Assessment Of The Importance Of Hygienists Practices In The Prevention And Control Of Water Borne Infection

Project and Seminar Material for Public Health

Assessment Of The Importance Of Hygienists Practices In The Prevention And Control Of Water Borne Infection


Abstract


Water adulteration is a major public health problem which affects the quality of life of people especially, school children. Water borne diseases are serious health hazards and major causes of morbidity and mortality in the developing countries of which Nigeria is one. The purpose of this study was to identify the strategies for enhancing the hygiene practices needed by water vendors in public primary schools in Nsukka Education Zone. The study was carried out in a descriptive survey research design. A total of 134 respondents were selected from the population figure out of which the sample size was determined. The primary source of data collected was mainly the use of a structured questionnaire which was designed to elicit information on the assessment of the importance of Hygienists practices in the prevention and control of water borne infection. The data collected will be analyzed using frequency table, percentage and mean score analysis while the nonparametric statistical test (Chi-square) was used to test the formulated hypothesis using SPSS (statistical package for social sciences). The results indicated that the respondents were in agreement with strategies that water vendors would adopt to enhance their hygiene practices. The findings of the study would enable the Health Ministry authorities to be aware and appreciate the roles and problems of water vendors.


Chapter One


Introduction

Background of the Study

The need to strengthen water safety and hygiene practices is a fundamental public health concern for all for the prevention of water borne diseases. World Health Organization (WHO) (1999) defines water as any substance, whether processed, semi processed or raw which is intended for human consumption. In a similar view, Akande (2002) defines water as any substance, prepared and eaten by people to take care of their physiological needs. Also, Ohiokpehai (2004) describes water as anything liquid or solid material which when taken and digested can provide the body with nourishment. It can be deduced form the above definitions that water is any substance eaten that can provide the body with its needs. It follows that water as a basic human need must be wholesome and safe. This is because good and adequate water promotes good health while poor and adulterated water substances are potential hazards to human health.

Water adulteration is a major public health problem which affects the quality of life of people specially, school children. Water borne diseases are serious health hazards and major causes of morbidity and mortality in the developing countries of which Nigeria is one. Bhat (2005) reveals that incidence of water borne diseases outbreak is due to micro-organisms like salmonella, campylobacter Jejuni or Norwalk virus. For instance, microbiological examination of various water items served by the water vendors in various parts of India indicated the presence of micro-organisms. According to Ankleshwaris (1999) water adulteration here refers to mixing of water with other substances that may be harmful to human consumption by water vendors.

Water vending helps in providing essential services to many of the urban inhabitants such as site workers, labourers, street dwellers, market traders as well as school children. Water vendors according to Lathan (1997) are small scale entrepreneurs normally seen in a simple set up facilities or stalls in public places in order to provide quick and cheap services to the people. The water vendors operate both in urban and rural schools, where they set-up their stalls adjacent to the schools or operate under a nearby tree. They provide different water varieties like rice, beans, okpa, agidi, ice cream, snacks among others. People who patronize such water are more interested in their convenience than their safety and hygiene.

Water vending is increasingly becoming popular perhaps due to some vital roles it plays such as providing of quick and cheap water services to the people as well as creating employment opportunities for women. Ohiokpehai, (2004) while acknowledging the vital role played by water vendors to the city dwellers observes that such water can pose significant health hazards to the people due to the vendors lack of hygiene practices.

Liu (2007) describes hygiene as a science that is concerned with environmental cleanliness of an individual or group or organization members to maintain healthy living. In this study hygiene is seen as all efforts towards ensuring good surrounding in order to prevent the occurrence of diseases or other health hazards. Thus, hygiene entails keeping once environment to avoid the ill-health of disease for a healthy living in the society. Muinde (2005) observes that water vending plays important role in the cities and towns of many developing countries in meeting the demands of the city dwellers. Millions of people are fed daily with a wide range of water that are relatively cheap and easily accessible regardless of the status of the water they eat form the vendors.

Vendors are not regulated by the local council health authorities, thus they operate without any monitoring of what they prepare and how they prepare them. Yet, they are found operating in the primary school premises where school children fall the victim of buying the water. Simoons (2006) assert that school children exposed to poor and unhygienic diets not only experience poor health but also retarded academic development. Simoons also states that body first uses energy to maintain critical organs functioning. It appears that poor families spend proportionately more of their income buying water from water vendors. Unfortunately, this cheaper waterare generally the least nutritious. The water stuffs as a result of poor storage are contaminated and vending of such water to school children and other people endangers their health.

