Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa
The Human Dimension to Environmental Quality
Definition of Key Terms
- Environment: Collective term used to describe all the living and non-living things that make up our surroundings. These include the biological, physical, cultural and social, economic and political environments . For the purposes of this paper, environment will exclude the cultural, economic and political environments.
- Health: A state of complete physical, mental and social well-being of an individual and is not necessarily the absence of disease or infirmity .
- Environmental health: Defined as the control of those factors in the environment that may have deleterious effects on people’s physical, mental, or social well-being . OR The effects of various environmental conditions on human health (author’s; derived from the definitions of environment and health).
- Conceptual: Related to or based on ideas .
- Guidelines: Rules or instructions that are given by an official organization telling you how to do something, especially something difficult .
Housing - The Importance of Housing for Health
Indoor Air Pollution: “Rule of One Thousand”
Environmental Tobacco Smoke
Health Impacts of Other Types of Air Pollution
Precautions to Guard against Indoor Air Pollution (Suggested by Authors)
- The children’s home should not be located close to major sources of pollutants e.g. petrol stations, manufacturing plants, garages, and quarries.
- Ensure that buildings housing the children’s home are well ventilated.
- All fireplaces in the home must have properly designed chimneys to dispose of pollutants.
- In homes that use jikos (charcoal stoves), home management should ensure that there is adequate air exchange whenever the stoves are in use.
- The home environment should preferably be declared a no-smoking zone to protect the children from environmental tobacco smoke and to decrease any chances of children copying from adults the unhealthy habit of smoking.
Water Management & Usage
Rainwater Harvesting from Roofs
Treatment of Drinking Water
Diseases Transmitted through Water
Health Risks of Inappropriate Excreta Disposal
Achieving Proper Disposal of Excreta in Children’s Homes - Suggestions by Authors
- Ensure that the home has adequate user-friendly sanitary facilities. In case the toilets are flush type, it is preferable that the toilet bowls be the squatting-type instead of the sitting-type. This is because the former are more convenient to use by children and are also recommended for communal use.
- In case the home uses pit latrines, they should be the modern improved ventilated pit latrine (VIP). These should be constructed under the supervision of the local public health officer or technician.
- The home management should provide adequate anal cleansing materials e.g. old newspapers, toilet paper, water, etc. This will discourage the children from using their bare hands for anal cleansing and smearing excreta on the toilet walls.
- Children should be taught to observe strict personal hygiene. Washing of hands after visiting the toilet should be made mandatory. Water in stand-pipes or leaking cans must be provided by home management.
Health Risks of Solid Waste
Measures to Achieve Better Solid Waste Management in Children’s Homes - Suggestions by Authors
- Provide proper waste receptacles e.g. plastic bins with lid.
- All waste generated should be stored covered in the bins to await collection in case a collection service is available.
- In case a collection service is not available, the waste can be separated into combustible, non-combustible and biodegradable types. Combustible waste e.g. plastics, papers and polythenes should be disposed of by burning while biodegradable waste can be applied at the home garden as organic fertilizer. Noncombustibles such as metal cans, etc should be disposed of into a pit.
- For (3) above to be achieved, source separation of waste is advisable i.e. there should be specific bins for each type of waste. In this case, three bins are required, each preferably marked according to waste type to be received.
- Children should never be allowed to play with or near waste storage or disposal sites.
Malaria Prevention & Control
Measures for Prevention & Control - Suggestions by Authors
- Provide all children resident in the home with insecticide-treated bed nets.
- Carry out indoor residual spraying (IRS) in the home after every six months.
- In areas with high mosquito density such as lowlands, provide window screening made of fine wire-mesh.
- Use of insecticide-treated materials (ITMs) e.g. curtains, mbu cloth (i.e. piece of cloth treated with insecticide and hung on walls) is also encouraged in high-density mosquito areas.
- Any receptacles such as tins, old tyres, old cups, etc that may collect rainwater and encourage mosquito breeding should be collected and disposed of appropriately.
- Any stagnant water in or around the home should be drained by digging drainage channels or the pools filled with earth to prevent water from standing.
- Bushes and long grass should not be allowed to proliferate in the home compound.
Prevention & Control of Vaccine-Preventable Diseases
Precautions against Vaccine-Preventable Diseases - Suggestions by Authors
- Before admitting any child into the home, his/her immunization status should be checked. The authority, relative or guardian from whose custody the child is taken should be able to provide this information.
- If the child’s immunization status cannot be determined, then immediate advice should be sought from the local medical officer of health or the local health centre.
- All children in the home must be immunized against all the vaccine-preventable diseases mentioned above.
