CW-School of Public Health

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An Assessment of the Impact Of Improved Child Care Campaigns on Child Health. An Environmental Health Perspective Among Pre-School Children In Kasarani Division
(Joypet Sevices & Printers Ltd., 2004) Keraka, M. N.
Many children in the wild today continue to suffer the consequences of environmental degradation. Collapsing ecosystems leave them less able to realize their rights and sustain their basic needs, for example, clean food, air and water. Environmental degradation has become widespread in Kindergarten environments due, in part, to lack of change in childcare practices. Many local and international organizers have carried out research on the influence of environmental conditions on child health but still there are increased cases of ill-health among under six year old children as have been revealed by UNICEF (2000). The aim of this paper was to evaluate the effectiveness of improved childcare campaigns on child health. Both primary and secondary data were utilized Primary data was collected using structured interviews in which 30 school managers were interviewed. Observation method was also used to collect data on the prevailing sanitation and hygiene condition in the schools. The key findings indicated that there were several specific threats of major importance to the children. Fifty per cent of the schools studied lacked safe water for drinking while sixty per cent did to have access to adequate water chance the necessary sanitary conditions were not maintained. Ninety per cent of the schools lacked adequate sanitary latrines. There was unsafe waste disposal and unhygienic childcare behavior and food preparation. The presence of waste dumps created unpleasant smell and hazardous environmental condition to the children. Water-borne and diarrhoea diseases were the most common diseases reported. The study recommends that a healthy learning environment should be given priority through increased environmental health education and community participation in designing and implementing environmental health education programmes. The proprietors of kindergarten schools should be encouraged to resist the number of the children proportional to the size of the class to avoid overcrowding and its environmental related effects.
Bacteriological Quality in Freshwater Reservoirs in Kericho Tea Estates in Kenya: Implications for Environmental Health Education
(Joypet Sevices & Printers Ltd., 2004) Akunga, D. N.; Wamicha, W. N.
This study was aimed at assessing the bacteriological quality of the drinking water sources in Tea Plantation Estates of Kericho District with a view to relating the water quality aspects to the frequency of waterborne disease outbreaks among the tea plantation workers. Fieldwork was undertaken at four private reservoirs for five consecutive months starting from November 2001 to March 2002. Standard plate count method was used for the quantification of heterotrophic bacterial density while the analysis of water for the presence of total and faecal coliforms was carried out using the multiple-tube fermentation technique. Data for waterborne diseases outbreaks were obtained from the Brooke Bond company dispensaries while data for household water treatment procedures were obtained by way of questionnaires and interview schedules. The results of microbial levels obtained indicate presence of bacteria of the coliform group in the dams and end user drinking joints, which is an indication that the water might contain microorganisms that cause diseases like typhoid fever or dysentery among others. About 35 percent of the workers seeking medical attention at the dispensaries were suffering from a waterborne related problem. Also observed was the fat that majority of the respondents had no proper information regarding good sanitary practices and or water treatment techniques that reduce the risk of bacterial infection. There is need for a spirited education and awareness campaigns among the workers in the plantation estates on the good sanitary practices.
Community Participation in Environment Health Education: A Case Study of Two Residential Estates in Nairobi, Kenya
(Joypet Sevices & Printers Ltd., 2004) Ondigi, S. R.; Nyakora, M.; Abaya, S. G.
Geographers and environmental scientists have marveled at the nature of cities round the world and the rate at which environmental degradation is eroding the beauty of the earth. The provision of basic urban services has not kept pace with the rapid urban population growth. This study was designed to investigate environmental sanitation in two sprawling residential estates in Nairobi. The findings indicated that although the communities had each pulled their efforts and resources together to improve the environmental conditions and participate effectively in educating the residents on environmental health measures, the problem of sanitation is far from being solved. It concludes that the problem of environmental sanitation need to be tackled by combined efforts of both the residents and the government to avoid any possible outbreak of environmentally related diseases.
Forests, Deforestation and Human Health
(Joypet Sevices & Printers Ltd., 2004) Aloo, T. C.
