strategic objective 8: to promote a healthier environment, · pdf file ·...

SEA/SPPDM-Meet.2/2.3 Page 273

Strategic Objective 8: To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health

REGIONAL PLANNING BRIEF 1. Major work of WHO for this SO in the region (RO and countries) during 2008-2009:

Water Quality Management

• Drinking water quality assessments carried out in Nepal and Thailand. • Training of national staff on water quality monitoring carried out in DPR Korea,

Maldives, Myanmar and Sri Lanka. • Water quality testing laboratories in Bhutan, Maldives, Myanmar, Nepal and Sri Lanka

strengthened. • Water quality standards and guidelines revised for Indonesia and developed for Timor

Leste. • About 20 water professionals from Bangladesh, Bhutan, India, Indonesia, Myanmar

and Nepal trained on Water Safety Plan as future trainers in the Region. • National level trainings on development, application and monitoring of Water Safety

Plan (WSP) held in Bangladesh, Bhutan, Myanmar and Nepal. • WSP pilots implemented in pourashavas with piped water supply schemes in

Bangladesh, in small community piped water schemes in Bhutan, in urban water systems in India and in community water supply and selected urban settings in Nepal.

• A pilot project on Household Water Treatment and Safe Storage in few rural and urban areas of Bangladesh implemented. Existing practices on household level treatment of drinking water in Indonesia reviewed.

• Produced a documentary on a transboundary river, highlighting the benefits, contamination of the river by manmade activities, its impact on health and best practices to protect the precious resource.

• A simple booklet on various tips to use water wisely has been also developed and copies sent to all member states.

Sanitation

• Organized Regional Workshop for Ecological Sanitation where key officials from 8 member states attended.

• Developed hand washing guidelines for primary schools in Indonesia. • Developed guidelines for waste water reuse in communities and

agricultural/industrial sectors in Thailand. • Training on hygiene and sanitation promotion for sanitarians and a national workshop

to introduce WHO guidelines on safe use of waste water, excreta and grey water in agriculture in Nepal conducted.

SEA/SPPDM-Meet.2/2.3 74

Occupational Health

• Facilitated workshops in Thailand and provided guidance for promoting the banning of asbestos and the elimination of silicosis, as a measure on worker safety.

• A baseline study undertaken in 10 countries (all except DPR Korea) to assess the readiness for implementing the recommendations of the global plan of action on workers’ health.

• Three occupational health status assessment studies were commissioned in Thailand. • Short-term occupational health trainings undertaken for training of community health

personnel from Bangladesh, Maldives and Sri Lanka on occupational health services. Healthy Settings

• Prepared a six-module based short (4 day) training course that includes the knowledge and skills development in areas that are critical to managing settings. Using this module, training workshops organized in Maldives, Indonesia and Sri Lanka.

2. Scope of work and major results planned for 2010-2011

Water Quality Surveillance and Sanitation

• Drinking water quality improvement through implementation of water safety plans, point-of-use treatment, water quality monitoring

• Appropriate and affordable sanitation technologies promoted in several member states

• Strengthened monitoring systems for water and sanitation in countries.

Healthy settings

• Expanding training of trainers on healthy settings management.

• Establishing network of healthy settings in SEA Region.

• Linking healthy settings with social determinants of health and primary health care revival.

Intensified collaboration for environmental health

• Capacity building in various national developmental sectors to appreciate the role of health in their work; thus contributing to “health in all” policies.

Workers’ health

• Strengthen occupational and environmental health surveillance and research that informs policy and practice and monitors progress towards targets.

• Provide technical assistance and support to member states for strengthening occupational and environmental health policy making, planning of preventive interventions, service delivery and surveillance.

• Develop and update norms and standards for prevention of key occupational hazards and promote occupational health.


• Technical support, guidance and capacity building in member states for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific workplace workplaces.

Environmental Health and Climate Change

• Continued support for capacity building for government and civil society to address and manage the environmental determinants of health in (indoor) air, health care waste management, and arsenic and mercury exposure.

• Health sector supported for building resilience to climate change.

• Evidence based policies, strategies and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change.

3. Regional Expected Results (RERs) with indicators, baselines and targets (attached):

The relevant RER matrix for SO8 is attached.