Prevention of Physical Injuries
Accidents in the home
Physical violence/intentional injuries
Children’s play facilities
- Tunnel i.e. tyres placed vertically in a straight line with the lower ends slightly dug below the ground surface.
Biological Hazards in Food
Chemical Hazards in Food
Precautions for Food Safety in the Homes - Suggestions by Authors
- All kitchen workers involved in food preparation and handling must undergo medical examination after every six months. This will eliminate the risk of them acting as reservoirs/carriers of food-borne disease pathogens.
- All foods must be properly and thoroughly cooked.
- Kitchen workers must maintain proper personal hygiene i.e. washing hands after visiting toilet; short kempt hair; clean wear; short fingernails.
- Food store should be clean, well aerated and free from any dampness that might encourage the growth of Aspergillus flavus (a mould) on grains.
- Proper kitchen management should be observed i.e. cleanliness, separation of food preparation areas from waste storage area, cooking area and serving area and proper storage and disposal of kitchen waste.
- To prevent the risk of consuming chemically-contaminated vegetables, the home management should verify the source of their supplies and prove that the vegetables are not grown on polluted soils e.g. sewage-irrigated fields and waste dumping sites.
- Home management should ensure that beef and pork supplies to the home are duly inspected by the relevant authorities. Verification can be done simply by looking at inspection stamp or certificate.
Precautions for Sexual Safety - Suggestions by Authors
- Improved security around the home to guard against sexual predators;
- Rape-prevention education amongst girls in the home. This can be facilitated by a local anti-rape organization or a children’s rights lobby group within the region;
- Sex and AIDS education. This can be conducted by teachers or health personnel. The focus should be on management of children’s (including adolescents) sexuality i.e. the appropriate conduct of both sexes towards each other.
- Adolescent boys and girls should sleep in separate room;
- Both boys and girls should not be presented with tempting opportunities e.g. allowing adolescent boys to visit girls’ rooms.
- If sexual safety cannot be guaranteed at the home, options for making it a single-sex home should be considered.
Prevention of Chemical Poisoning/Chemical Safety
Precautions to Safeguard Chemical Safety- Suggestions by Authors
- Do not keep chemicals in containers that the kids are familiar with and might confuse them e.g. soda bottles;
- Keep all chemicals and medicines out of reach of children, probably in a lock-and-key store;
- Dispose of chemical containers safely e.g. by burying deep in the ground or incineration;
- Keep chemicals away from kitchen and food store to eliminate the danger of any accidental contamination;
- Teach children the dangers of handling any chemicals.
Vitamin A deficiency
Rodent & pest control
Preconditions for Fires
- Oxygen (from atmosphere)
- Combustible material (fuel)
- Heat -to ignite the fire
Common Causes of Fires:
- Electrical faults
- Overheated materials
- Hot surfaces
Structural Features and Exits
- No parts of building to be far from exit leading to the outside
- Each floor must have at least one exit;
- A clearly visible sign post to direct fire escapees;
- No obstruction to the fire exit; direct its location;
- Outside stair ways and fire escapes not lead in to interior court yards;
- Doors opening outwards or sliding doors.
Fire Extinguishing Equipment
- Hose pipes (water must be available)
- Dry sand
- Portable fire extinguishers
How to Extinguish Various Fires
Definition of housekeeping
The Purpose of Housekeeping
- being hit by falling objects;
- slipping on greasy, wet or dirty surfaces;
- striking against projecting, poorly stacked items; or misplaced material cutting, puncturing, or tearing the skin of hands or other parts of the body on projecting nails, wire, etc.