Agba (1994) observes that unhygienic practices by water vendors expose children to diseases like vomiting, abdominal pains, diarrhea and other forms of health risks in the environment. Although school children enjoy water from these water vendors, in many cases the water is of poor quality and it poses a serious health risk to the school children. Water vendors provide the bulk of these children snacks, breakfast, lunches in many schools in Nsukka Education Zone. Agba (1994) states that some of the primary schools are located at far away from the children homes, hence most of them leave early for school without breakfast, thus they depend most of the time on water sold around the premises by these vendors. Agba also observes that the water vendors use dirty water to wash their plates and pour out dirty water around their surroundings. Some of them equally appear in dirty clothes, and unkept hair.

The unhygienic practices in the preparation, cooking, serving and storage of water often lead to the contamination of water with pathogens and substances, that result in infection and diseases in the person that eats the water especially school children. These unhygienic practices by water vendors in the schools expose the pupils who eat their water to the risk of contamination of diseases like diarrhea, constipation among others. As a result, the researcher is interested infinding out strategies needed to enhance the hygiene practices of water vendors in public primary schools in Nsukka Education Zone of Enugu State.


Statement of the Problem

The practices of water vendors especially within public primary school premises generate a lot of concern to the general public. Children are ignorant of unhygienic water and may not be concerned about the health hazard of what they buy and eat in the schools. Many water vendors in public primary schools are found not keeping adequate hygiene practices not only in their preparation but in the exhibition of their products for sale.From the researcher’s observation and experience some of them have unkept hairs, dirty foot wears, spit and cough without the use of hand kerchief, leave water open to flies and use dirty water to wash utensil in unhygienic environment. The above condition often leads to water contamination with substances that may result to infection and diseases among the school children. These activities of the water vendors call for urgent actions in the school environment. The problem of this study therefore put in a question form is: What are the strategies to be adopted to improve the hygiene practices of water vendors in public primary schools in Nsukka Education Zone?


Purpose of the Study

The purpose of this study was to identify the strategies for enhancing the hygiene practices needed by water vendors in public primary schools in Nsukka Education Zone.

Specifically, this study is designed to:

  1. Identify hygiene practices needed by good vendors to operate in public primary schools in Nsukka Education Zone.
  2. Identify personal hygiene practices needed by water vendors to operate in public primary school in Nsukka Education Zone.
  3. Identify environmental hygiene practices needed by water vendors to operate in public primary schools in Nsukka Education Zone.
  4. Suggest strategies that should be adopted in enhancing the hygiene practices needed by water vendors in public primary schools in Nsukka Education Zone.

Research questions

The following research questions guided the study.

  1. What are the hygiene practices needed by water vendors to operate in public primary schools in Nsukka Education Zone?
  2. What are the personal hygiene practices needed by water vendors to operate in public primacy schools in Nsukka Education Zone?
  3. What are the environmental hygiene practices needed by water vendors to operate in public primary schools in Nsukka Education Zone?
  4. What other strategies are needed to enhance the hygiene practices of water vendors in public primary schools in
    Nsukka Education Zone?

Research Hypothesis

There is no significant difference between the mean rating of water vendors and teachers with regard to strategies for enhancing hygiene practices of water vendors in public primary schools in Nsukka Education Zone.


Significance of the Study

The theoretical significant of this study is anchored on social learning and Humoral theory of water and culture respectively. The principles of the two theories place emphasis on acquisition of knowledge and behaviour change through interaction with the environment. The practical significance of the study would be of immense benefits to the following Ministry of Health, water vendors, parents, school children, researchers and the entire society. The findings would enable the Health Ministry authorities to be aware and appreciate the roles and problems of water vendors in the public primary schools. This will help them to come up with good policy intervention to promote water safety measures in the various school environments where the water vendors operate.

The findings would help water vendors to adopt good hygiene practices that will prevent water contamination. It would provide them with the skills to ensure proper hygiene as well as the need for them to maintain their personal and environmental cleanliness where they sell their products.The parents who give their children pocket money would also benefit. This will assure them of the quality and safe water sold to their children in the schools. The children themselves would benefit from the findings. They would be offered good quality and safe water by the vendors in the schools. The good quality water would help to improve their nutritional status.

Researchers interested in other areas of water research would find the findings as useful background knowledge in the area. The findings would benefit the entire society. This would go a long way in reducing the outbreak of water poisoning. It would enable the people to appreciate the need for water safety through adopting proper water preparation under better hygienic conditions in their homes.