4. Budget information for the Strategic Objective for Country Offices (CO) and the Regional

Office (RO) (in USD thousands)

PB 2008-2009* PB 2010-2011 Country offices Regional Office

SO Component Planned Resources Planned Resources CO RO 1. Evidence based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor quality drinking water and wastewater reuse)

3,306 1,975 685 718

2. Technical support and guidance provided to Member States for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings (e.g. workplaces, homes or urban settings) and among vulnerable population groups (e.g. children).

4,275 2,759 1,382 1,678

3. Technical assistance and support provided to Member States for strengthening national occupational and environmental health risk management systems, functions and services.

1,017 387 586 486

4. Guidance, tools and initiatives created in order to support the health sector in influencing policies in other sectors to allow policies that improve health, the environment and safety to be identified and adopted.

178 51 60 20

5. Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors so as to tackle the root causes of environmental threats to health, through means such as responding to emerging and re-emerging consequences of development on environmental health and altered patterns of consumption and production and to the damaging effect of evolving technologies.

194 46 755 249

6. Evidence based policies, strategies and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change.

0 0 0 0

TOTAL 8,970 5,218 3,468 3,151 6,685 4,000 * Resources as of May 15, 2009


South-East Asia Regional Expected Results for Regional PB 2010-2011

Strategic Objective 8: To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health

Organization-wide Expected Result Regional Expected Results Indicator Baseline Target

Number of new and updated assessment of national environmental risk on selected EH burdens.

11 22

Number of countries adapting WHO norms, standards and guidelines to national needs

9 11

1. Evidence-based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor-quality drinking-water and waste-water reuse).

1. Evidence-based assessments, norms and guidance on priority environmental health risks prepared or updated and multilateral environmental agreements (MEA), including the MDGs, monitored.

Number of countries that have set up/updated monitoring systems for reaching MDGs and implementing MEAs

8 11

Number of countries implementing healthy settings programmes

8 11 2. Technical support and guidance provided to Member States for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings (e.g. workplaces, homes or urban settings) and among vulnerable population groups (e.g. children).

1. Primary prevention interventions effectively implemented to reduce environmental hazards to health, especially in local settings, and among vulnerable populations.

Number of countries having acquired improved capacity for managing healthy settings programmes

2 7



Number of countries that have generated through WHO-led effort, specifically outlined policies and programs for the delivery of occupational health services

5 8

Number of countries establishing or strengthening surveillance systems to provide evidence for action and practice

5 8


1. Occupational health policy, programmes and services delivery (preventive and promotional interventions and surveillance) strengthened.

Number of countries implementing WHO-led initiatives to reduce occupational and environmental health risks

6 10


1. Guidance, tools and initiatives disseminated to countries to strengthen the health sector to influence policies in priority sectors, to assess the health impacts and determine costs and benefits of policy alternatives in those sectors, and to encourage their investments in health and safety.

Number of countries where the health sector has directly guided and collaborated with other sectors to assess health and environment impacts and implement common programs that spell mutual development benefit to the partners.

4 8




1. Health sectors leadership enhanced through the preparation of health related policies in other sectors on existing and emerging environmental concerns affecting the Region.

Number of countries where, through the persuasion of the health sector, non- health sector programs have incorporated well defined health outcomes

2 5

6. Evidence-based policies, strategies and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change.

1. Health sector leadership enhanced to promote healthy public policy to identify, prevent and tackle public health problems resulting from climate change

Number of countries having included health dimension in national climate action plans

0 5


Country Planning Brief: Bangladesh (SO 08) 1. Major work of WHO for this SO in country during 2008-2009:

• Water & Sanitation: developed training manuals and reference texts on water safety plans (WSP); piloted WSP in small towns; pilot project on chlorination of piped water supplies; pilot projects on ecological sanitation and sanitation facilities for flood-prone areas.

• Healthy Settings: developed 3 new Local Environmental Health Action Plans; supported observance of World health Day, World Water Day, and World No-Tobacco Day (in collaboration with WHO NMH); organised national workshop on healthy settings

• Arsenicosis: developed training materials for community medicine departments on arsenicosis patient management and detection; supported training of Professors & Lecturers in use of training materials in 15 Medical Colleges

• Occupational Health: organised national workshop in collaboration with ILO on policy development; published compendium of recent research studies in Bangladesh; KAP survey of construction workers and developers leading to set of practical recommendations.