Benefits of Good Housekeeping Practices
- fewer tripping and slipping accidents in the children’s home
- decreased fire hazards
- lower children’s exposure to potentially hazardous substances e.g. medicines, detergents, paraffin
- more efficient equipment cleanup and maintenance
- better hygienic conditions leading to improved health
- more effective use of space
- reduced property damage by improving preventive maintenance
- aesthetic appeal of the interior environment
Elements of an Effective Housekeeping Program
Drug and Substance Abuse
Training of Management Staff
Conclusion and Recommendation
|Protection against communicable diseases||Safe water supply|
Sanitary excreta disposal
Disposal of solid wastes
Drainage of surface water
Safe food preparation
|Protection against injuries, poisonings and chronic diseases||Structural features & furnishings|
Indoor air pollution
|Reduction of social & psychological stress||Adequate living space, privacy & comfort|
Personal security of occupants
Access to recreation facilities
Protection against noise
|Disease type||Mode of transmission||Examples|
|Water-borne diseases||Water acts a passive vehicle for the infecting agents; depend also on poor sanitation.||Cholera, typhoid, bacillary dysentery, infectious hepatitis, leptospirosis, giardiasis, gastroenteritis.|
|Water-washed diseases||Due to lack of adequate quantity of water; poor personal hygiene creates conditions favourable for spread; intestinal infections due to improper human waste disposal||Scabies, yaws, leprosy, lice & typhus, conjunctivitis, bacillary dysentery, amoebic dysentery, salmonellosis, paratyphoid fever, ascariasis, trichuriasis, whipworm, hookworm|
|Water-based diseases||Infecting agents spread by contact with or ingestion of water; life cycle of infecting agent takes place in an aquatic animal; some are affected by waste disposal.||Schistosomiasis, guinea worm, filariasis, onchocerciasis, threadworm.|
|Water-related vector-borne diseases||Mosquitoes, flies and other insects breed or bite near water, especially active and aggressive near stagnant open water.||Yellow fever, dengue fever, rift valley fever, bancroftian filariasis, malaria|
|Diarrhoeal diseases||Strongly linked to poor excreta disposal, poor personal and domestic hygiene and unsafe drinking water.|
|Schistosomiasis||Strongly related to unsanitary excreta disposal and absence of nearby sources of water|
|Infection with intestinal helminthes||Strongly linked to poor excreta disposal, poor personal and domestic hygiene and unsafe drinking water.|
|Type of Waste||Diseases Associated with Waste|
|Infected sharp waste||Staphylococcosis, hepatitis B, hepatitis C, AIDS, Streptococcosis, tetanus|
|Waste-generated infected dust||Anthrax, trachoma, mycosis, conjuctitivis, pneumonia|
|Vectors breeding in or living in waste generated ponds||Malaria, filariasis|
|Stray animals and rodents feeding on waste||Rabies, plague, leishmaniasis, hydatidosis|
|Disease agent||Important reservoir/carrier||Examples of food that can become contaminated|
|Bacillus cereus||Soil||Cooked rice, cooked meats, vegetables, starchy puddings|
|Brucella spp||Cattle, sheep, goats||Raw milk, dairy products|
|Campylobacter jejuni||Chickens, dogs, cattle, pigs, birds||Raw milk, poultry|
|Clostridium botulinum||Soil, mammals, birds, fish||Fish, meat, vegetables|
|Clostridium perfringens||Soil, animals, humans||Home-preserved honey, cooked meat, poultry, gravy, beans|
|Escherichia coli||Humans, cattle, poultry, sheep||Salads, raw vegetables, cheese, undercooked meat, raw milk|
|Mycobacterium bovis||Cattle||Raw milk|
|Salmonella spp.||Humans, animals||Meat, poultry, eggs, dairy products, vegetable salads|
|Shigella spp.||Humans||Potato, egg salad|
|Staphylococcus aureus||Humans||Ham, egg salads, poultry, cream-filled bakery products, ice cream, cheese|
|Vibrio cholerae||Humans||Salads, shellfish|
|Vibrio parahaemolyticus||Seawater, marine life||Raw fish, crabs and other shellfish|
|Yersinia enterocolitica||Water, wild animals, pigs, dogs, poultry||Milk, pork, poultry|
|Hepatitis A virus||Humans||Shellfish, raw fruit, vegetables|
|Norwalk agents||Humans||Shellfish, salads|
|Cryptosporidium spp.||Humans, animals||Raw milk, raw sausage (non-fermented)|
|Entamoeba histolytica||Humans||Vegetables, fruits|
|Giardia lamblia||Humans, animals||Vegetables, fruits|
|Toxoplasma gondii||Cats, pigs||Undercooked meat, raw vegetables|
|Ascaris lumbricoides||Humans||Soil-contaminated food|
|Trichuris trichiura||Humans||Soil-contaminated food|
|Taenia saginata||Cattle||Undercooked beef|
|Taenia solim||Pigs||Undercooked pork|
|Trichinella spiralis||Pigs, carnivores||Undercooked meat|
|Fasciola hepatica||Cattle, goats||Watercress|
|Paragonimus spp.||Freshwater crabs||Undercooked/raw crabs|
|Bed bugs||Rooms; beds; furniture (also chicken nests)||Malathion; ronnel; dichlorvos; diazinon||Apply lightly to mattress surfaces and more heavily to bed frame. Allow to dry before using. Never apply to children’s crib.|
|Cockroaches||Enclosed spaces such as kitchens or store-rooms.||Residual sprays||Apply to hiding places and runways. Use a spray and not a mist. Pay attention to warm humid places. Do not treat where children are likely to contact surfaces.|
|Fleas||Dusty floors.||Diazinon; ronnel;malathion||Spray floor and base boards and walls to a height of 10cm.|
|Flies||Refuse and manure pits; pit latrines||Ronnel; malathion||Treat garbage, refuse, manure and other fly breeding sites.|
|Lice (head, body and pubic lice)||Head, body or pubic area.||Lindane||Keep out of eyes and mucous membranes. Sterilize clothing and beds by laundering. Do not apply to eyes and clothes.|
|Mites||Clothing||Any mosquito repellent is toxic to mites.||Keep out of eyes.|
|Rats||Rooms, pit latrines||Any rodenticide locally available in the market.||Rodenticides are highly poisonous even to humans and precautions should be taken to prevent potential food contamination and access by children. (See guidelines on chemical safety).|
|Class of fire||Source||Precautions/equipment|
|A||Carbonaceous solids, wood, paper, and rubbish.||Water jets – they quench the fire and cool the material below its ignition temperature.|
|B||Flammable liquids, solvents, liquifiable solids, oil, paints etc.||Blanketing method (foam, sand etc.).|
|C||Gases – fractured gas main.||Stop gas leak.|
|D||Metals: magnesium, sodium, potassium with water||Dry powder.|
|E||Electrical equipment||De-energize the equipment, then follow as in class A or B.|
- Children’s Environmental Health Network. About children’s environmental health. http://www.cehn.org. Accessed 12/10/2005.
