EVALUATION OF THE EFFECTIVENESS OF ENVIRONMENTAL SANITATION IN THE CONTROL OF MALARIA IN UYO L.G.A, AKWA IBOM STATE

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

A safe living environment is a sine qua non to national growth and general development. This can be done by efficient environmental sanitation and hygienic practice. Roland et al. (2014) argued that environmental sanitation consists of the proper collection, transport, disposal and treatment of human excreta, solid waste and wastewater, disease vector control and laundry facilities for personal and household hygiene, for public health.’ Bindeshwar (2016) also considered effective environmental sanitation as a necessary requirement for growth. Sadalla et al (2011) noted that environmental sanitation problems may be caused by inadequate provision of facilities and actions of residents in communities and neighborhoods Despite its significance in individual life, Mosleh Uddin and Sudhir (2015) argued that the provision of environmental sanitation facilities and services is weak in Africa and developing countries such as Nigeria. Roland et al (2014) added that many people in these developing countries have “lack of access to adequate water supply, environmental sanitation and food security.” According to Bindeshwar (2016), this raises the ‘mortality rate of millions of children under the age of five per year and about 50 diseases are related to poor environmental sanitation.’

This hazard is also exacerbated by poor environmental practices of individuals. Although the provision of efficient sanitation facilities could at best be seen as a means to an end, because the behaviors and behavioral activities of the stakeholders promote an end. The public interest in the need for proper sanitation goes a long way towards achieving the desired end that would mitigate the consequences. Globally, poor sanitation practices could result from overcrowding, insufficient services and facilities, low levels of education and knowledge of successful sanitation practices, poverty, and unplanned housing development, among others. Many studies have shown that environmental sanitation problems are not unique to a specific residential area. Such research indicates that such problems exist in conventional or rural core regions, metropolitan areas and peri-urban areas or suburbs. Studies focused on successful sanitation issues in the core areas include for example, Edo studies (Kenneth et al, 2013); Oyo studies (Egunjobi, 2016) in Nigeria. Such studies also occur outside of Nigeria. These include those in Addis Ababa, Ethiopia, and India (Bindeshwar, 2016, and Sabur, 2016), Bangladesh (Musleh Uddin, 2010), and Nakhon Pathon, Thailand (Lagho, 2011).

A safe environment that improves healthy living and is free from hazards is a fundamental right of every human being. In fact, deposition of fecal matter in the vicinity of residential homes, pollution of drinking water supplies, bad drainage systems, dumping and depositing of waste and sweeping into empty gutters, defecation and disposal of feces by street corners and waterways, and selling of food and cooked food by roadside are all unhygienic activities that pose a potential risk to development. Hand washing after defecation and before food preparation is of particular importance in the reduction of disease transmission, inadequate housing often leads to and increases poor health of the community and its consequent contribution to the health of Nigerians and individuals in Akwa Ibom. Measures to prevent diseases such as cholera, typhoid and malaria include, for the most part, the provision of clean water and proper sanitation for people who do not yet have access to basic environmental sanitation services; health education and good food hygiene are equally essential (Ekong 2015). Efficient environmental sanitation is identified as the principles and practice of making safe and healthy. Weak sanitary conditions in our climate provide a good breeding ground for disease-causing species (pathogens). This situation increases the spread of diseases such as malaria, particularly in tropical areas such as Nigeria. Some of the tropical diseases that have become difficult to manage due to the dirty conditions of our climate are malaria, cholera, diarrhea, ascaris, lower respiratory infections and accidental injuries. In certain adults and children under the age of five, one third of all diseases are caused by environmental factors such as contaminated water and air pollution (WHO 2012). Environmental sanitation practice in Nigeria is often a misconstrued topic. It’s generally understood as an exercise rather than a practice, Daramola (2015). Environmental problems in many places threaten to undo the advances made in public health over the last few decades.’ Every human being should have a healthy and prosperous life in harmony with nature (Ayres 2010). According to the National Environmental Standards and Regulations Agency for the Protection of the Environment (2011), insufficient and inadequate regulations for the protection of our environment represent a major challenge to socio-economic growth. NESREA has developed twenty-four environmental regulations which have been published in the Official Gazette of the Federal Republic and are now in force. The main purpose of this Regulation is to establish a legal basis for the implementation of sustainable and environmental hygiene practices in the field of environmental sanitation and waste management in order to reduce environmental pollution. The majority of public health and environmental contamination issues are the result of environmental sanitation problems, such as unsafe housing conditions, insufficient sanitation, inadequate or polluted water and smoky cooking fuels (Basher 2012) (basher 2012).