• Environmental Health: completed research on health impacts of indoor air pollution (IAP) on women & children; organised semi-regional workshop on IAP; developed training materials on IAP.

• Health Care Waste Management: supported revision of reference text on health care waste management; developed posters for health care facilities; KAP survey carried out in Upazila Health Complex.

• Climate Change: published a booklet on climate change and health; organised Divisional-level seminars on climate change and health.

2. Scope of work and major results planned for 2010-2011 (by SO component):

• Water & Sanitation: support provided for the widespread implementation of water safety plans; research and development of sustainable sanitation systems.

• Environmental & Occupational Health: support provided to develop and implement a national action plan on indoor air pollution; practical guidance to specific employment sectors on health and safety developed and disseminated

• Healthy Settings: healthy settings approach extended to new locations and new settings including schools in collaboration with WHO NMH (SO6).

• Climate Change: research priorities and plan on climate health and health developed and implemented; working group of health sector professionals established to coordinate health sector engagement in climate change debate and awareness raising.

3. How the scope and results are related to the Country Cooperation Strategy:

• Water & Sanitation (SD 4.1) • Environmental & Occupational health (SD 4.2) • Healthy Settings (SD 4.2) • Climate Change (SD 4.2)


4. Budget information for the Strategic Objective (in USD thousands)

PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC

actual* AC VC 1. Evidence based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor quality drinking water and wastewater reuse)

633 115 0


212 294 35


81 50 0


0 0 0


0 0 0


0 0 0

TOTAL 926 459 35 923 721 * Available as of 15 May 2009

5. Possible VC funding through new or continuing projects:

Anticipated that AusAID will provide VC for funding for the Water & Sanitation component of up to $650,000 currently under negotiation

6. Staff requirements for 2010-2011 (short and long-term):

Scientist – Environmental Health National Professional Officer - Water, Sanitation, Environmental Health


Country Planning Brief: Bhutan (SO 08)

1. Major work of WHO for this SO in country during 2008-2009:

• Capacity building in the area of ecosan technology. • Conducted TOT for on rain-water harvesting system and identified one of villages in eastern

Bhutan for situational analysis for settlements that can be benefited by fog harvesting. • National laboratory protocol for water testing developed.


To provide policy and technical support in: • Implementation of primary intervention that reduces environmental hazard to health • strengthening occupational and environmental health policy and surveillance • develop health impact assessment tool • putting in place appropriate policy measures for safe drinking water supply and sanitation

including alternative non-polluting energy sources • Mainstream occupational health into the development programs.


Strategic Priority #05 • Help reducing the Burden of Diseases through key interventions focusing on Health

Promotion and risk factors with a multi-sector approach • Healthy environment (water, sanitation, food safety, occupational health and climate

change.



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


57 149 30


0 0 0


28 73 0


0 0 0


0 0 0


0 0 0


5. Possible VC funding through new or continuing projects

None

6. Staff requirements for 2010-2011 (short and long-term): None


Country Planning Brief: DPR Korea (SO 08) 1. Major work of WHO for this SO in country during 2008-2009:

Water Quality and safety Water Quality Surveillance system initiated. Health professionals were trained in Water quality standards and monitoring and surveillance system. Community awareness for water quality was raised through development of IEC materials. Overseas fellowships were undertaken for water quality monitoring and surveillance and air pollution control. Medical Waste Management Medical/Hospital waste management was identified as priority with local training at provincial and county level.


