National Environmental Health Policy and Strategy 2012-2016

National Environmental Health Policy and Strategy 2012-2016 Ministry of Health 1 National Environmental Health Policy and Strategy 2012-2016 Acknowledgement The National Environmental Health Policy and Strategy 2012-2016 has been prepared with the view to strengthen the existing Environmental Health programs within the Department of Public Health. The contributions of Viran Tovu, Morris Amos, Pakoa Rarua, Nelly Ham, Marie France Maleb, Keith Jacob, Johnson Vutinamoli, John Harrison, Iou Pousin, Tasso Eliab, John Masiga, David Malakay, Johnny Joe (Late) in the development and completion of this policy is gratefully acknowledged. The Department of Public Health wishes to acknowledge with thanks the technical input from Dr. Akihito M Watabe in the ensuring that this policy is one that is practical and achievable within the proposed time frame. An extended acknowledgement to the Director of Public Health, Len Tarivonda in supporting the Environmental Health unit in developing this document to provide directions for the Ministry of Health with the Environmental Health programs. The contributions of other individuals whom have contributed to the completion of this document is also very much appreciated. Thank you very much for all the support that the Environmental Health Team has been receiving in terms of technical and financial support in enabling us to complete this document. Shirley Laban Tokon Acting Manager Environmental Health, Health Standards and Inspections Services Department of Public Health 2 National Environmental Health Policy and Strategy 2012-2016 Foreword I am pleased to present this National Environmental Health Policy and Strategy 2012-2016 as it provides a roadmap for the Ministry of Health in terms of identifying key strategies to ensure a safe environment and public health for the people in Vanuatu. There are 8 key strategic areas identified in this document to guide the implementation of the Environmental Health Program. Each strategy is focuses on the current situation being encountered in Vanuatu and at the same it provides for the goal to be achieved through applied objectives. The strategies include: 1. Safe Water and Sanitation 2. Food Safety 3. Occupational Health and Safety 4. Waste Management 5. Public Health Legislations 6. Communicable Disease Surveillance 7. Development Control 8. Public Health Emergencies and Disasters These strategies will provide the mandate for the Ministry of Health and its partners in achieving their goals and at the same time use the identified indicators in measuring the impact of Environmental Health and Inspection Services in Vanuatu. The challenge for the Department of Public Health through the Environmental Health Unit and the relevant partners would be the implementation of these strategies. While it is appreciated that not all the identified activities may be achieved within the projected period, the Ministry of Health urges all its partners in the Environmental Health Programs, both nationally and internationally to support as much in ensuring all our goals are being met. I take this opportunity to thank our staff from the Environmental Health Unit and Public Health Department in committing themselves in ensuring this policy and strategies be developed to guide the Ministry of Health in its deliberations towards achieving its goals. The National Environmental Health Policy and Strategy will guide us in ensure that a public health is achieved for the people of Vanuatu. Len Tarivonda Director of Public Health 3 National Environmental Health Policy and Strategy 2012-2016 Table of Contents 1. Introduction ........................................................................................................................................ 4 2. Definition of Environmental Health ................................................................................................... 4 3. Administration of Policy and Plan ...................................................................................................... 4 4. Environmental Health Policy 2012-2016 ............................................................................................ 4 5. Environmental Health Program Strategies ......................................................................................... 6 Strategy 1:Water, Hygiene and Sanitation ............................................................................................. 6 Strategy 2:Food Safety ........................................................................................................................... 7 Strategy 3:Occupational Health and Safety ........................................................................................... 8 Strategy 4:Waste Management .............................................................................................................. 9 Strategy 5:Legislations and Compliance ............................................................................................... 10 Strategy 6:Communicable Disease Surveillance .................................................................................. 