- WHO, Health and Environment in Sustainable Development – Five Years after the Earth Summit; Geneva, 1997; pp. 117–199.
- Callahan, D. The WHO definition of ‘Health’. Hastings Centre Studies 1973, 1, Chapter 3. 77–78. [Google Scholar]
- Pan-American Health Organization. Health conditions in the Americas; Washington DC; PAHO (Scientific Publication No. 549), 1994; pp. 96–112.
- Oxford Advanced Learners’ Dictionary, 6th Edition ed; Oxford University Press; Oxford, 2000.
- Hunt, S. Damp and mouldy housing: a holistic approach. In: Unhealthy housing: research, remedies and reforms; Burridge, R, Ormandy, D, Eds.; London; E & FN Spon, 1993; Chapter 3; pp. 64–99. [Google Scholar]
- WHO, Guidelines for healthy housing; Copenhagen; WHO Regional Office for Europe; Environmental Health Series, 31; 1988; pp. 56–71.
- WHO. Tobacco alert Special issue, World No-Tobacco Day 1996. 1996s, 13–17.
- WHO. Diarrheal diseases morbidity, mortality and treatment surveys. CDD update 1987a, 1(1–3), 45–66.
- Huttly, S. Water, sanitation and personal hygiene. In: Quantifying global health risks: the burden of diseases attributable to selected risk factors; Murray, CJL, Lopez, AD, Eds.; Cambridge; Harvard University Press, 1996; Chapter 6; pp. 103–136. [Google Scholar]
- Murray, CJL; Lopez, AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020; Published by the Harvard School of Public Health on behalf of WHO and the World Bank; Cambridge, Massachusetts; Harvard University Press, 1996b; pp. 245–274. [Google Scholar]
- Najera, JA; Hempel, J. The burden of malaria; Geneva; WHO (Unpublished document CTD/MAL/96.10), 1996; pp. 35–71. [Google Scholar]
- Aaby, P; et al. Further community studies on the role of overcrowding and intensive exposure on measles morbidity. Review of Infectious Diseases 1998, 10(2), 474–477. [Google Scholar]
- Byass; et al. Assessment and possible control of endemic measles in urban Nigeria. Journal of Public Health Medicine 1995, 17(2), 140–145. [Google Scholar]
- UNCHS, An urbanizing world: global report on human settlements, 1996; Oxford University Press: Oxford, 1996b; pp. 145–183.
- Government of Kenya, Ministry of Health press release: Nairobi, 2004.
- Howard, M. The effects on human health of pest infestation in houses. In Unhealthy housing: research, remedies and reforms; Burridge, R, Ormandy, D, Eds.; London; E. & F. N. Spon, 1993; Chapter 2; pp. 24–63. [Google Scholar]
- Omwega, TM. Fire Safety. In A Workshop Paper Presented to a Health and Safety Committee Training Held; James Finlay (K) Ltd: Kericho, 2003; pp. 3–4. [Google Scholar]
© 2007 MDPI All rights reserved.
Share and Cite
Muruka, C.; Muruka, A. Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa. Int. J. Environ. Res. Public Health 2007, 4, 319-331. https://doi.org/10.3390/ijerph200704040008
Muruka C, Muruka A. Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa. International Journal of Environmental Research and Public Health. 2007; 4(4):319-331. https://doi.org/10.3390/ijerph200704040008Chicago/Turabian Style
Muruka, Charles, and Andrew Muruka. 2007. "Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa" International Journal of Environmental Research and Public Health 4, no. 4: 319-331. https://doi.org/10.3390/ijerph200704040008