2011 National Annual Environmental Health Review Meeting

By Young Samanyika
The 2011 national annual Environmental Health Services (EHS) review meeting was held from 2nd to 4th November, 2011 at Chikho hotel in Kasungu district.
Kasungu district is located to the northern part of central region of Malawi, about 180 kilometres north of the capital city, Lilongwe. The meeting was attended by over fifty six Environmental Health (EH) staff from twenty three of twenty-eight districts of the country. Each District Health Office (DHO) sent two delegates: the District Environmental Health Officer (DEHO) and any other EH staff, either an Environmental Health Officer (EHO) or an Assistant Environmental Health Officer (AEHO).

Districts that sent delegates to the meeting are: Rumphi, Mzimba North & South, Nkhatabay, Likoma in the northern region;  Kasungu, Nkhotakota, Dowa, Ntchisi, Lilongwe, Mchinji, Dedza, Salima, Ntcheu in the central region  and Balaka, Mangochi, Chiradzulu, Mulanje, Blantyre, Neno, Mwanza, Thyolo, Chikhwawa, Nsanje in the southern region attended the meeting. The five districts which failed to attend the meeting are: Chitipa, Karonga from the north and Phalombe, Machinga, Zomba from the south. These districts failed mostly due to fuel shortage that is affecting the whole country.

Annual EHS review meetings are organized to review progress made during the year in the provision of preventive health services, sharing achievements, best practices and experience on challenges and mitigation measures. However, the 2011 review meeting that was officially opened by the Deputy Director for Preventive Health Services (DDPHS) responsible for EHS took a slightly different approach. It mostly focused on bringing awareness on the National Environmental Health Policy (NEHP), (which is waiting for approval from Office of the President and Cabinet (OPC)) to the EH staff as one way of mainstreaming EHS in the rest of preventive health services.

The meeting which was facilitated by the EH section of the Ministry of Health (MoH) in Malawi, outlined the general overview of the policy and then critically looked at each of the thematic areas which are:
1) Food Hygiene and Safety (FSH)
2) Water, Sanitation and Hygiene (WASH);
3) Disease Control and
4) Health and Safety.

FSH in Malawi also looks at some of nutrition aspects especially micronutrient fortification monitoring on top of the safety and hygiene of food. It is a requirement that salt coming into Malawi has to comply with a prescribed level of iodine. Very soon it will also be a requirement that certain food staffs like sugar and cooking oil, have to comply with prescribed levels of Vitamin A. The monitoring of the compliance is part of food inspection that is conducted by EH staff.

WASH looks at promotion of sanitation and hygiene, advocacy for proper waste management and inspection of premises.

Health and safety services, which was generally the weakest area of EHS in Malawi, will be focusing on issues of Occupational Health and Safety, Disaster Management, Safety of business premise and some aspects of indoor and outdoor air quality.
Disease control includes issues of disease surveillance and response, and vector control. All these four thematic areas have health promotion as a cross cutting component.

The review meeting was arranged in such a way that a presentation on each of the thematic area was being made by a national level Environment Health Officer and then followed by group discussion and plenary to reach at a consensus on what should be done, in order to make the policy operational at district and community levels.

In general, what came out from the group discussions was that all districts should: designate desk officers to be coordinating each of the thematic areas; enhance collaboration with other sectors that provide services of EH in nature like the Irrigation and Water development, Ministry of Labour, Malawi Bureau of Standards, City Councils and Ministry of Environmental Affairs;  strengthen inspectorate services; and create simple excel data bases for each of the thematic area to be able to track progress.

However serious challenges were also noted like inadequate, and in most instances, lack of equipment (like for air, water and noise pollution monitoring; water quality monitoring; and HACCP monitoring) and in-adequate laboratory support in case of disease investigations including food borne disease outbreaks. The other serious challenge highlighted was lack of specialized expertise in each policy thematic area. There is serious need for expert knowledge on the thematic areas to guide policy implementation. This could be achieved by providing the national EHOs with some short courses in each of the thematic areas who will in turn impart the knowledge to district staff as a short term measure and sending some EHOs for post graduate trainings in line with the thematic areas as a long term measure.

Despite these challenges, it was still agreed that implementation should start right away with whatever resources that are available and improve from there. Whenever chance arise, organizations within and outside Malawi like IFEH, REHIS, AAEH and training institutions and MoH development partners like WHO, UNICEF, USAID, DFID, JICA, AUSAID, FAO, NORAD and any other organization interested in EH should assist on this area of capacity building. 

Malawi Environmental Health Association also underscored its role during the meeting, as it will be crucial in making sure that EH staff is kept abreast of guidelines and new knowledge regarding each of the thematic areas through Continuing Professional Development (CPD). The President for MEHA who doubled as one of the national EHOs leading the discussions made a presentation on EH professional development and how it will be run to supplement the MEHA campaign initiative that is already under way.

It is hoped that this year’s review meeting will be another milestone in the provision of EHS in Malawi. All EH staff are being encouraged to work hard to ensure that implementation of EHS is in line with the policy.

This article will be supplemented by the actual EH policy that will be posted soon.