MBBS Students
Benadir University”BU”
“Safe, affordable housing is a basic necessity for
every family. Without a decent place to live, people
cannot be productive members of society, children
cannot learn and families cannot thrive.”
- Tracy Kaufman
Introduction
 The term “shelter,” which is often used to define
housing, has a strong connection to the ultimate
purpose of housing throughout the world.
 The mental image of a shelter is of a safe, secure
place that provides both privacy and protection
from the elements and the temperature extremes
of the outside world.
 Human beings require protection against the
physical elements that may have direct or indirect
impact upon their health, a place to store and
prepare foods, adequate, comfortable and secure
place for all the families to enjoy.
 Inadequate housing conditions expose people to
physical, chemical and biological hazards, and
to various adverse psychological and social
factors
 These health problems arising from poor
housing prevail or may be aggravated as a
result of lack of awareness of the inhabitants,
poor design and construction of the house,
inadequate illumination and ventilation, lack of
maintenance and due to poor housekeeping
practices.
 The level of hygiene in the dwelling/housing
is another environmental factor that should
never be neglected especially for those who
spend most of their time indoors, such as
infants, young children, the elderly, and
handicapped.
Housing, along with food and clothing, is thus, a
basic necessity for one’s life.
 Health, home construction, and home
maintenance are inseparable because of their
overlapping goals.
 It seems obvious that health is related to
where people live. People spend 50% or more
of every day inside their homes. Consequently,
it makes sense that the housing environment
constitutes one of the major influences on
health and well-being.
Healthful Housing?
“The connection between
health and dwelling is one
of the most important that
exists.”
- Florence Nightingale
WHO Definition of “Healthful housing”
“The physical structure that man uses for shelter
and the environment of that structure including
all necessary services, facilities, equipment and
devices needed and desired for the physical and
mental health and social wellbeing of the family
and the individual.”
Other definition:
“Physical structure including all necessary services,
facilities, equipment and devices needed or
desired for the physical, mental, and social wellbeing of the family and individual.”
Social Goals of Housing
 Shelter
 Family life: Adequate space for family life and
related activities – preparation of food, meeting,
sleeping etc.
 Access to community facilities: such as Health
services, shopping area, school etc.
 Family participation in community life: Family is a
part of larger community.
 Economic stability: House is a form investment of
personal savings.
Good Housing
Dwellings having four or more of the following basic
deficiencies are considered to be an extreme slum:
 1. Provided with inadequate and contaminated water
supply
 2. Lack of toilets or space to construct an excreta disposal
facility outside of the structure
 3. Lack of bathing facility inside or outside the structure
 4. Greater than 1.5 persons per habitable room
 5. Overcrowding of sleeping rooms
Slum:- is an area in which substandard housing predominates and
frequently accompanied with overcrowding.
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6. Lack of dual egress (doors for emergency exits)
7. Lack of installed electricity
8. Rooms lacking windows for light and ventilation
9. Lack of waste disposal facilities
10. Having problems of arthropods and rodents
11. Lack of proper drainage
12. Lack of open spaces, pathways, and all weather
roads between individual structures and etc.
Slum dwelling in INDIA
Basic principles of healthful housing
 Basic principles of healthful housing include all
those fundamental requirements the house should
fulfill and maintain them all the time to avoid health
risks in the residential environment:-
i.
ii.
iii.
iv.
Satisfaction of physiological needs
Protection against infection
Protection against accidents
Protection against psychological and social
stresses.
I. Satisfaction of physiological needs
Housing should provide for the following
physiologic needs:
1. protection from the elements,
2. a thermal environment that will avoid
undue heat loss
 3. a thermal environment that will permit
adequate heat loss from the body
 4. an atmosphere of reasonable chemical
purity
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 5. adequate daylight illumination and avoidance of
undue daylight glare,
 6. direct sunlight,
 7. adequate artificial illumination and avoidance of
glare,
 8. protection from excessive noise
 9. adequate space for exercise and for children to
play.
Housing should also provide physiological
needs of proper: Ventilation/Breathing
 Sleeping
 Seeing/Vision
 Eating
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II. Protection against infection
 A good house must satisfy the need for
protection of occupants from risk of diseases
through provision of safe water supply, proper
excreta and refuse disposal, prevention of
vermin, insects, rodents, and proper storage
for foods.
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Cross contamination of water sources in the
house should be eliminated, and it is very
important to strictly follow the sanitary
recommendations to cut down the incidence of
water borne diseases among the family.
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Locally accepted, but safe methods of waste
disposal systems should be promoted.
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 Waterborne diseases are often referred to as
“dirty-water” diseases and are the result of
contamination from chemical, human, and
animal wastes. Specific diseases in this group
include cholera, typhoid, shigella, polio,
meningitis, and hepatitis A and E.
 Water-based diseases are caused by aquatic
organisms that spend part of their life cycle in
the water and another part as parasites of
animals e.g-Schistosomiasis
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 Water-related diseases are linked to vectors
that breed and live in or near polluted and
unpolluted water. These vectors are primarily
mosquitoes that infect people with the disease
agents for malaria, yellow fever, dengue fever,
and filariasis.