Water Quality and Safety To strengthen national and provincial capacities towards improving water quality and environmental pollution surveillance system Medical/Hospital Waster Management • To advocate for development and implementation of ‘biomedical waste management strategy’

for the country; • Develop guidelines for hospital waste management across different levels of health system with

capacity building Climate Change • Engage MOPH for raising awareness of the health consequences of climate change and other

environmental determinants

3. How the scope and results are related to the Country Cooperation Strategy: Strategic Priority 5 Address environmental determinants of health



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


0 0 0 0 0


54 32 0 50 21


0 0 0 0 0


0 0 0 0 0


0 0 0 0 0


0 0 0 20 22


5. Possible VC funding through new or continuing projects None 6. Staff requirements for 2010-2011 (short and long-term):

National Professional Officer - One (shared responsibilities) with short/medium term technical assistance/STC


Country Planning Brief: India (SO 08) 1. Major work of WHO in country during 2008-2009:

• Develop of WSP in two selected cities. • Training for WQ testing/surveillance. • Launching of National Program. Prevention and control of Fluorosis. • Disease burden due to inadequate water, sanitation and hygiene practices. • Development of self learning training documents for HCWM. • Handling of E-Waste in two selected cities. • Impact of indoor air pollution on Reproductive health. • National workshop on OH. • Status of workers health in selected unorganized sector.

2. Scope of work and major results planned for 2010-2011 • To provide technical guidance on drinking water quality issues and waste water management for

Strengthening Environmental Health programme for vulnerable population. • To facilitate development of interventions to promote reduction in environmental hazards

among vulnerable population in selected settings/ work places in both urban and rural settings • To provide technical support for evidence based assessment of risks of vulnerable population

towards chemical substances and hazardous waste. • To render technical support in strengthening the National Occupational Health policy framework

to meet the needs of vulnerable population. • To provide necessary support for strengthening national programme on Occupational Health by

preventive and promotional activities in organized and unorganized sectors. • To facilitate strengthen health system observatory mechanism by linking with other related

sectors. • To provide technical support in preparation and dissemination of public health policy for senior

policy makers of Health and other related Ministries on emerging environmental health issues related to global environmental change.

• To facilitate strengthening national Programme on Climate Change and its impact on Public Health.


The Country Cooperation Strategy does not directly look into environmental health issues being a cross cutting programme. But without having environmental health programme no preventive measures could be taken. Hence it has got its own priority for addressing Pubic Health issues.



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


87 466 62 40 189


258 470 44 210 189


72 400 41 30 100


5 50 0 20 50


13 120 0 25 75


0 0 0 25 75

TOTAL 435 1,506 147 350 678 * Available as of 15 May 2009


• There are possibilities of getting VC Funds for handling Hazardous chemicals and Water Safety Plan


• National professional Officer – Health and environment


Country Planning Brief: Indonesia (SO 08)


• A procedure developed and a pilot activity undertaken to assess health impacts from climate change in vulnerable areas. A national guideline is prepared to promote household water treatment and safe storage.

• A national strategy has been drafted by MoH on occupational health promotion in informal sector outlining roles and responsibilities at different levels.

• Technical guidelines are prepared for promotion of food hygiene in school canteen. Also a guideline is developed to promote hand washing in primary schools. A revised national drinking water quality technical guideline is being drafted.

• Interactive annual meeting of Poison Information Centre at national and provincial levels conducted. Also a workshop for hospital emergency staff was organized on poison prevention and management. A national guideline for poison management and information at hospitals is being developed.

• Guideline on monitoring and control of the environmental radiation risks has been drafted. Risks of Mercury poisoning from informal gold mining is being field surveyed for drafting a framework on risk minimization of local Mercury use. Also risks associated with household use of pesticides are being field surveyed for drafting strategic actions for participatory risk management and control of pesticide use.

• A national stakeholder’s meeting is conducted to share experiences on successful implementation of Healthy Food Markets and containment of Avian Influenza (AI) risks. Healthy Food Market Development Plan for a project (WHO jointly with European Commission) has been revised and updated, and field activities on participatory preparedness for local risk reduction of AI have been initiated in three different pilot markets.


Scope of Work for 2010-2011 • Providing technical support to regularize the identification and management of environmental

health risks of major concern and attempts towards minimization of associated disease-burden • Promotion of public health approaches to change people’s risky behaviour and life-style and

establish “healthy settings” at appropriate indoor and outdoor situations • Promotion of the environmental aspects of health in view of the increasing effects from climate

change and their direct or indirect impacts on human health and livelihood particularly the vulnerable groups.

• Support to the Ministry of Health and health sector in strengthening their partnership and coordination with other partners as appropriate to foster inter-sector collaboration and investment in preventive-health.