Scope of the Study

This study covered the water vendors in public primary schools in Nsukka Education Zone. The study examined the hygiene practices of water vendors with particular interest on hygiene practices, personal hygiene practices and environmental hygiene practices of water vendors in public primary schools in Nsukka Education Zone. The study also examined strategies for hygiene practices that water vendors would adopt to enhance the hygiene practices in public primary schools in Nsukka Education Zone.


Chapter Five


Discussion of Findings, Implications, Conclusion and Recommendations

Discussion of Findings

In this chapter the findings of the study as they relate to research questions and hypothesis that guided the study were discussed.

Hygiene practices needed by the water vendors

The following hygiene practices as found out by the study: keeping kitchen areas clean, washing water items before cooking, using clean water in cleaning utensils, keeping water free from rodents, displaying water with cover, buying bottled water that have not expired are in support of the recommendation of Winchell (2009) that water vendors should wash water items as well as keep the kitchen surroundings clean. This is to avoid water poisoning and contamination. Clark and Fox agree that water items should be kept away from rodents to prevent them from harmful bacteria that could cause contamination. According to Adeoye (2007) disinfectants should be used to keep the kitchen free from bacteria and other harmful rodents. The above hygiene practices are necessary so as to ensure that water served the pupils in public primary schools are free from contamination, poisoning and water-borne diseases.

Personal hygiene practices needed by water vendors

Personal hygiene practices which include bathing on regular basis, washing hand with water and soap after toilet, using handkerchief while sneezing and coughing, cleaning mouth and teeth with brush daily, not smoking while selling water, wearing apron and cap regularly are in line with the opinion of Clark and Fox (2009) that water vendors should ensure proper personal hygiene such as bathing regularly, washing hand with water and soap after toilet to prevent harmful bacteria. Barabara and Claridge (2000) are of the opinion that water vendors should use handkerchief while sneezing and clean mouth regularly to avoid cross contamination. Personal hygiene is as important as water itself. This is because the water vendors cleanliness is central since otherwise will be hazardous to the health of the pupils through the water they sell and handle.

Environmental hygiene practices needed by water vendors

The following results about environmental hygiene practices needed by water vendor- not allowing people to urinate in the selling premises, having enough store for water items, removing ashes after cooking regularly, often washing the kitchen, washing plates after use, having a standard waste bin, covering waste bin always, inspection of stall premises regularly are in line with the view of Kubik, Lyttle, Perry and Story (2003) that environmental hygiene is important to hygienic water preparation. This agrees with Hobbs and Roberts (1982) that bins must be covered always to avoid dangerous odour that may breed healthy problems. Nwana (1994) on his part maintained that water vendors in Nsukka have high standard of environmental hygiene. According to him, water vendors have enough store for water and inspect stall premises regularly.

Strategies needed to enhance hygiene practices of water vendors

Strategies needed to enhance hygiene which include: setting up water committee in public schools, water vendors should under go medical checkup before they are allowed to sell water in schools, water vendors should go for routine check up at least once a year, kitchens should be cited in areas free from odour, developing hygiene and instructional manual, use of striking poster and cartons, giving orientation to water vendors on their admittance to sell water in school, organizing seminars for water vendors at least once a term are in agreement with views of other authors. Onyechere (2010) maintained that seminars and workshops should be organized for the water vendors to sensitize them on the importance and consequence of hygiene in the society. Akande (2002) stated that medical check-up has to be done periodically to ensure proper control of water borne diseases among the pupils who buy water from vendors.

Furthermore, the responses of the respondents were separated and subjected to t-test analysis. The result indicated that the respondents were in agreement with strategies for enhancing the hygiene practices of the water vendors that operate in public primary schools in Nsukka Zone. Based on the above, the formulated hypothesis for the study was accepted, implying that there is no significant difference in the mean ratings of the water vendors and teachers with regard to the strategies for enhancing the hygiene practices of the water vendors in Nsukka Education
Zone.


Educational Implications

From the findings of this study, the following implications have emerged for Nsukka Education Zone, Enugu state Ministries of education, health, parents and head teachers and to children in the public primary schools in the state: Water is one of the physiological needs of an individual; hence it is critical and central to human existence and development. It therefore, becomes imperative that water procurement, preparation and service must be hygienically handled especially with regard to water vendors in both urban and rural areas including public primary schools.

