Health data;
iii. Conduct routine reporting, dissemination and feedback activities in environmental health management;
iv. Initiate periodic strategic planning processes in environmental health matters;
v. Coordinate Environmental Health Management Information system.

3. Division of Pollution Control
i. Ensure Public Health Safety of Water sources -- e.g., streams, rivers, wells, ponds, boreholes, pipe borne water, etc.).
ii. Conduct routine sanitary surveillance of drinking water quality.
iii. Map sources of contamination and pollution of water supply using Global Positioning System (GPS);
iv. Ensure safety of recreational water bodies -- e.g., swimming pools and beaches;
v. Remediate impacted sites;
vi. Prosecute polluters of water sources;
vii. Develop and application of assessment tools for pollution control;
viii. Enforce standards, rules, regulations and laws on pollution control;
ix. Liaise with stakeholders on environmental health monitoring;
x. Provide Environmental Health Laboratory support

4. Division of International Health and Port Health Services
i. Enforcement and implementation of International Health Regulations;
ii. Disease surveillance within the ports and frontier posts of entry and exit;
iii. Notification of occurrence of any diseases as required by national and international authorities;
v. Maintaining Environmental Sanitation including waste management within ports and frontiers; Ensuring Pest and Vector control within and around ports and frontiers;
vi. Ensuring food safety and hygiene at ports and land borders;
vii. Inspection of establishments
viii. Vaccination of certificates;
ix. Responding to any health emergencies within and around the port area;
x. Organizing periodic health education and promotion activities within the port;
xi. Ensuring compliance with relevant policies, rules, regulations and laws.
xii. Liaising with other stakeholders in the implementation of port health activities.

5. Division of Occupational Health and Safety
i. Ensure routine Inspection, detection and abatement of nuisances   in all work places.
ii. Ensure enforcement of use of safety devices by workers in workplaces.
iii. Ensure education/enlightenment of workers on safety regulations and standards.
iv. Conduct occupational health and safety assessments in work places.
v. Keep records of Occupational Health and Safety activities.
vi. Coordinate Health Safety and Environment (HSE) activities/programme in work places.
vii. Identify environmental health issues and challenges in relation to radiation, noise, air quality and EHIA.

6. Division of Environmental Health Education and Promotion;
i. Conduct periodic sensitization of the public on Environmental Health issues.
ii. Develop messages and sensitization packages for Environmental Health programmes;
iii. Develop and implement Environmental Health Education Behavioural change strategies;
iv. Develop and disseminate advocacy tool kits and education packages for Environmental Health Services.

7. Division of Epidemiology of Communicable and Non-Communicable Diseases Control
i. Identify local endemic diseases and health events.
ii. Institute disease prevention strategies.
iii. Participate in integrated disease surveillance and response.
iv. Investigate disease outbreaks and control.
v. Conduct disinfection and disinfestations.
vi. Map infected areas for disease control.
vii. Creation awareness on the signs, symptoms and prevention of diseases.
viii. Conduct hygiene and sanitation surveys.

8. Division of Emergencies and Response
i. Prediction and mapping of disaster prone areas.
ii. Risk forecasting and development of mitigation plans
iii. Identification and management of disaster and health emergencies.
iv. Collaborating with stakeholders in disaster and health emergencies.
v. Awareness creation on disaster management and control (including simulation)
vi. Establishment and updating of data base on disaster and emergencies.
vii. Predicting of environmental health risks due to climate change.
viii. Development of control and mitigation plans.

9. Division of Food Safety and Hygiene
a. Approval of food vending.
b. Inspection and licensing of food premises.
c. Annual approval and permitting for eateries, Cold rooms, butchers shops, fishmongers’ shops, and other food associated outlets.
d. Formulation of Food Safety Policy and implementation.
e. Food safety risk assessment, risk management and risk communication.
f. Surveillance on food borne diseases/illnesses.
g. Promoting food safety, quality and hygiene control
h. Awareness creation and Information dissemination to the Public on food safety.
i. Ensuring safety of genetically modified food for public use.
j. Conducting periodic surveys and operational research on food hygiene and safety.
k. Ensuring compliance with regulations guiding imported food items.
l. Collaboration with relevant agencies, (NAFDAC, Consumer Protection Council, etc.) to ensure the development, harmonization and enforcement of food safety standards.
m. Legislation on food hygiene and safety issues.

The WHO recommends a ratio of 1:8000 (EHO per population) for effective Environmental Health Service delivery. There is need for adequate number of Environmental Health Officers in all prescribed Divisions at National, State and [GA to ensure effective service delivery. There were 6,200 EHOs registered in Nigeria as at December 2011. Considering the fact that Nigeria has a population of approximately 160 million persons (2011 estimate), this translates to about 1:26,000 (EHO per population). This number of EHOs is grossly inadequate. There is urgent need to train and employ more EHOs. Therefore, EHORECON recommends that the ratio of EHO to the population shall be 1:6000 in densely populated area and 1:4000 in sparsely populated area.

Source:  Practice Guide of Environmental Health Officers in Nigeria, 2012 published by Environmental Health Officers Registration Council of Nigeria [EHORECON]