• Strengthening the capacity of health sector in developing innovations and using appropriate standards or protocols to deal with major environmental determinants to health.


• Contributing to strengthen risk assessment and surveillance, response to and preparedness for disease outbreaks and pandemic (current focus on AI); with promotion of preventive-health aspects, especially in the context of the International Health Regulations (IHR-2005)

Major Results Planned for 2010-2011 • Health and environment impact assessment tools widely used to deal with major environmental

determinants to health • National capacity strengthened for health promotion and interventions on EH determinants

through “Healthy Setting” approach • Technical support provided for enhancing effective implementation of national strategy and

guidelines pertaining to EH, along with their necessary revision and updates • Health sector supported for building resilience to climate change introducing more advocacy

and awareness at different levels in good partnership and coordination with others • Sustainable “Healthy Food Markets” piloted at local participatory assessment and containment

of AI risks 3. How the scope and results are related to the Country Cooperation Strategy:

The above-mentioned scope of the work and major results for 2010-2011 plan are also related to the different explanations and expressions in CCS document, particularly relevant to the health and environment programme area, as mentioned in the different context such as; • Page 5: Health development plan towards healthy Indonesia 2010 has set goals as “to maintain

and enhance individual, family, and public health, along with improving the environment”, and “to promote public self-reliance in achieving good health”.

• Page 9: under the section Health Profile it is mentioned as “Environmental determinants of health are an important issue in Indonesia. Considerable air pollution resulting from extensive burning of fossil fuels, use of leaded gasoline in cities and major forest fires throughout Indonesia impact negatively on public health. Indoor air pollution resulting from extensive use of biomass fuel in poorly ventilated households, combined with unreliable or intermittent supply of safe water and adequate sanitation, have led to dangerous levels of household pollution in some areas.”



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


601 300 0


163 1,391 1,109


0 0 0


0 0 0


0 0 0


0 0 0

TOTAL 764 1,691 1,109 666 859 * Available as of 15 May 2009


European Commission funding for avian influenza prevention and control as well as healthy food market development activities in Indonesia: this is a continuing collaborative programme for the year 2010, commencing in 2008.

6. Staff requirements for 2010-2011 (short and long-term)

Long-term international professional staff -1 Short-term national professional staff -2


Country Planning Brief: Maldives (SO 08) 1. Major work of WHO for this SO in country during 2008-2009:

• Nationals trained in determining quality of drinking water • Developed rainwater harvesting guideline (draft) • Conducted awareness programmes for communities on environmental health issues • Nationals trained on environmental health impact assessment • Developed national occupational health profile (draft) • Nationals trained on proper handling and safe management of chemicals in garages

2. Scope of work and major results planned for 2010-2011 (by SO component): • Strengthen capacity to address occupational health issues (chemical profile etc) including

legislation • Strengthen capacity to implement water and sanitation master plan for the country • Strengthen technical capacity of Ministry of Environment, Energy and Water, Maldives Water

and Sanitation Authority and MoH staff for more effective programme coordination, management and implementation

• Implementation of strategies for health-care waste management in the context of the national waste management programme

• Assess the vulnerability to climate change, prepare and implement mitigation and adaptation plans

• Implement National Adaptation Plan of Climate change addressing health issues

3. How the scope and results are related to the Country Cooperation Strategy Priority areas: 3 – Noncommunicable diseases, mental health and health promotion 7 – Environmental health



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


14 30 20


37 73 0


12 20 0


0 0 0


3 28 0


0 0 0


5. Possible VC funding through new or continuing projects None 6. Staff requirements for 2010-2011 (short and long-term)

Temporary International professional – Technical Officer for 6 months


Country Planning Brief: Myanmar (SO 08)

1. Major work of WHO for this SO in country during 2008-2009: Provided technical assistance and funding support on: • Promotion of healthy settings • Improving managerial and technical capacity on occupational and environmental health and

water and sanitation • Provision of commodities and logistics support for key activities geared towards improving

occupational and environmental health as well as access the adequate safe water supply.