10 Strategy 7:Development Control .......................................................................................................... 10 Strategy 8:Public Health Emergency and Disasters .............................................................................. 11 7. Financial Plan .................................................................................................................................... 12 8. M&E Plan ........................................................................................................................................... 12 9. Conclusion ......................................................................................................................................... 12 10. References…………………………………………………………………………………………………………………………………12 4 National Environmental Health Policy and Strategy 2012-2016 1. Introduction Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health. In Vanuatu Environmental Health services have been established as early as the 70s. The services of Environmental Health are those services implemented to control and monitor environmental health policies. The National Environmental Health Policy 2012-2016 with the Ministry of Health in Vanuatu acknowledges the need for minimum standards in the following areas of Environmental Health: clinical waste, food, water, solid waste management, housing, pollution, sanitation, and port health and further recognizes that multi-sectoral collaboration is essential in the implementation of environmental health programmes. 2. Definition of Environmental Health The World Health Organization defines Environmental Health as those aspects of the human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and controlling factors in the environment that can potentially affect. Environmental Health includes the assessment and control of all environmental factors that can potentially affect health. It is targeted towards preventing disease and creating supportive environments. 3. Administration of Policy and Plan The Environmental Health, Health Standards and Inspection Unit, is the core unit within the Public Health Department of Ministry of Health which is mandated to implement environmental health programs. Resources capacities within the national and provincial environmental health units are scarce which limits the output of the services to the community. This document, also serves as an opportunity to identify the required resources for undertaking the activities. The Environmental Health Officers recruited within the unit are required to have qualifications that range from Certificate to Masters in Environmental Health, Public health or other health related programs. While this is the benchmark for any recruited officer, it is one of the unit’s biggest challenges to find such personnel. Therefore, this document recognizes the Human Resource Development Unit, within the Ministry of Health to facilitate and ensure that the recommended qualifications are being catered for. 4. Environmental Health Policy 2012-2016 This policy defines a roadmap for the Environmental Health services within the Ministry of Health and the other partners implementing such services. This plan provides the mandate for the Ministry of Health to provide such services and identifies the specific strategies that are expected to deliver to all people in Vanuatu. Based on the environmental health issues that are being encountered in Vanuatu and also considering regional and international areas of concerns, the following areas have been identified as 4 key strategic areas to address during the period of 2012-2016; 1. 2. 3. 4. Ot5. 6. 7. 8. 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Environmental Health Program Strategies Strategy 1: Water, Hygiene and Sanitation Problem Statement: The availability of safe water and proper sanitation provides the fundamental barrier for disease control. In Vanuatu, access to safe water and proper sanitation is still inadequate in majority of the rural communities which make up the 80% of Vanuatu’s population. These populations also have limited knowledge on Sanitation & Hygiene practices and importance of safe water. Most of the water catchments available are prone to contamination because of lack of knowledge on the importance of water catchment areas. If these trends exist, Vanuatu will not meet the MDG 7 timeframe. Goal: Reduce illness and death from disease, and also impact poverty reduction and socio-economic development as result of improving access to safe water, adequate sanitation, and proper hygiene education. Objectives: This strategy ensures that there is accessibility of safe water and proper sanitation for people in Vanuatu through strengthening of existing WASH activities. This will result in: 1.1. By 2016, 90% of people with access to safe water 1.2. By 2016, 80% of people with access to improved sanitation 1.3. By 2016, 50% of people with appropriate information and skill on Water, Hygiene and Sanitation 1.4. Lead partnership in Water, Hygiene and Sanitation through WASH Project and Healthy Islands Initiative Activities Output 1.1: Access to safe water 1.1.2: Introduce