 Provision of adequate sleeping spaces
minimizes the spread of contagious
infections such as scabies, and other
dermatological problems, pediculosis, etc.
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III. Protection against accidents
 The incidence of indoor accidents is directly
related to the housing condition, its engineering
design and arrangements of physical objects in
the house such as the different household
equipment, and work methods etc.
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Improving housing and maintaining it,
somehow can significantly reduce the rate of
such accidents.
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Possible home injuries and their contributory
causes.
Injury
Conditions that may cause the injury
Person falling over causing broken
bones, bruising etc.
Slippery floor; steps that are too high or too low
Building materials falling on people
Poor structure of roof and walls
Burn
Improper use of fuel; damage to electrical wires
Chemical poisoning (a child drinking
pesticide, handling drugs, etc.)
Improper handling and storage of chemicals
Lack of air, breathing problems
No separate kitchen; keeping children close by
while cooking with wood or dung fuel
Electric shock
Electrical wire is damaged by a rat; incorrect
installation, etc.
 Protection against falls and other mechanical
injuries in the house.
 Education of the public on prevention of
accidents is also recommended for accident
prevention.
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IV. Protection against psychological and social
stresses
The Psychological and social stresses cannot be
physically observed but they may be revealed in the
words people use to describe how they feel. We know
that stress is not good for a healthy person.
For example, Poorly built housing or the absence of
water in a household could be a source of stress.
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Seven fundamental psychological needs for healthy
housing include the following:
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1. adequate privacy for the individual
2. opportunities for normal family life
3. opportunities for normal community life
4. facilities that make possible the performance of
household tasks without undue physical and mental
fatigue
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 5. facilities for maintenance of cleanliness of the
dwelling and of the person
 6. possibilities for aesthetic satisfaction in the
home and its surroundings, and
 7. concordance with prevailing social standards
of the local community.
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Effects of poor housing
 Respiratory infection: Common cold,
bronchitis, tuberculosis etc.
 Psychological effects: Depression and
nervous disorders.
 Skin infection: Scabies and ring worm
 Rat infestation
 Arthropods: House flies , mosquitoes etc.
 Morbidity and Mortality
 Accidents
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Poor Housing.
Overcrowding
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It refers to situation in which more people are
living within a single dwelling than there is
space for ,- so that, movement is restricted,
privacy secluded, hygiene impossible, rest and
sleep difficult.
 Overcrowding is a health problem In human
dwelling/housing.
 It may promote the spread of respiratory
infection such as TB, influenza and many
infectious diseases.
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overcrowding
Noise
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Protection Against Excessive Noise is also
very important.
 Noise is defined as unwanted sound.
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Sound is any pressure vibration or stimulus,
which produces sensory responses in the brain.
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 Noise pollution is practically observed to be a
problem of urban settings than rural.
 Exposure of family to such urban noise may
serve primarily as source of nuisance if it
doesn’t impair hearing of the inhabitants.
 Excessive noise can be damaging.
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Criteria for Healthful Housing
Healthful Housing:
 provides physical protection and shelter.
 Provides adequately for cooking, eating,
washing, and excretory functions.
 It designated , constructed, maintained and
used in a manner such as to prevent
communicable diseases.
 Provides for protection from hazards of exposure
to noise and pollution .
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Is free from unsafe physical arrangements due
to construction or maintenance , and from toxic
or harmful materials.
 Encourages personal and community
development and promotes social relationship.
 Reflects regard to ecological principles.
 Promotes mental Health.
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Guidelines for model Housing
SITE
Should:
 Be elevated from it’s surroundings
 Have an independent to a street of adequate
width
 Be away from breeding places of mosquito and
flies
 Be away from nuisance such as dust, smoke,
smell, excessive noise and traffic
 Be in peasant surrounding
 Soil should be dry and safe
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SET BACK
For proper lightening and
ventilation, there should be an
open space all around the
house, this is called Set back
In rural area- 1/3 should be
built
In urban area- 2/3 should be
built
FLOOR
Impermeable
Smooth and free from cracks
and crevices to prevent the
breeding of insects and
harborage of dust.
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WALL
Reasonably strong , should
have a low heat capacity
Weather resistance
Unsuitable for harbor of rats
and vermin
ROOF
Should not be less than
10feet(3meter) in the absence
of air conditioning for comfort
Should have a Low heat
transmittance co-efficient
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ROOMs
Should not be less than two
Rooms for sleeping (bedroom), eating
meals (dining room or salon) and
storage (store room) are important.
Number should be increased as per
the family member.
WINDOW
Every living room should be provided
with at least 2 windows and one of
them should open directly on to an
open space.
The windows should be placed at a
height of more than 3feet(1m) above
the ground in living rooms.
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KITCHEN
 Must have a
separate kitchen
 Must be protected
against dust and
smoke,
adequaetely
lighted, provided
with water supply,
provided with a
sink for washing.
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Garbage and refuse should be removed from
the dwelling at least daily and disposed of in a
sanitary manner.
 Bathing and washing facilities must there.
 House should have a safe and adequate water
supply available at all times.
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Reference
1-WHO Health principles of Housing(Geneva)
2-American journal of Public health
3-Health housing reference Manual (U.S)
4-Housing and Institutional Health book
5-Pro-Jamal Hassan