Environmental and occupational Health • Capacity strengthened to assess and address environmental and occupation health issues • National strategies and policy for mitigation of environmental and occupational health risks

developed updated • Results: Key staff at Central/State/Division levels/TMOs and BHS in selected townships

trained and health care providers in selected industries trained in occupational and environmental health

• Environmental and occupational health risk in selected settings assessed • Standards on occupational health promoted and adherence monitored • National Poison Control Center strengthened • Health setting promoted

Water and Sanitation (OWER2) • Low cost and innovative water treatment promoted • Water safety plans developed and implemented in selected townships • Technical and managerial capacity strengthened


The scope of work and the expected results will contribute in addressing the excess burdens of communicable and non-communicable diseases.



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


70 41 0 225 72


167 158 0 15 8


34 15 0


0 0 0


0 0 0


0 0 0



None

6. Staff requirements for 2010-2011 (short and long-term): Staff included under SO2 (malaria)


Country Planning Brief: Nepal (SO 08)


WHO work has concentrated on • water quality, through the application of water safety plans (7 pilot projects in Central and

Western Development Region, and re-development of 15 treatment plant schemes in Eastern Development Region) and capacity building for diagnosis and reporting of arsenicosis;

• total sanitation, through substantial support to the sector-wide Year of Sanitation 2008 Secretariat; (yielding substantial increase in government funding for sanitation, Darechowk ecological sanitation as part of support for Chitwan district total sanitation plan, and support for regional workshop on ecological sanitation and re-use of waste (water) in September 2008);

• technical support for Sector-wide approach for the watsan sector; • organization of a High-level Regional Meeting on Rainwater Harvesting at end May 2009; • capacity building through DoHS and HECAF for health care waste management (activities in

15 districts, DoHS instructional materials developed and printed, multi-media material produced, shift from incineration to autoclaving taken on board by Government, elimination of Mercury in health-care sector adopted, 12 students trained in IGNOU course on HCWM);

• Reducing risks of Indoor Air Pollution (through national workshop, together with Practical Action, promulgation of Indoor Air Quality standards for Nepal by the regulatory authority: Ministry of Environment, Science and Technology);

• support to Climate Change (through capacity building of NHRC, formulation of research agenda, and regular stakeholder meeting, studies on vector distribution;

• Applied Environmental Health Research promoted through various studies with Nepal Health Research Council (update of Environmental Health Status of Nepal, 2009) ;

• Negotiating an interest by Health Sector in linkage between environmental and primary health;

• Adoption of the National Urban Policy, which includes substantial reference and guidance on Healthy Settings, and continued capacity building and piloting through Department of Capacity building at national and international level in a wide range of environmental health interests.


Continued support for capacity building for government and civil society to address and manage the environmental determinants of health in water quality, sanitation and personal hygiene, (indoor) air, health care waste management, arsenic and mercury exposure, and occupational health.


Ø To strengthen multi-sectoral coordination mechanism and capacity to address priority environmental health determinants associated with poor status of water quality, sanitation and (indoor) air pollution, through health, water and local government components. Results: • functioning watsan SWAP Phase 1 • water quality standards gradually applied and including WSPs • Government taking increasing responsibility to promote appropriate sanitation in all

communities and institutions • Regulation and control of Health Care Waste Management agreed between Health and

Local Development sectors • Preparation of Nepal Environmental Health Action Plan 2010

Ø Support local government and NGOs/CBOs to implement primary preventive interventions

to reduce exposure to environmental hazards, in specific settings and in partnership with national and district based agencies, focusing on vulnerable populations. Results • 47 functioning WSPs • 150 VDCs are open-defecation free • 40% of districts have functioning watsan MIS, with local links to HMIS • 20 Municipalities are part of the Nepal Health City Network

Ø To facilitate multi-sectoral and multi-disciplinary coordination mechanism led by health, to

do evidence-based assessment and knowledge management to address the health and well-being risks associated with the effects of climate change in respect to water, agriculture, food, environment and disaster mitigation. Results • implementation of a research agenda, focusing on vector distribution, water resources

management (floods, water quality, rainwater harvesting, drought), heat stresses (building design, ventilation)

• Identification of mitigation measures and advisory on adaptation on climate change in Nepal

• Review of GoN policies in agriculture, water resources, infrastructure, transport, labour with respect to climate change and human health in order formulate appropriate recommendations for good practice


• Section 6.5 Healthier Environment lists a range of strategic approaches to promote [development and application of] suitable and cost-effective technological options for improving environmental health.

