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Fulltext Environmental Management and Sanitation as a Malaria Vector Control Strategy: A Qualitative Cross-Sectional Study Among Stakeholders, Sunyani Municipality, Ghana

Agyemang-Badu SY, Awuah E, Oduro-Kwarteng S, Dzamesi JYW, Dom NC, Kanno GG

Environ Health Insights, 2023;17:11786302221146890.
PMID: 36620305 DOI: 10.1177/11786302221146890

BACKGROUND: For centuries malaria infection remains a public health burden globally as well as in the Sunyani Municipality. This exploratory qualitative study aimed to assess the prospects of environmental management and sanitation (EMS) as a malaria vector control strategy among key stakeholders involved in the prevention and control of malaria in Sunyani Municipality, Ghana.
METHOD: We used an exploratory qualitative study and a designed focus group discussion (FGD) guide (with specific research questions) to solicit opinions and/or views among Malaria Control Focal Persons, Environmental Health Officers (Health Inspectors), and Honourable Assembly Members. Data were collected between December 2019 and February 2020. The responses were analyzed according to the specific research questions.
RESULT: Findings from this study shows that high government support and/or political will by investing in environmental sanitation infrastructure, creating the enabling environment for strict enforcement of environmental sanitation bye-laws by Environmental Health Officers/Health Inspectors, effective and efficient collaboration among key stakeholders and organization of communal labor activities is likely to help reduce the majority of the mosquito breeding sites.
CONCLUSION: The prospects of environmental management and sanitation (EMS) as a vector control strategy, look promisingly very high, pertinent, and workable and a likelihood game changer of winning the fight against malaria due to the residual transmission that is happening outdoors. However, EMS can be employed as a supplementary method to the current core vector control methods if the following conditions and bottlenecks are addressed and in place: (a) Effective collaboration among key stakeholders at all levels; (b) Adequate allocation of funds to the Environmental Health and Sanitation Department; (c) Enactment of robust educational campaigns across all educational levels and via different media; (d) Recognition, empowerment, and adequate resourcing of Environmental Health Officers; (e) Adherence to the building regulations to prevent encroachment of natural wetlands; (f) Revision of fees/fines and prosecution of sanitary offenders; (g) Enactment of an Environmental Sanitation Day (ESD), and establishment of the Environmental Health and Sanitation Fund (EHSF).
Fulltext Fecal Contamination in the Wastewater Irrigation System and its Health Threat to Wastewater-Based Farming Households in Addis Ababa, Ethiopia

Ali AS, Gari SR, Goodson ML, Walsh CL, Dessie BK, Ambelu A

Environ Health Insights, 2023;17:11786302231181307.
PMID: 37362237 DOI: 10.1177/11786302231181307

Due to rapidly growing demand, the production of vegetables is increasing along the Akaki Rivers. The objective of this study was to examine the degree of fecal contamination and levels of fecal contamination and dissemination throughout the wastewater irrigation system. Irrigation water, irrigated soil, and leafy vegetables were collected twice during 2 vegetable growing seasons, at the maturity period of the growing season, from 19 sampling points along the 2 Akaki Rivers. Composite samples were taken from all sampling points and E.coli was enumerated. The mean E.coli load in wastewater and non-wastewater sources were 1.16±5.53 CFU/100 ml and 2.232±1.292 CFU/100 ml respectively. All counts of E. coli in the wastewater exceeded the WHO's standards indicating that the irrigation water quality was unacceptable. In the wastewater-irrigated and non-wastewater-irrigated soil, the mean E.coli were 3.62 ±1.582 CFU/g and 1.322±87.1 CFU/g respectively. Meanwhile, the mean E.coli counts on the lettuce and Swiss chard were 78 ± 2 CFU/g and 44 ±3CFU/g respectively. The E.coli count on the leafy vegetables was found to be associated with the E.coli in the wastewater and soil. The production of leafy vegetables using wastewater with unacceptably high levels of E.coli and high occupational exposure introduces high levels of risk to the farming communities and to the consumers. Leafy, low-growing raw edible vegetables need careful treatment during food production and harvesting procedures or activities.
Fulltext Modelling the Mediating Effect of Health Care Healing Environment on Core Health Care Delivery and Patient Satisfaction in Ghana

Amankwah O, Weng-Wai C, Mohammed AH

Environ Health Insights, 2019;13:1178630219852115.
PMID: 31217690 DOI: 10.1177/1178630219852115

OBJECTIVE: The multifaceted nature of health care delivery has led to the need to incorporate strategies that will help to enhance performance and maintain the quality of the health care environment. However, even though dedicated health care staffs contribute to patients' satisfaction of health care delivery, the health care environment must ensure the safety and well-being of patients. Like most developing countries, many public hospitals in Ghana are faced with challenges in the area of health care healing environment. Therefore, this article investigates the mediating effect of health care healing environment between health care core business and patients' satisfaction.
METHOD: This is a cross-sectional study involving adult patients of Komfo Anokye Teaching Hospital, Tamale Teaching Hospital, and Cape Coast Teaching Hospital in Ghana. A questionnaire survey based on the 'A Staff and Patient Environment Calibration Toolkit (ASPECT)' dimensions and health care core service dimensions was used to collect data from 622 patients. SmartPLS was used to analyse the data collected.
RESULTS: The findings of the study show that the quality of health care healing environment mediates the relationship between patients' satisfaction and all of the constructs under the core health care delivery.
CONCLUSION: Stakeholders of the Ghanaian health care sector should take initiatives to constantly improve the quality of health care healing environment as it has an influence on patient satisfaction of the overall core health care delivery.

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