Proposed Study to Assess the Environmental Sanitation Needs of Ghanaian Communities

1. Proposed Study to Assess the Environmental Sanitation Needs of Ghanaian Communities Yela Awunyo-Akaba Department of Social and Behavioural Sciences Sch. of Public Health, Univ. of Ghana

2. Background • As a research institution, mandate to conduct studies to improve the health of our people • Environmental Sanitation- critical problem in spite of prior and ongoing interventions • What accounts for lack of behaviour change? • Focus: Solid Waste Management • Waste Management involves the collection, transportation, processing and recycling of waste materials produced through human activity

3. Government Environmental Structures • The government’s structures for managing our waste well defined • The Ministry of Local Government and Rural Development’s National Sanitation Policy supports the Environmental Sanitation Service Delivery and enforces compliance of sanitation rules • The programme components are: effective environmental health inspections (Sanitary Inspections), dissemination of sanitation information (Hygiene Education), pests/vector control and law enforcement

4. continued • Regulatory Authority is vested in the Environmental Protection Agency (EPA) • The Ministries of Health, Education and Industry are also stakeholders

5. continued • The Metropolitan, Municipal and District Assemblies are responsible for the collection and final disposal of solid waste through their Waste Management Departments and their Environmental Health and Sanitation Departments • but there are inefficiencies due to insufficient resources, ineffective management and the lack of well trained and motivated personnel.

6. Conclusions-Government Agencies • DAs are semi-autonomous and can decide % of budget to allocate to sanitation projects • Revenue generated cannot support effective waste collection and disposal • Public unaware of need to pay for waste collection • Improper tax system for urban dwellers • The laws and regulations are not a sufficient deterrent to bad hygiene behaviour and not consistently enforced • Poor institutional cooperation and collaboration

7. Interventions to Manage Sanitation and Hygiene • The Urban Environmental Sanitation Project (UESP), 1997 • Ministry of Local Government and Rural Development project in 7 settlements within 3 cities • to support primary drainage, citywide sanitation and solid waste management • Aspects of the project included the rehabilitation of existing public toilet facilities and the provision of communal solid waste containers • government subsidized thus raises the issue of sustainability

8. Interventions to Manage Sanitation and Hygiene (cont.) • School Health Education Program (SHEP) • This initiative though commendable has not resulted in the wide spread reduction in poor sanitary practices due to • Poor maintenance of the school latrines such that the school still remains an unsafe place for the child with respect to sanitary diseases • Poor sanitation and hygiene practices learned at home are also introduced into schools

9. Interventions to Manage Sanitation and Hygiene (cont.) • The increase in knowledge is not reflected in sustained behaviour change partly because of mismatch of facilities for practice • Beneficiary Schools channel resources under the capitation grant to other priority projects • Schools cannot afford to make minor maintenance repairs on the facilities • Poor community support-vandalism etc

10. From NGOs • Donor funded projects-not sustainable • Lack of proper documentation and sharing of knowledge • Duplication of interventions • Ineffective evaluation component • Researcher initiated projects • Work independently of Government Structures • Lack of community ownership

11. Problem Statement • Waste management is still a major problem in our urban and peri-urban communities in spite of previous initiatives to address sanitation and hygiene needs in Ghana

12. Rationale • Children still suffer disproportionately from Health Effects of Poor Hygiene and Sanitation • School Health Initiatives have ignored the Community Sanitation Needs Limiting Effectiveness of these Projects • Need to Bridge the Gap between School Health and Community Sanitation

13. Broad Objectives • Main aim to diagnose the environmental sanitation needs of communities to ensure that planned public health programs are based on the outcome measures of assessment • Action plan will focus on advocacy, education, communication and practical interventions but the exact components will depend on our assessment within the capacity of the communities

14. The Way Forward • Critically assess the waste management practices in urban and peri-urban communities • Investigate the gaps in policy implementation • Determine the knowledge, attitudes and practices in hygiene and sanitation behaviour in two communities in the Greater Accra region (pilot)

15. To Do This • Community members active participants in all aspects of the decision making process • The health researcher will serve as a facilitator to help communities manage their own waste problems • Increasingly the practice of public health seeks to move away from researcher initiated interventions to encourage complete community ownership of all planned health programs

16. Assessment Components • Needs identification • Analyzing the causes and variations of problems • Collecting and interpreting data • Monitoring and forecasting trends • Researching the outcomes • Evaluating the outcomes

17. Possible Questions to Explore • What do community members consider unsanitary or unhygienic practices? • What are the initiatives the community itself has embarked upon to improve their sanitation? • What are the local resources available within the community to improve sanitation?

18. Study Population • Community Members • Relevant Government Agencies • Opinion Leaders • Members of Households • School Children • School Authorities • NGOs • etc.

19. Long Term Goals • Study communities would have a well managed waste collection system in place • School Children would have access to good sanitation at home as well as in school

20. Thank You