• In addition several horizontal linkages are foreseen within the GoN-WHO collaborative programme mainly in control of communicable diseases, vector control and emergency response, and within the UNDAF in collaboration on watsan activities with UNICEF and UN-


Habitat. All activities will further contribute to poverty alleviation and gender-equity and will reflect a rights-based approach.


PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


228 303 75


537 67 0


0 0 0


0 0 0


0 0 0


0 0 0



AusAid : Phase II, a further 150k being negotiated for 2009 Phase II, 350k US$ (2010-2011)

GAVI : 35k for 2009 expected, continuing project 70k for next Biennium Donor to be identified for Climate Change activities


6. Staff requirements for 2010-2011 (short and long-term) Technical Officer – Environmental health National professional Officer Temporary National Professional Officer – (for AusAID project): 24 months


Country Planning Brief: Sri Lanka (SO 08) 1. Major work of WHO for this SO in country during 2008-2009:

To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health Country: Sri Lanka • Water Quality surveillance mechanism available • Multy sectoral Subcommittee on water quality functioning • Water quality testing capacity improved at provincial level laboratory and HR • Occupational and environmental health response capacity at national and district level

improved • Occupational health training module available • Draft National Environmental Health Action Plan developed • Piloted healthy settings approach to reduce environmental hazards • Revised and piloted hospital health promotion policy and concept to reduce environmental

risks • Build up the capacity of central and peripheral health staff on healthy settings • Advocated health promoting settings in the estate sector • Build up capacity of health and estate health staff on healthy settings approach


• Evidence based assessment made ,and norms and standards formulated and updated on major environmental hazards to health (e.g. poor air quality, chemical substances, electromagnetic fields, radon, poor quality drinking water and wastewater reuse)

• Technical support and guidance provided to Member States for the implementation of primary prevention interventions that reduce environmental hazards to health ,enhance safety and promote public health, including in specific settings (e.g. workplaces, homes or urban settings)and among vulnerable population groups(children)

• Technical assistance and support provided to Member States for strengthening national occupational and environmental health risk management systems, functions and services

• Guidance ,tools and initiatives created in order to support the health sector in influencing policies in other sectors to allow policies that improve health, the environment and safety to be identified and adopted

• Health-sector leadership enhances for creating a healthier environment and changing policies in all sectors so as to tackle the root causes of environmental threats to health, through means such as responding to emerging and re-emerging consequences of development on environmental health and altered patterns of consumption and production and to the damaging effect of evolving technologies

• Evidence based policies, strategies and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change (NEW)


3. How the scope and results are related to the Country Cooperation Strategy

• Enhance management and quality in delivery of services and interventions • Address priority communicable disease programmes, in particular malaria, , dengue, rabies

filariasis and vaccine preventable diseases of childhood • Support pre-service (basic) and continuing education in clinical, public health (including

community /home based care) and service management competencies • Enhance management and quality in delivery of services and interventions • Strengthen the regulatory framework to ensure quality of performance of health staff

(public- private partnership) • Enhance fairness and financial risk protection in health care and optimal use of resources

SEA/SPPDM-Meet.2/2.3 2


PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


27 60 0


18 40 40


38 13 0


7 27 0


0 0 0


0 0 0


5. Possible VC funding through new or continuing projects JYICA, WB, USAID and AusAID


National Professional Officer - Environmental and Occupational Health


Country Planning Brief: Thailand (SO 08) 1. Major work of WHO for this SO in country during 2008-2009:

• Assessment for environmental health risk of enterprises according to the Public Health Act of 1992

• Mobilizing stakeholders supports and willingness to respond to the development of the coalition for prevention and control of asbestos-related diseases

• An assessment of Arsenic Contamination for Establishing a Guideline for Health Surveillance and environmental Management

• The Improvement of Rural Tap Water Quality at Drinkable Standard • Establishment of network for National Environmental Health Action Plan (NEHAP)

implementation in Thailand • The model development for local administrative authority in prevention and control of

environmental pollution • Model development of surveillance for Legionnaires disease • focusing in big cities • Proposed Improvement Occupational Health Services Model in Thailand • Capacity Building in occupational diseases surveillance among health personal working in

