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Situational Analysis and Needs Assessment: ENVIRONMENTAL EXPOSURES, OCCUPATIONAL SAFETY & HEALTH, AND CLIMATE CHANGE IN ETHIOPIA Establishing a GEOHealth Hub for East Africa School of Public Health, Addis Ababa University, Ethiopia & University of Southern California, USA Regional Workshop on Planning for the Global Environmental and Occupational Health (GEOHealth) Kampala 22 April 2015 1 Outline • Purpose • Methods • Key Findings • Conclusions • Recommendations • Future actions 2 Major events • Contact Established through MOU (July 2011): USC & AAU • Dec 2011 announcement RFA-TW-12-001 • Grant application March 2012: Paired Wise • Two years Planning grant: Sept 2012-Aug 2013; Sept 2013-Aug 2014 • Year I: Ethiopia’s SANA: Launching and inception meetings; National workshops • Year II: Mini SANA East Africa • Regional workshop in Addis Ababa July 31 /2014 • 3rd Year Sept 14- Aug 2015: Supplementary Grant • Nov 11_Grant application for the GEOHealth Hub 3 Partnership for the Planning Grant: the cornerstone Multi - desciplinarity in nature Service providers • Organizations: FMOH, FEPA, FMOLSA Knowledge generators • NGOs: PANA • Addis Ababa University: Horn of Africa, Inst of Environment and Development • Professionals-Experts: 12 individuals (5 from USC and 7 from AAU (SPH+Horn of Africa+Inst of Env’t and Development) Launching meeting - 20 Nov 2012 5 Regional Workshop participants: July 31/2014 6 Objectives of SANA_GEOHealth-Ethiopia • What is the Existing situation? • What are the gaps? Challenges? • What are the needs? • What can be suggested that Academia can do Vs needs • Air pollution • Climate Change and Health • Occupational Safety and Health • Policy and Organizational structure? Context? 7 Methods Situational Analysis • By large literature review (published) • Gray literature: Reports review (gov’t, unpublished) Needs Assessment • Situational analysis synthesis outcome • In-depth interviews with key informants • Face to face discussion with experts, authorities: MOLSA, BOLSA, EPA, NMA • Visits of enterprises (Textile, leather, Paint, printing press, Metal) 8 1. Findings - OSH Work places • Agriculture • Large and medium scale manufacturing • Small Scale enterprise • Informal sector • Two types of work forces • Proc No 377/2003: “2.1 mln” • Proc No. 515/2007: 1.1 mln Hazards/exposures • Physical hazards: dust, noise, heat, vibration, illumination, etc • Chemical haz: pesticides, heavy metals (Lead, ) • Ergonomics • