Factors influencing implementation of public health standards in selected city council markets in Nairobi, Kenya

Abstract

Public Health involves the organized efforts by societies to protect, restore and promote the health of the population. Public health programs and activities focus on the prevention of disease and enhancement of health. They are directed towards the population as a whole rather than individuals. Creation of healthy market places is part of the Healthy Cities Programs (HCP) strategy developed by World Health Organization. This approach aims to create environments that are supportive to good health. However, many market places set a poor example. Most of the Nairobi City Council markets have questionable public health standards but little is known about the factors leading to such state of affairs. No remedial measures can be taken if such conditions are not identified, hence the need to carry out this study. The purpose of the study was to find out the factors influencing implementation of public health standards in Nairobi City Council markets. The markets were conveniently selected due to their location. The study employed a descriptive survey research design because it allowed for extensive data collection on a large population within a short period of time. The study population consisted of three hundred customers, one hundred food vendors, six market administrators, four public health officers and two senior staff from the department of social services and housing. Pre-tested questionnaires and interview schedules were used for data collection, while observations were used as illustrations to major findings. Data was analyzed using Statistical Package for Social Sciences (SPSS) software. Majority of the food vendors (66%) were aware of the requirements of the public health act. A significant number of vendors (63%) underwent a medical check up in line with section 135 of the public health act. There was no significant association between medical examination and duration of operation in the market x2=2.384; df;= p³?0.05). Nuisance is prohibited in section 115 of the Act. Never the less, both customers and vendors acknowledged presence of nuisance in the market which included poor waste disposal, presence of pests, poor sanitary conditions and foul smell. Public health officers' visits to the markets are paramount to ensure public health requirements are maintained, in line with section 123 of the Act. However, the study revealed that the officers lacked official transport arrangements and security details, unless there was a disease outbreak or when conducting arrests. Five out of the six market administrators noted that inadequate finances posed a major challenge in implementation of public health standards, since all the money collected from the markets was submitted to the City Treasury. Decentralization of funds generated from the markets is thus recommended. These funds can then be re-invested in maintenance, expansion and offering better services within the markets. The results of this work could be useful to the city council of Nairobi in ensuring that public health standards are observed in the markets.