CEHI Risk Assessment Tools
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1 CEHI Risk Assessment Tools applied in Oman & Tunisia for assessing environmental risk factors affecting children s health within the home environment Ruba Al-Zoubi National Expert
2 CEHI Risk Assessment Tools EMRO Pilot Application of CEHI Initiative Main objectives Assess the availability, accessibility, accuracy and reliability of information on CEH Assess and prioritize the environmental health risk factors affecting children within the home environment and its immediate surroundings Refine CEH indicators in view of regional conditions and promote their use as a tool for decision making to improve environmental conditions for children Establish a monitoring system of EH risk factors affecting children in pilot countries
3 CEHI Risk Assessment Tools EMRO Pilot Application of CEHI Initiative The Approach Generate preliminary report on the state of children environmental health using existing information sources Undertake household surveys of the EH risk factors affecting children to fill information gaps and assess & prioritize risks to children s health Prepare report on the assessment including analysis of findings and trends and present it to a national seminar Generate the national report on the State of Children Environment Health
4 Purpose To report the status of exposure and health effects To assess and prioritize the risk factors affecting children within the home environment and its immediate surroundings To provide data for investigative analysis of the risk factors
5 The MEME Model Contexts Social conditions Economic conditions Demographic conditions Exposure Health outcome Distal Ambient environment causes Well-being Less severe Proximal Community Home attributable to Morbidity Mortality More severe Preventive actions Remedial actions Actions
6 Issues Risk Factors Indicators Exposure Conditions Health Effects Household Survey Tools
7 A comprehensive search was conducted to identify survey tools and questionnaires used to assess each of the proposed issues. Search included: Contacting concerned entities in member states & worldwide Reviewing publications Searching the internet
8 Main Search Results World Health Survey (WHS) 2002 Iraq Draft Questionnaire (Iraq Multiple Indicator Rapid Assessment) Environmental Health Indicators in A Danish Health Interview Survey Jordan Survey (Health & Environment Status) Jordan DHS Survey 2002 London School of Hygiene & Tropical Medicine, Vision 21 field trials Kenya 2003 Oman Environmental Survey MEASURE DHS+ Model B Questionnaire
9 Main Search Results (cont d) The Dwelling & its Environment: Jordan camp survey 1999 (Fafo/SPRC) ZAP Asthma Project: Health & Environment Survey Instrument Health Behaviour in School-aged Children (WHO Cross-National Study) Questionnaire EPA Factsheet on Sources of Indoor Air Pollution Applied Poverty-Environment Indicators: the Case of Nigeria Definition of Crowding & Effects of Crowding on Health: A Literature Review Sources of Noise Health & Sanitary Elements of A Housing Inspection Protect your children by poison proofing your home
10 Hundreds of questions were identified, screened, and categorized (by issue) and three survey modules were developed: Module I: Roster of People & Health Module II: Housing Quality Module III: Water, Hygiene & Sanitation
11 Module I: Roster of People & Health It includes the Household Roster (Name, Age, Education, Occupation,..etc) It reports on health outcomes indicators: ARI morbidity (20), incidence of physical injuries (43), diarrohea morbidity (29), physical injuries mortality (42) It reports on Permanent Income Indicators (socioeconomic context)
12 Module II: Housing Quality Reports on the following indicators: Overcrowding (14) Housing Quality (13 & 15) including physical characteristics, infrastructure & surroundings, light, dust, play area, household safety margins..etc. Indoor Air Quality (17 & 18) including heating, cooking, cooling, indoor smoking, animals & pets,..etc. Disease Vectors & household Insects (35) Household Food Safety & Hygiene Household Chemical Safety
13 Module III: Water, Hygiene & Sanitation Reports on the following indicators:(drinking water quality (25), children without basic services for water, sanitation & hygiene (27), children without access to piped water (41)) Water Supply Services Water Consumption & Cost Water Supply Continuity & Reliability (including water handling and water quality) Hygiene Practices & Facilities Sanitation Waste Disposal
14 The three Modules were: Pilot tested in Oman & Tunisia on small scale Refined & adapted for Oman & Tunisia surveys Finalized Available for further adaptation by countries To be annotated, published & distributed
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