Primary Care Units (PCUs) • Feasibility study for the strengthening of occupational and environmental cancer

surveillance system in Thailand • Development of Thai Chemical Tool Kit for Chemical Hazard Control in Thailand • Development of guidelines for health impact assessment (HIA) at project level • Development of guidelines for wastewater reuse in industrial sector. • Strengthening of policy network for prevention and control of environmental diseases at all

levels • Building capacity in environmental health disaster management for local officers in Thailand • Establishment of mechanism responsible for monitoring health impacts of climate change in

Ministry of Public Health 2. Scope of work and major results planned for 2010-2011 (by SO component):

I. Scope of work • Environmental health & climate change • Occupational health

II. major results planned

Environmental health & climate change

• Information management system to serve programme in environmental health areas. There should be core components of databases, surveillance system, and monitoring and evaluation built in this Information management system. In practice, ‘information center’


or ‘clearing house’ may be expected at all levels to support health development at least in the aspects of environmental health.

• Formulating innovations in environmental health areas. • Strengthening leadership capacity in environmental health areas. • Study of climate change and health impacts in Thailand

Occupational health

• Technical assistance and support provided for strengthening national occupational health risk management systems, functions and services.


The scope and results stated in 2. respond to the CCS 2008-2011 (Thailand): ‘(6) To promote environmental health and surveillance of environmental hazards.’



PB 2008-2009 PB 2010-2011

SO Component AC VC planned

VC actual* AC VC

1. Evidence based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor quality drinking water and wastewater reuse)

60 50 0


30 200 0


100 100 0


30 50 0


30 0 0


- - 0


5. Possible VC funding through new or continuing projects: 6. Staff requirements for 2010-2011 (short and long-term):


Country Planning Brief: Timor Leste (SO 08)


• A water quality specialist was recruited in mid 2008 to develop a national standard for monitoring of water quality developed, updated and implemented. In addition a training plan for health staff on water quality and sanitation and other environmental health aspects were developed. Monitoring of water quality and sanitation tools and forms were also developed including the key performance indicators for water and sanitation.

• Water test kits (rapid test H2S strips) were procured and used by the District Public Health Officers to monitor the water quality at the community level across the countries.

• All the 13 districts establish a system for monitoring and testing of water quality. • Advocacy and awareness and climate change and health were initiated during the World Health

Day in 2008. IEc materials were widely distributed through radio, TV, newspapers and media interviews.

• Training module on basic epidemiology course for environmental health officers was developed by WHO to train a total of 42 participants in two batches for the MoH’s district sanitarians and Ministry of Development’s district environmental officer on the basic environmental health program. The trainings were conducted in November 2008 and January 2009 in collaboration between the two ministries.

• Training of Trainers for health staff on water quality will be conducted in Indonesia by end of 2009.


• Technical support to Ministry of Health for institutionalization of water safety plans, household water treatment and storage

• Strengthening the monitoring and testing of water quality in collaboration with other sectors. • Promotion of various low cost and sustainable latrine • Promote operational research on water and sanitation


• In the TLS CCS, water and sanitation is included as “Other focus” under the Strategic Agenda 2 (Disease Prevention and Control).



PB 2008-2009 PB 2010-2011

SO Component AC VC

planned VC


11 4 0


45 19 0


0 0 0


0 0 0


0 0 0


0 0 0



• Major donor on water and sanitation are Ausaid and USAID. Ausaid recently contributed USD 5 Millions over five years to focus on rural water supply and sanitation programme. However, the funds are managed by the independent contractor to support the Ministry of Infrastructure and Ministry of Health. USAID also supported similar projects in district that are not covered by USAID programme. Funding for VC through WHO is very limited on water testing kits with the


support from Ausaid, as there are a lot of international and national NGOs directly implement the water and sanitation programme.

• Funding for 2010-2011 will be explored from WHO SEARO/WHO HQ and possibly from USAID and AusAID.


• Core staff: Nil. • Non core staff: One NPO will be recruited for SO5 and SO8.

strategic objective 8: to promote a healthier environment, · pdf file ·...

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