Abstract Trees and forests have beneficial effects on the environment. They conserve biodiversity, protect soils and watersheds and act as a carbon sink. Deforestation on the other hand results in deleterious effects on the environment. The bestknowneffects of deforestation are those attributed to the green house gases and climate change. Deforestationalso results in habitat changes, which affect disease vectors and parasites resulting in a change in disease incidences. Thispaper explores the effects of trees, forests and deforestation on human health. It is based on a survey of available literature and a three-week market survey conducted in Nairobi. The paper starts by discussing the role of herbal medicines andforest foods on human health. The thrust of thepaper is on the effect of deforestation on a few nameddiseases. Deforestation is the most important factor in some disease incidences due to the resultant alteration of the vector habitat. Human populations venturing into and opening up new forest areas for settlement are exposed to diseases such as yellow fever and malaria. Deforestation or bush clearance has been used to control tsetse flies, vectors of sleeping sickness and has also been shownto result in lower incidents of river blindness (Taylor 1997). Only one incidence of afforestation resulting in increasedmalaria is reported in Trinidad (Taylor 1997). In. view of the importance of forestry and trees in human life, the paper recommends the inclusionof relevant forestry topics in the material taught to students of Environmental Health
Health Education in Kenya: Present Perspectives and Challenges
(Joypet Sevices & Printers Ltd., 2004) Waswa, L. M.; Waudo, Judith N.
The demand for Health Education in Kenya has been made possible by the vast improvement in the knowledge of methods of prevention and control of diseases as well as the pressing need to find solutions to the aggravated problem of providing medical services. To respond to this need, the concept of Health Education has emerged and schools have been considered excellent places to carryout Health Education because among all organized institutions set up by the society, the school is one through which the largest mass of a given age range pass and also because they present the broadest and deepest channel for putting information at the disposal of a country’s citizens. Although health education is a special case, it is often not a recognized school subject and is taught as a component of other subjects. In the highly competitive struggle for timetable space, Health Education is usually seen as being in conflict with the timetabling requirements of other subjects; as such it risks losing integrity and impact. The methods used to teach Health Education in Kenya lack an interactive approach and are basically theoretical, with minimal practical experiences. Health Education promotion has also been hampered by lack of teaching, learning materials and facilities, insufficient integration into the school curriculum, and lack of policies that place a high priority on Health Education. This, therefore, calls for collaboration among health and educational officials, teachers, students, parents and community leaders in fostering health and learning through improvement of school environment, policies and practices.
The Impact of Drug Abuse Sensitisation Campaigns in Kenya
(Joypet Sevices & Printers Ltd., 2004) Kombo, D. K.
The use of drugs for purposes other than therapeutic ones by youths in Kenya is a worrying issue. This is made more complex by the fact that drug abuse is on the increase. This study sought to find out why drug abuse was on the increase among youths despite sensitization campaigns. Specifically the study sought to find out the concept youths, teachers and parents had on drug abuse, their awareness of the type of drugs on the Kenyan market and the associated dangers and why drug abuse was on the increase despite sensitization campaigns. The study utilized qualitative research methods. Sixty youths, ten teachers and ten parents participated in the study. Questionnaires and interviews were used. The study findings indicated that although the majority of respondents were aware of the term drug abuse, and viewed drug abuse as a serious problem in Kenya, they were reluctant to take individual responsibility in its eradication as it was felt this could cause unnecessary collision and it wasn't their responsibility. Bhang was regarded by respondents, as more prevalently abused than alcohol and tobacco. Peer group influence was seen as a major contributor to drug abuse. Drug abuse sensitization campaigns were regarded as not successful due to poor targeting; lack of focus on causative factors; poor implementation and they were boring. Recommendations included effective sensitization campaigns, emphasis on individual and parental responsibility, guidance and counseling programmes, incorporation of drug related topics in school curriculum, and stern measures taken by government on drug trafficking and abuse.
The Impact of Household Energy and Indoor Air Pollution on the Health of the Poor: Implications for Policy Action and Intervention
(Joypet Sevices & Printers Ltd., 2004) Kirubi, C.
More than 2 billion of the world’s poorest people still rely on biomass and coal burning for household energy needs. Use of these fuels leads to levels of indoor air pollution many times higher than acceptable ambient air quality standards. This exposes women and children to a major public health hazard. Including the risk of acute respiratory infections (ARI), (pneumonia, chronic respiratory disease and lung cancer), and is estimated to account for a substantial proportion of the global burden of disease in developing countries. Other important direct health impacts from household energy use among the poor include burns to children and injuries to women from carrying wood. A wide range of interventions can reduce the impact of indoor air pollution. These include changes to the Source (improved stoves, cleaner fuels), living environment (better ventilation) and user behaviour (keeping children away from smoke during peak cooking times). These can be delivered through policies operating at national level and local level. Experience to date shows that successful implementation requires participation by local people (particularly women), collaboration between 'sectors' with responsibility for health, energy, environment, housing, planning etc., and with an emphasis on market sustainability.
The Implications of Water Governance System on Environmental Health in Marginalised Communities in the Arid and Semi-arid Regions in Kenya: The Case of Njemps of Kenya
(Joypet Sevices & Printers Ltd., 2004) Yatich, T. T.; Koskey, P. K.
Water is not only ecologically complex, but also socially, politically and economically loaded with meaning and opportunity. It forms a vital part of social infrastructure, playing a key role in health, industry, agriculture, energy and general consumption by both humans and beast. It is an essential resource for all forms of life, yet the total amount of water that is available is limited. It is estimated that 80 per cent of the countries of the world suffer from serious water shortages and this is expected to worsen in the coming decades. When this scenario persists, quenching the thirsty of human beings, their enterprises and health would be a dream especially if we will want to protect the resource’s fundamental ecological support systems. The scarcity of water negatively affects the environmental health within marginalized communities because of the relative scarcity compared to that in the high potential areas. One of the causative factors is the adopted governance system on management of this scarcity which directly affect the health of the people. Since independence, the Kenyan Government embarked on intensive water programmes in the rural areas. It financed water development because the physical environmental conditions and economic incapability of the rural populace dictated the system under water and health planning. The paternalistic approach was adopted. State ownership and control over water resources was in itself an impediment to the management of rural water resources and public health. This led to the introduction of the need to involve the community members; the beneficiaries. This was based on the fact that public interests in water resources may subordinate individual property interests and public health. The traditional, command - and – control regulation of water resources was therefore perceived inadequate and negatively impact on public health. The bottom-up approach considered the interests and the rights of landowners or customary users, but still there is need to develop reciprocal relations as a means of balancing private and the varied public interests in this scarce resource. The balancing of the local community, private and the government interests have been realized Marigat Division through the "Distributed Governance" approach. Marigat Division is within an arid and semi-arid region where the resource is scarce and, therefore the achievement of effective allocation regulation and conservation involves a multifaceted approach which emphasizes environmental health..
The Potential Impacts of Climate Change on Human Health and the Need for Health Education in Kenya
(Joypet Sevices & Printers Ltd., 2004) Agwata, J. F.
Human health is dependent on a good and clean environment and many of the factors that lead to a deteriorated environment also lead to poor health. Pollution of the atmosphere, lack of sufficient and or polluted water supplies and other forms of environmental degradation, for instance, present serious dangers to human health and well being and contribute to the spread of various diseases. Many of these factors tend to be exacerbated through climate change while increased incidences of climate hazards such as droughts and floods lead to higher human health risks from a variety of causes. In this paper the potential effects of climate change on human health are highlighted and the need for appropriate research and training needs with a view to establishing appropriate measures and mechanisms for adapting and/or responding to the various climate change-human health related effects proposed.
The Potential of Medicinal Plants in Africa: The Current Challenges for Environmental Health
(Joypet Sevices & Printers Ltd., 2004) Kung'u, J.B.
There is great potential in the sale of herbal medicine in the world. The trade worldwide currently exceeds USD 5 billion per year. In Eastern Africa, consumption of herbal medicines especially in arid and semi arid areas has long been high. It increases poor people s access to health care since clinics and drug stores are rare in these areas. The raw material used to make herbal medicine can earn producers who are mainly resource poor farmers millions of dollars a year. Small-scale entrepreneurs can earn a living by processing and trading in herbal medicines. This sector therefore has enormous potential to contribute to poverty eradication by raising incomes and creating jobs in the arid and semi arid areas. Currently the demand for numerous popular plant species used for herbal medicines exceeds supply. Many of the popular species are becoming extinct. The declining supply of these plants is likely to generate significant economic and social losses considering the huge number of people who depend on medicinal plants either as a cure or as a source of income. Most of the trees and shrubs which are the main source of medicines, have neither been documented nor studied and are still being considered solely as products of the wild. The local health traditions are also being lost because they are oral and largely undocumented. A decline in the availability of a culturally important and easily accessible consumer goods is likely to generate significant losses for the community. The loss of income-earning opportunities for people active in the plant trade also represent a serious loss to those involved in the trade. This paper identifies the potential of medicinal plants in Africa and the challenges for environmental health
Poverty and Environmental Health in Garissa, Kenya: Reflecting the Links
(Joypet Sevices & Printers Ltd., 2004) Dekow, M. S.; Koskey, P. K.
At independence, the government of Kenya identified poverty, disease, illiteracy and ignorance as obstacles to national development and had to formulate policy strategies, which have been articulated in National Development Plans, Sessional Papers and Task Force Reports. This paved way to establishment of special programs such as Rural Water Supply and Health Promotion. Despite the government 50 efforts, today, over 60% of Kenyans languish in poverty and are victims of environment-related diseases such as malaria, diarrhoea and typhoid. The situation is more deplorable in Garissa District. This paper, therefore, explores the links between poverty and the poor environmental health of the residents of Garissa. Data was collected through literature review, field observation and key informant interviews. The study concludes that poverty leads to poor environmental health and for environmental health to be improved, poverty has to be reduced among the population.
Preventive Health Curricular in Kenya: A Quest for Policy Backup
(Joypet Sevices & Printers Ltd., 2004) Wamicha, W. N.
Going by the WHO 1948 Alma Ata declaration, the current decade (2001 to 2010) was envisioned to be "healthy for all". In Kenya, though some diseases like small pox and polio have since in way been controlled, other challenging health aspects have emerged. At the same time the health offering institutions are strained in many aspects. In order to respond to these challenges, there is need to review the health policy/legal framework in Kenya. This is therefore a policy analysis work. During this work, the legal/policy documents were transcribed and commented upon in order to elaborate the legal jargon. The quantitative data from the legal documents was tabulated while the qualitative data was coded and these codes tabulated. Finally selected tabulated data was illustrated in graphs and charts. Population projections indicate that, some of the trends will have a bearing on the health services. For example, HIV/Aids is expected to cause a lag in the population growth due to its major adverse effects on health. Other aspects that are expected to change are densities per given area and female to male ratios. The Public Health Act of 1986 in Kenya laid a lot of emphasis on the clinical aspects of health. However the existing clinical health institutions in the country are now strained in terms of coping with the daily attendances and due to personnel drain. There is therefore the need to develop other aspects of health especially those dealing with disease prevention. At the university level, capability to train such personnel in preventive health fields was also analysed. Three universities namely Kenyatta, Nairobi and Moi do offer high quality programmes in these areas. However in a future health legal/ policy framework, it may be necessary to define more clearly the following; Health Inspection, Community Health, Public Health and Environmental Health.
Re-orientation of Indigenous Environmental Health Norms through Contemporary Religious Institutions in Mara Region in Tanzania and Coast Province of Kenya
(Joypet Sevices & Printers Ltd., 2004) Nyaga, S. N.
