Proposed Study to Assess
the Environmental
Sanitation Needs of
Ghanaian Communities
Yela Awunyo-Akaba
Department of Social and Behavioural
Sciences
Sch. of Public Health, Univ. of Ghana
Background
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As a research institution, mandate to conduct
studies to improve the health of our people
Environmental Sanitation- critical problem in
spite of prior and ongoing interventions
What accounts for lack of behaviour change?
Focus: Solid Waste Management
Waste Management involves the collection,
transportation, processing and recycling of
waste materials produced through human
activity
Government Environmental
Structures
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The government’s structures for managing our
waste well defined
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The Ministry of Local Government and Rural
Development’s National Sanitation Policy supports
the Environmental Sanitation Service Delivery and
enforces compliance of sanitation rules
The programme components are: effective
environmental health inspections (Sanitary
Inspections), dissemination of sanitation information
(Hygiene Education), pests/vector control and law
enforcement
continued
 Regulatory
Authority is vested in the
Environmental Protection Agency (EPA)
 The Ministries of Health, Education and
Industry are also stakeholders
continued
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The Metropolitan, Municipal and District
Assemblies are responsible for the collection
and final disposal of solid waste through their
Waste Management Departments and their
Environmental Health and Sanitation
Departments
 but there are inefficiencies due to insufficient
resources, ineffective management and the lack
of well trained and motivated personnel.
Conclusions-Government Agencies
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DAs are semi-autonomous and can decide %
of budget to allocate to sanitation projects
Revenue generated cannot support effective
waste collection and disposal
Public unaware of need to pay for waste
collection
Improper tax system for urban dwellers
The laws and regulations are not a sufficient
deterrent to bad hygiene behaviour and not
consistently enforced
Poor institutional cooperation and
collaboration
Interventions to Manage Sanitation
and Hygiene
 The
Urban Environmental Sanitation
Project (UESP), 1997
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Ministry of Local Government and Rural Development
project in 7 settlements within 3 cities
to support primary drainage, citywide sanitation and
solid waste management
Aspects of the project included the rehabilitation of
existing public toilet facilities and the provision of
communal solid waste containers
government subsidized thus raises the issue of
sustainability
Interventions to Manage
Sanitation and Hygiene (cont.)
 School
Health Education Program
(SHEP)
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This initiative though commendable has not resulted
in the wide spread reduction in poor sanitary practices
due to
• Poor maintenance of the school latrines such that
the school still remains an unsafe place for the
child with respect to sanitary diseases
• Poor sanitation and hygiene practices learned at
home are also introduced into schools
Interventions to Manage Sanitation
and Hygiene (cont.)
• The increase in knowledge is not reflected
in sustained behaviour change partly
because of mismatch of facilities for
practice
• Beneficiary Schools channel resources
under the capitation grant to other priority
projects
• Schools cannot afford to make minor
maintenance repairs on the facilities
• Poor community support-vandalism etc
From NGOs
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Donor funded projects-not sustainable
Lack of proper documentation and sharing of
knowledge
Duplication of interventions
Ineffective evaluation component
Researcher initiated projects
Work independently of Government Structures
Lack of community ownership
Problem Statement
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Waste management is still a major
problem in our urban and peri-urban
communities in spite of previous
initiatives to address sanitation and
hygiene needs in Ghana
Rationale
 Children
still suffer disproportionately from
Health Effects of Poor Hygiene and
Sanitation
 School Health Initiatives have ignored the
Community Sanitation Needs Limiting
Effectiveness of these Projects
 Need to Bridge the Gap between School
Health and Community Sanitation
Broad Objectives
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Main aim to diagnose the environmental
sanitation needs of communities to ensure that
planned public health programs are based on
the outcome measures of assessment
 Action plan will focus on advocacy, education,
communication and practical interventions but
the exact components will depend on our
assessment within the capacity of the
communities
The Way Forward
 Critically
assess the waste
management practices in urban and
peri-urban communities
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Investigate the gaps in policy implementation
Determine the knowledge, attitudes and
practices in hygiene and sanitation behaviour
in two communities in the Greater Accra
region (pilot)
To Do This
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Community members active participants in all
aspects of the decision making process
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The health researcher will serve as a facilitator
to help communities manage their own waste
problems
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Increasingly the practice of public health seeks
to move away from researcher initiated
interventions to encourage complete community
ownership of all planned health programs
Assessment Components
 Needs
identification
 Analyzing the causes and variations of
problems
 Collecting and interpreting data
 Monitoring and forecasting trends
 Researching the outcomes
 Evaluating the outcomes
Possible Questions to Explore
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What do community members consider
unsanitary or unhygienic practices?
What are the initiatives the community
itself has embarked upon to improve their
sanitation?
What are the local resources available
within the community to improve
sanitation?
Study Population
 Community
Members
 Relevant Government Agencies
 Opinion Leaders
 Members of Households
 School Children
 School Authorities
 NGOs
 etc.
Long Term Goals
 Study
communities would have a well
managed waste collection system in place
 School Children would have access to
good sanitation at home as well as in
school
Thank You