Water Safety Plans for community water catchments 90% population coverage1.2.3: Introduce H2S testing of Water to all communities 80% population coverage1.2.4: Develop National Water Drinking Standards Endorsed by DCO 1.2: Access to improved sanitation 1.2.1: Develop National Sanitation Standards; VIP, Water seal, water tanks, compost toilets and septic tanks Endorsed by DCO 1.2.2: Improve sanitation facilities in communities ; school and health facilities 80% population coverage 1.3: Access to appropriate information1.3.1: Develop and distribute IEC materials on Water, Hygiene and Sanitation 50% population coverage1.3.2: Training for Environmental Health Officers on WASH and National Sanitation Standards All EHO qualified as trainers 1.3.3: Introduce National Sanitation Standards to communities 80% population coverage 7 National Environmental Health Policy and Strategy 2012-2016 Strategy 2: Food Safety Problem Statement: The availability of safe food and proper handing, preparation and storage of food provides the fundamental barrier for disease control. In Vanuatu, access to safe food is limited due to; non conformances to the standards set out in the Food Control Act no.21 of 1993, other related food legislation, Food Codes and the lack of knowledge and skills on the safe food practices. Goal: Minimize food borne illness and death, and also impact poverty reduction and socio-economic development as result of improving access to safe food through adequate and proper food hygiene education. Objectives: This strategy ensures that there is accessibility of safe food through proper Handling, preparation and storage for people in Vanuatu through strengthening of food safety activities. This will result in: 2.1. By 2016, relevant food legislation and compliance system is established 2.2. By 2016, 50% of people with appropriate information and skill on Food Safety 2.3. Lead partnership in Food Safety through Healthy Islands Initiative Activities Output 2.1: Food Legislation and Compliance 2.1.1: Development and Review Food Control Act No. 21 of 1993 and other relevant legislations and Food Standards. Annual Amendment to Food Control Act 2.1.2: Develop and Implement National Food Compliance Program > 1,000,000vt collected annually >3 Prosecutions/year >50 complains received 2.1.3: Development and Review of Food Inspection Guideline and other relevant food guidelines Endorsed by MOH 2.1.4: Train EHO on Food Inspection Techniques All EHO qualified as trainers 2.2: Access to knowledge in food safety 2.2.1: Develop and distribute IEC Materiel on Food Safety IEC material distributed to all Health facilities 2.2.2: Train EHO on Food Safety All EHO qualified as trainers 2.2.3: Introduction of Food safety in communities 50% population coverage 8 National Environmental Health Policy and Strategy 2012-2016 Strategy3: Occupational Health and Safety Problem Statement: In Vanuatu, work related illnesses and injuries have always been an issue due to unsafe working conditions. In the absence of proper legislative framework, this OHS issues have not been addressed consistently. Goal: Reduce the incidence of health related injuries and illness through a safe working environment. Objectives: This strategy ensures that a safe work environment is provided for all people. This will result in: 3.1. By 2013, develop and enforce the OHS legislation and its guideline 3.2. By 2016, establish over 10 Healthy Workplace Activities Output 3.1: Legislation and Compliance 3.1.1: Develop and Review OHS Legislation Amendment to the Public Health Act 3.1.2: Develop and implement OHS Compliance Program >1 prosecution /year3.1.3: Development of National OHS Guideline Endorsed by MOH 3.2: Healthy Workplace 3.2.1: Train EHO on OHS All EHO qualified as trainers 3.2.2: Introduction of Healthy Workplace >10 established Healthy Workplace 9 National Environmental Health Policy and Strategy 2012-2016 Strategy4: Waste Management Problem Statement: In Vanuatu Waste Management practices differ from urban and rural areas. Residential and Industrial wastes are being produced in excessive amount will little control over how it is managed. Communities have limited knowledge and skills on how to manage or control the amount of waste they produce. Goal: To reduce incidence of infectious diseases through better waste management. Objectives: This strategy ensures that communities are informed of the importance of controlling diseases through waste management. This will result in: 4.1. By 2016, all 6 hospitals are well equipped with proper medical waste management system 4.2. By 2016, 50% of people with appropriate information and skill on Waste Management 4.3. By 2016, develop and enforce a legislation on Waste Management 4.4. Lead partnership in Waste Management through Healthy Community Project Activities Output 4.1: Medical Waste Management 4.1.1: Develop Medical Waste Management Guideline Endorsed by MOH 4.1.2: Train EHO/Hospital Staff on Medical Waste Management All EHO qualified as trainers /All maintenance officers and handy man practice 4.1.3: Improve Medical Waste Management Facilities All 6 hospitals to be equipped with incinerators 4.2: Access to Waste Management