This paper underscores that sustainable environmental health education among African communities requires a shift of perceptions, which are based on people s environmental health norms. The polemic assesses the possibility of using contemporary environmental health education to conscietize religious communities on suitable environmental health ideals through socio-religious institutions. The paper starts with a highlight of cross cutting cosmological and environmental health beliefs and norms among two communities; concept of good health, causes of sickness and methods of health care practices. Major environmental health challenges are identified, and implications on sustainable holistic development. The paper then examines how environmental health values; beliefs and norms are disseminated in the indigenous communities and possible ways of using contemporary religious institutions to re-orientate them towards sustainable environmental health practices. In this regard attention is given on formal and informal environmental health education disseminated in religious institutions, eBOs and NGOs. Appropriate intervention measures are recommended.
Relevance of Environmental Health Education
(Joypet Sevices & Printers Ltd., 2004) Kerich, R. K.
Environmental Health Education offered in learning institutions is intended to serve a dual purpose. First, it is to generate and impart new knowledge on how to respond to environmental health problems and secondly, it is intended to promote good health through enhancement of appropriate use of natural and human resources. Thirdly, it is to effectively accomplish these objectives, Environmental Health Education in the formal Education system must offer relevant content. This paper discusses the "relevance" of Environmental Health Education in learning institutions. Like other types of Education, Environmental Health Education entails passage of new knowledge, acquisition of new skills, and development of desirable attitudes and values. Hence, it is important that as the learners acquire new knowledge and skills and as they develop their attitudes and values, relevant content on health and environment is offered. Here relevance refers to the type of content dealt with that would enhance the attainment of the intended goals. Environmental Health Education content discussed in this paper applies to learners as well as Health Scholars, researchers, professionals, and community members. In assessing the quality of Environmental Health content, relevance is seen as a function of a number of variables namely:- Environment (both its diversity, and dynamism), Technology, and socio cultural situations. In this paper paper therefore, the optimal combination of the above mentioned factors would present the most relevant content. Presently, because of the intervening variables mentioned, the quality of Environmental Health Education content has fallen below expectation especially with respect to precision, recency, practicability and relevance to the contemporary society. Because of this important areas that needs attention are identified. These include; improvement of current research procedures, increase of awareness campaigns to overcome stereotype ideas among the community, development of relevant teaching material, adequate selection of appropriate mode of information dissemination, and retraining of personnel handling the content. Even where adequate attention has been paid to the above areas, selection of appropriate content is still necessary. For relevant content to be obtained, exhaustive consultation is needed especially with curriculum experts, learners, teachers, communities, researchers, and professionals. Thus, the paper concludes, by providing a more durable Environmental Health Education Programme with highly relevant content.
The Role of Alternative Medicine in Kenya: Experiences of a Herbal Practitioner
(Joypet Sevices & Printers Ltd., 2004) Githae, J. K.; Wamicha, W. N.
In Kenya there are about 15 medical doctors for every 100,000 persons, a ratio that is quite low. Due to this, people are bound to seek other forms of health care. For this reason, about 80% of people in the developing country do seek alternative treatment in one form or other. Therefore, the development of alternative medicine in a Country would improve and ensure the availability of basic health. This study was therefore aimed at highlighting how herbal medicines are prepared and applied. The legal/policy framework for herbalists in Kenya is also analysed. Methods of policy analysis are used. Herbal medicine extractions from different plant parts are as follows: the stems (43%), whole plant (20%), each of the leaves and roots (J 0), the bark (7%) and flowers (7%). The costs of herbal medicine is distributed as: procurement from forests (30%), processing (52%) and distribution to clinics (12%). About 5% of the costs goes to resource conservation. Of the 6 clinics analysed, Nairobi has the highest number (80) while Nakuru has the lowest (20) patients visiting the clinics daily. In a rank of 10 diseases, headache (J 3%) is the most recurrent complaint in the herbal clinics followed by; abdominal (J 2%) and cardiovascular ailments (7%). Impotence (2%) and cancer (1%) are characterised by the least complaints. Those most affected by headaches are students with 34% of the complaints and business people (32%) which maybe due to studying and business uncertainties respectively. In terms of cardiovascular ailments, employed people (35%) and housewives (30%) are the worst affected. This could be due to their characteristic taking of high-energy diets coupled with lack of exercise. The students (4%) are the least affected by cardiovascular ailments due to rigorous exercises and their youthfulness. Most frequent abdominal ailments occur in Nairobi district (35%) and Kiambu (19%) while Nyandarua and Nyeri areas are characterised by Lessthan 10% of the cases. Bones and joints ailments show similar trends to those of abdominal ailments. Abdominal complaints usually reflect poor quality of water a population is using. Nairobi and Kiambu water sources usually have high contents of fluorine, which can cause brittle bones. Poor joints in adults are usually associated with gout as a result of consuming high amounts of red meat. It is observed that all sorts of diseases are treated in clinics distributed over all the provinces of Kenya except Nairobi. Hence herbal medicine is feasible. However despite this the Ministry of Health has neither a system of registering herbal medicine practitioners nor programmes for training herbalists. Since Kenya is signatory to the WHO Charter, then it is time to take action.