Despite some levels of dedication to malaria prevention, malaria remains a major public health issue worldwide, not only in Nigeria. Malaria kills not less than one million people every year, 90% of whom live in sub-Saharan Africa (SSA) like Nigeria, and causes 300 to 500 million people to fall ill (Bloland et al. 2010). Malaria parasite is one of the leading and growing causes of morbidity and mortality among the Nigerian population and sub-Saharan Africans, especially among under-five children. The World Bank (WB; 2016) estimated that up to one-third (300,000) of all malaria deaths worldwide have occurred in West Africa, Nigeria. Malaria also puts a heavy socio-economic burden on Nigeria’s households and health care systems (WHO 2018). Due to the burden of disease over several years, Nigeria was a signatory to the African Roll Back Malaria (RBM) summit held in Abuja Fct in 2010 (often called the Abuja Summit), which reached a declaration to achieve global coverage of insecticide-treated mosquito nets (ITNs) and to ensure urgent care of vulnerable populations (including under-five children and pregnant women, and breastfeeding women). Unfortunately, since the summit, the origin of malaria control in Nigeria has been one of inadequate commitment and funding to achieve the objectives. That’s why the increase was too slow. It is therefore uncertain whether Nigeria will achieve the Millennium Development Goals (MDGs) goal of malaria prevention (to alleviate 80 percent of the burden of malaria by the year 2015). As of 2015, one third of children with signs of fever received no antimalarial medications, fewer than 20% of homes had at least one mosquito net, and only 6 percent of children under the age of five slept under the ITN (National Malaria Control Program [NMCP] in Nigeria 2015).

The poor state of environmental sanitation in the country has been shown to play a significant role in the etiology of food-borne diseases and other environmental diseases. Malaria is one of the major diseases that increase as a result of inadequate environmental sanitation. The malaria mortality rate is estimated to be between 1.6 and 2.5 million each year, according to the World Health Organization (WHO, 2012). National figures indicate that about six hundred thousand (600,000) cases of malaria occur every year in children under the age of five (Alabi, 2010). Similarly, the number of cases of cholera has been worrying over the years. Between January 2010 and December 2010, 41,787 cases in Nigeria, including 1,716 cases reported mortality in 222 local government areas (LGAs) in 18 states. The most affected states with high malaria rates were Borno, Bauchi Katsina and Akwa Ibom. For the benefit of disease problems, Nigeria is losing around N455 billion annually or equal to 1.3% of Gross Domestic Product (GDP) due to inadequate environmental sanitation practices identified by the World Bank’s water and environmental sanitation programs (Vanguard 2013). Most of the affected children are small children. Other diseases caused by inadequate environmental sanitation practices include schistosomiasis, trachoma, soil-borne helminthiasis and malaria (WHO, 2013). One of the most important public health programs is the provision of clean drinking water and sanitation. However, accumulation of faecal matter in the vicinity of residential homes, pollution of drinking water supplies (sometimes caused by poorly built or maintained drainage systems), dumping of garbage and sweeping in the gutters, defecation and disposal of faeces by street corners and waterways, and the selling of food and food by road are all unhygienic activities that pose potential risks. The research therefore focuses on the assessment of the efficacy of environmental sanitation.