Information4.2.1: Develop National Waste Management Guideline Endorsed by MOH 4.2.2: Train EHO on National Waste Management Guideline All EHO qualified as trainers 4.2.3: Introduce Waste Management to communities 50% population coverage 4.3: Legislation and Compliance 4.3.1: Develop and review Waste Management Legislations Amendment to the Public Health Act. 4.3.2: Develop and Implement Waste Management Compliance program. >1 prosecution/ year 10 National Environmental Health Policy and Strategy 2012-2016 Strategy5: Legislations and Compliance Problem Statement: In Vanuatu, the existing Public Health Legislations are insufficient and are not implemented consistently due to the lack of trained officers and relevant resources. Goal: To reduce the incidence of communicable and non-communicable disease through the development and implementation of appropriate public health legislation. Objectives: This strategy will reduce the incidence of communicable disease through the following: 5.1. By 2016, Public Health Act No. 22 of 1991 and its relevant regulations and standards will be developed, amended and enforced effectively. 5.2. By 2016, Food Control Act No. 21 of 1993 and its relevant regulations and standards will be developed, amended and enforced effectively 5.3. By 2016, Tobacco Control Act and its relevant regulations and standards will be developed, amended and enforced effectively 5.4. By 2016, appropriate resources will be available to enforce the public health legislations. Strategy6: Communicable Disease Surveillance Problem Statement: In the absence of any disease surveillance in Vanuatu, Ministry of Health is having difficulty in identify what the priority diseases are so as to guide its planning unit on its deliberations. Goal: The Ministry of Health to provide timely responses and appropriate interventions and planning to reduce illnesses and death in Vanuatu. Objectives: This strategy ensures that there is an established disease surveillance system in place to monitor the disease patterns of progression. This will result in: 6.1. By 2013, initiate a lab-based Communicable Disease surveillance system 6.2. By 2013, initiate five key syndromic surveillance system; Acute Fever and Rash, Diarrhea, Influenza-like Illness, Prolonged Fever and Dengue-like illness Strategy 7: Development Control Problem Statement: In Vanuatu, Health Impact Assessment is nonexistence in the planning system of local authorities such as the municipal councils, provincial councils and government authorities who grants permission for any development in land use and new building. Goal: To reduce the risks of any health hazard in any development of land and building in Vanuatu. Objective: This strategy will reduce the risks of health hazards in any development of land and building. This will be achieved by: 11 National Environmental Health Policy and Strategy 2012-2016 7.1. By 2016, introduce Health Impact Assessment in any development of land and building 7.2. By 2013, all Environmental Health Officers trained on the process of Health Impact Assessment Strategy8: Public Health Emergency and Disasters Problem Statement: Vanuatu is vulnerable to natural disasters which create public health emergencies, such as water and food contamination and other emerging diseases. The current capacity within Ministry of Health and community is insufficient to address any public health emergencies. Goal: The Ministry of Health will be able to respond in a timely and consistent approach to any public health emergency. Objectives: This strategy ensures that Public Health emergencies and disasters response will be achieved through the following: 8.1. By 2013, 10 communities develop the skill in responding to public health emergencies 8.2. By 2013, develop public health emergency procedures 12 National Environmental Health Policy and Strategy 2012-2016 7. Financial Plan This policy recognizes the importance of undertaking a cost analysis exercise to determine the financial implications of these identified strategies, this can be catered for in the annual business plan. The strategies, such as that of Legislation and Compliance provides for the collection of revenues through fines and penalties from non conformances of the legislations. 8. M&E Plan In collaboration with Public Health department and Provincial Health team, Environmental Health unit monitors the annual output every year. Especially for WASH Project, Environmental Health unit works closer with health partners to collect data to monitor the programme implementation. Evaluation of outcome and impact of this policy, Ministry of Health utilizes Multiple Indicator Cluster Survey and National Population and Housing Census data in the end of term if applicable. 9. Conclusion Environmental Health services can become very complex and requires a strategic approach in managing the issues related. This document is designed in such a way to enable all users of the document to determine what, how and when environmental health related issues is to be addressed within it intended period of time. 10. Reference 1. Vanuatu Health Sector Strategy 2010-2016 2. Ministry of Health Policies, Vanuatu, 2002