The Status, Constraints and Environmental Health Implications of Service Provision and Management in Informal Settlements of Eldoret Municipality, Kenya
(Joypet Sevices & Printers Ltd., 2004) Letema, S. C.; Koskey, P. K.
One of the major challenges facing local authorities in developing countries is how to meet the ever-rising demand for urban environmental services. The problem is prominent in urban informal settlements where service provision and management seems to have failed to cope with rapid expansion and intensification of land-use development. This paper discusses environmental services provision and management in informal settlements of Eldoret Municipality. Stratified random and purposive samplings were used to sample the study sites. Data were collected through the use of questionnaires and urban report cards, interviews, traverse observations and secondary data were also used. Results indicate that there was dismal environmental services provision and management in urban informal settlements of Eldoret, and recommends partnerships in development, extension, operation, and maintenance of environmental services; subcontracting services under built-operate-transfer arrangements; environmental health education; establishment of service tariff distinguishing consumer categories and privatisation.
Tbe Impact of Poverty on tbe Nutritional Intake of Expectant Women
(Joypet Sevices & Printers Ltd., 2004) Ondigi, Alice N.
The health and well being of expectant women depend greatly on the nutritional intake and moral support received from family and the community. Studies done show that malnutrition before, during and after pregnancy coupled with stress brings complications and, thus, endangers the life of the mother and that of the baby. The study attempted to investigate whether pregnant women involved in this study ate a well-balanced diet and whether their level of education and monthly income had any significance to their livelihood. The findings indicated that although the majority of the women had at least some level of education, this did not change the fact that poverty was the determining factor. Since good nutrition, and stress free environment tend to improve birth outcomes, it is therefore important for the Government to take measures to improve infrastructure by ensuring that every women has access to good health care, create and educate women in income generating activities so as to sustain their livelihood, improve poor sanitation conditions, and promote women's perceptions, family and the surrounding community
Water Quality and Environmental Health Education
(Joypet Sevices & Printers Ltd., 2004) Abwao, P.
Fresh water is a finite resource, essential for agriculture, industry and for human existence. Without fresh water of adequate quantity and quality, sustainable development is not possible. Water pollution and wasteful use of fresh water threatens socio-economic development and make costly water treatment essential to satisfy increasing needs for drinking water. Human impacts on the environment have increased dramatically during the past decades and they continue to grow in natural ecosystems, freshwater and marine environments and the atmosphere. Socio-economic development - including urbanization, industrial production, agricultural activities and their associated pollution - has reached a level where water quality becomes a limiting factor for further development in many river basins. There is now a fundamental need for scientific assessment of water quality on a world- wide basis. Such assessments must raise awareness of the magnitude of the problems and emphasize the urgent need for action, in addition to establishing a rational basis for water pollution control. Water can affect health in a number of different ways. Lack of water for personal hygiene may result in the increased transmission of some diseases, called water-washed diseases. On the other hand, water may carry the specific diseases, called water-borne diseases. Or it may be necessary in the life cycle of a disease vector - such diseases are called waterrelated diseases. This paper therefore examines key issues related to water quality and how they relate to Environmental Health Education.

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