STATEMENT OF THE PROBLEM

It is clear that malaria is a deadly infectious disease, which is widespread particularly in children below the age of five, and even in adults, which in some cases leads to death or high morbidity. Recent studies show that in sub-Saharan Africa, Nigeria accounts for 25 per cent of the overall burden of malaria in Africa as a result of poor environmental sanitation, among others, resulting in the loss of one million lives each year in the country, most of which are children under the age of five and pregnant women, among others. While malaria is a curable or treatable disease, it is an endemic and a major public health problem not only in Nigeria but in Africa as a whole. “In Nigeria, malaria-related deaths account for up to 11% of maternal morbidity or death. Similarly, they contribute up to 25 per cent of child morbidity and 30 per cent of under-5 morbidity, resulting in around 300,000 child deaths per year. Bad environmental sanitation conditions, such as stagnant water pools, facilitate the breeding of mosquitoes that are vectors for malaria. In Akwa Ibom state today, insufficient or weak sanitation practices have contributed to a rise in malaria-related deaths, which could be avoided by good environmental sanitation practices, have been largely ignored not only by the government, but also by the citizens of Akwa Ibom state. These and several other factors motivated the researcher to set out to study the assessment of the efficacy of environmental sanitation in malaria control in Akwa Ibom state.

OBJECTIVE OF THE STUDY

The main aim of this study is to analyze the evaluation of the efficacy of malaria management of the environment in Akwa Ibom. The basic goals are as follows:

1) To analyze the effect of environmental sanitation on malaria control in Nigeria.

2) To analyze the extent of productivity in the control and management of malaria waste in the state of Uyo, Akwa Ibom.

3) To investigate the relationship between the efficacy of environmental sanitation practices and malaria prevention in Akwa Ibom.

4) To investigate the problems posed by successful environmental sanitation practices in Nigeria

5) To propose solutions to the problems of effective environmental sanitation in Akwa Ibom.

RESEARCH QUESTIONS

1) What is the impact of the effectiveness of environmental sanitation on malaria control in Nigeria?

2) What is the level of efficiency in the control and management of waste in the control of malaria in Uyo, Akwa Ibom state?

3) What is the relationship between the effectiveness of environmental sanitation practices and Malaria control in Akwa Ibom state?

4) What are the challenges of effective environmental sanitation practices in Nigeria?

5) What are the solutions to the challenges of effective sanitation practice in Akwa Ibom state?

RESEARCH HYPOTHESES

Hypothesis 1

HO: There is no significant effect of environmental sanitation practice on malaria control in Akwa Ibom state

H1: There is a significant effect of environmental sanitation practice on malaria control in Akwa Ibom state

Hypothesis 2

HO: There is no significant relationship between effectiveness of environmental sanitation and malaria control in Nigeria

H1: There is a significant relationship between effectiveness of environmental sanitation and malaria control in Nigeria.

SIGNIFICANCE OF THE STUDY

The research will help educate society about the evaluation of the efficacy of environmental sanitation in malaria control in Akwa Ibom. It would also prepare the ground for interested researchers who may wish to carry out more research in related areas and could contribute to established literature.

SCOPE OF THE STUDY

The study is restricted to assessment of effectiveness of environmental sanitation in Malaria control in Akwa Ibom state

LIMITATION OF THE STUDY

Financial constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview)

Time constraint: The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

DEFINITION OF TERMS

Environmental sanitation: involves the regulation of environmental factors related to the spread of diseases. Subsets in this group include solid waste management, water and wastewater treatment, industrial waste management and noise emission control.

Malaria: The key existing initiatives focus on reducing interaction between mosquitoes and humans, the destruction of larvae by environmental control and the use of larvicides or mosquito larvae predators, and the destruction of adult mosquitoes by indoor residual spraying and insecticide-treated bed nets.

Malaria: Malaria is a severe and often lethal disease caused by a parasite that usually infects a certain sort of mosquito that feeds on humans. People who get malaria are generally very sick with high fever, chills, and flu-like illness.