The state Ministry of Education through the Ministry of Health is better placed to legislate on matters of water vending operations in the school system. This becomes important to ensure that appropriate hygiene practices are adhered to, by vendors to save the innocent school children and members of the society from water diseases that may arise due to poor and unhygienic conditions on the part of the water sellers. The school authorities themselves are expected to ensure that water vendors in their schools maintain a high level of water, personal and environmental hygiene practices where they serve customers. Thus, the head teachers of schools can liaise with sanitary inspectors to regularly monitor the watervendors and their hygiene practices in their areas of operation, be it in the schools or in the streets of the town.

Parents can on their own reduce the tendency of allowing their wards to buy water from the vendors by giving them prepared water in water flasks to be taken to schools.


Recommendations

Based on the findings, the following recommendations were made

  1. On hygiene practices, water vendors should ensure storage of water items to prevent water poisoning and contamination through rodents and other bacterial.
  2. On the personal hygiene practices of the water vendors, headmasters and teachers should ensure that water vendors maintain high personal cleanliness in the school premises they operate.
  3. On environmental hygiene, government through its health workers should monitor the activities of the water vendors with a view to ensuring compliance with hygiene practices.
  4. Seminars and workshops should be organized
    periodically to sensitize the water vendors and the general public on the importance of hygiene practices and the danger of avoidance of the practices.
  5. It is therefore, the opinion of this researcher that seminars on hygiene be regularly organized not only for water vendors but to the entire stakeholders in water service operations in the society. The principals, teachers, water vendors, health workers and nongovernmental bodies should collaborate to contribute in ensuring that appropriate hygiene practices are maintained in the society for the benefit of all.

Limitation of the Study

There may be some faking in the responses made by the respondents in filing the questionnaire and this may influence the findings of this work.


Suggestion for Further Research

Based on the strength of the findings of this study, the researcher suggests that further research works be done in the following areas;

  1. Effect of water borne diseases on the academic performance of school children in Nsukka Education Zone
  2. Relationship between water and intelligence among school children in Nsukka Education Zone.
  3. Water Management practices of home makers in Nsukka Education Zone
  4. Introduction of Health Education as a compulsory subject in public primary schools in Nsukka Education
    Zone.

Conclusion

The following conclusions are drawn based on the finding of the study.

  1. Water vending helps in ensuring provision of essential services to many of the urban in habitants such as site workers, labourers, street dwellers, market traders as well as school children. It also serves as small scale business units that render quick and cheap services to the people where they operate both in the urban and rural areas. However, while acknowledging this vital role it plays, it becomes imperative that people who engage in the business of water vending, are to appreciate the importance of proper hygiene practices in the services provided to the people.
  2. Water vendors should embrace appropriate water, personal and environmental hygiene to ensure that water are free from poisoning, contamination and other diseases.
  3. Efforts should be made to ensure the safety of the environment in which water vendors operate especially with regard to public primary schools in the zone. This is to help save parents and other stakeholders from the dangers of water poisoning, diseases and other associated health problems resulting from improper hygiene practices.
  4. All stakeholders, site workers, labourers, water vendors, school heads, their teachers and pupils are to cooperate in enforcing good and appropriate hygiene practices in the society.

Summary of the Study

The study was carried out in Nsukka Education Zone of Enugu state. Descriptive survey research design was adopted for the study. The population comprised teachers from selected public primary schools and water vendors that operate in them. The sample size for the study was 548 respondents. Structured interview schedule and questionnaire were used as the instruments for data collection. The instrument was facevalidated by experts and Cronbach Alpha method used in computing the reliability estimates. Four research questions and one null hypothesis guided the study. Mean and standard deviation were used to analyze the research questions while ttest was applied in testing the hypothesis at 0.05 level of significance.

The findings revealed that hygiene practices needed by water vendors include: keeping kitchen areas clean, using clean water in cleaning utensils, buying fresh water such as fruits and vegetables without bruises among others. Personal hygiene practices needed by water vendors include: bathing on regular basis, wearing apron and cap regularly washing hand with clean water and soap after toilet, using clean towel among others. Environmental hygiene practices needed by water vendors include: not allowing people urinate around the selling premises, having a standard waste bin, covering waste bin always etc. Strategies needed to enhance the hygiene practices of water vendors include: setting up water committee in public primary schools, the water committee should inspect the water before they are sold to children, water vendors should undergo medical checkup before permitted to sell in schools etc. The researcher in general recommended that government, non-governmental bodies, head teachers, teachers, health workers and water vendors should collaborate to contribute in ensuring that appropriate hygiene practices are maintained in the society for the benefit of all.


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