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The Environmental Health Programme. [EHP] TransNzoia District RVP-Kenya. A presentation to the 2 nd AfricaSan Conference. 18 th to 20 th February 2008 DURBAN South African Republic.
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The Environmental Health Programme [EHP] TransNzoia District RVP-Kenya
A presentation to the 2nd AfricaSanConference 18th to 20th February 2008 DURBAN South African Republic
ByP.O.Luttah District Public Health OfficerTransNzoiaDip EHSc,DipFScs,MPH(Health Promotion)
Programme Design 1999 The planning stage 2000 – 2002 Implementation phase 2003 – 2005 Consolidation phase 2006 and Beyond Evaluation Sustainability
Programme Goal To put in place Preventive and Promotive Heath Care measures aimed at reducing Environmental related health problems in the Community.
Specific Objectives NB These are WATSAN &HYGIENE specific • Increase access to safe/clean water in the rural and peri-urban areas by at least 50% • Increase Latrine Coverage from 60% to 100% • Promotion of Hygiene Education. • Ensure safe drinking water by ALL school children. • Adequate Solid/Liquid waste Management. • Increase community awareness on the dangers of Kitchen Smoke.
Community Entry • Village Health Committees(VHCs). • Locational Environmental Health Committees (LEHCs). • Women Groups. • School Health Clubs(SHCs). • Others: Market Committees ,Health Facility Committees, Constituency AIDS Committees-CACCs & School(PTA/BOG) Committees.
Components • Hygiene Education Promotion • Improved Housing • Environmental Sanitation • School Health Action • Food Hygiene and Nutrition • Malaria/Vector Control • Safe Water Supply • Indoor Air Pollution • Others: HIV/AIDS/TB Control ,MCH/FP Services
Strategies • Primary Health Care-PHC • Participatory Hygiene and Sanitation Transformation-PHAST • The Healthy Village Initiative-HVI • Healthy Environments for Children's Alliance –HECA • Solar Disinfection of Water-SODIS • Towards Unity for Health-TUFH
Key Activities • Social Mobilization -Community Sensitization -Community Organization -Community Empowerment • Village Sanitation • Market Sanitation • School Sanitation • Health Facility Sanitation(Preventive Maintenance) • Hygiene Education-an essential package • Safe Water supply • Nutrition and Food Supply • Polythene Free Environment Movement • Kitchen Smoke (silent killer) Alleviation Activities • Community Based Disease Surveillance • Condom Promotion • School Health Club(SHC)Festivals • Sanitation(Clean-up )Days • Public Health Field days • Persuasion and Legislation
Stakeholders • Communities (CBOs,VHCs,LEHCs) • GoK line Ministries/Departments (MoH,MoE,NEMA,OP,Dept.Soc. Services, Local Gov.) • FBOs • NGOs • Local Institutions of Higher Learning(e.g. Moi University- Eldoret)
Sources of Funds • Donors : -Sida( Before 1999) -WHO,UNICEF,ITDG(Practical Action), • The Global Fund • FIF/Cost Sharing • GoK : -Central Government (AIA,Dev.Fund,FPEduc,CDF) -Local Government(LATF) • NGOs • FBOs • Community
Primary Health CarePHC • This is a concept/Strategy embracing the need for:- -Community Sensitization/Education -Community structures and Linkages [VHCs,CHWs,LEHCs,HFCs,SHCs and Market Committees] -Training/Empowerment -IGAs [For Health and Development, Self reliance and Sustainability] -Inter Sectoral Collaboration
Healthy Environments for Children's Alliance-HECA- • This is a WHO initiative aiming at tackling Environmental threats to Children’s Health. • The aims focus on how the communities can be supported to ensure Healthy Environments for Children. • Activities:NA,Awareness and Advocacy, Latrine provision ,provision of Hand washing facilities, safe Water supply.
Towards Unity For Health -TUFH- A WHO initiative advocating for:- • Sustainable Partnerships for Global Health and Community Development. i.e. Improving the badly needed( one pace) collaboration, rather than competition among the Partners/Stakeholders. • A more purposeful relationship with the Community to ensure:- -Quality ) -Cost Effective ) Health - Relevant ) Services -Equitable )
Healthy Village Initiative-HVI- • Village: i) An average of 120 Households i.e. a population of 600 people. ii) The area of jurisdiction of a Village Elder • A group of Ideal Homesteads • All Homesteads meet the standards set on the Public Health checklist e.g. -Latrine with hand washing facilities -Access to safe water etc • The village has a Village Health Committee(VHC) and 6 Community Health workers(CHWs) • Village Health office i.e. an info center for the village
Results • A well sensitized/Educated community as verified by their health seeking behavior. • Well established community structures/Linkages. • Available well trained and motivated CHWs. • Highly active School Health Clubs in most schools.
Cont. Results • 42 Healthy Villages established. - 100% latrine coverage with hand washing (soap and running water)facility. - 100% access to safe drinking water. - All HHs with a waste management facility. - All Homesteads are Polythene Free • Accelerated Kitchen smoke alleviation activities leading to improved Respiratory Health of women and children <5 • The success story (HVI) has attracted many people and we have shared experiences with over 20 Districts of Kenya and several institutions of higher learning.
Challenges • Lack of capacity to Expand(Scale-Up) and Evaluate the programme. • Poverty(some HHs cannot implement fully what they know) and the HIV/AIDS Menace. • The need to capacity build the Technical Staff(especially the Public Health Officers) on WATSAN and HYGIENE promotion. • Urban Health: Community structures difficult to put in place.Bussiness Community embrace Competition rather than Partnerships
Lessons Learnt • Lack of support from the Establishment is detrimental to any health programme • Hostile Political environments are not conducive to Community Health Activities.
Way Forward • Evaluate the programme and obtain baseline data for the next phase. • Scale up the specific Water , Sanitation and hygiene activities • Review plans and source for more funds in respect to ensuring that the MDGs on Sanitation are met. • Embrace the COMMUNITY STRATEGY being advocated for by the MoH and Partners-Kenya. • Adherence to the Recently Launched “National Environmental Sanitation and Hygiene Policy "for Kenya.
1.Improvement of the most basic indicators of human development can be done at local level if technical staff are willing to support the Community and Stake Holders are ready to provide the necessary logistical support.
2.Succeses on this programme can be used to :- • Increase the Knowledge base of policies and action strategies that work to reduce Environmental related Health Problems. • Establish the basis for replication and scaling- up of activities in countries that are committed to the Sanitation MDG of Halving those without access by 2015.
END Ahsante sana kwa kunisikiza
Contacts • E-mail address patrickluttah@yahoo.com • Telephone Landline:- 30234 Wireless:- 0203510332 Cell phone:- 0722339886 or 0733291692 • Post Office P.O.Box 98 , Kitale. 30200 (Kenya)-EA
Appendices • Hand Book for the LEHCs. • Checklist for a Healthy Village. • Map of the District. • Background info on TransNzoia District. • Photographs.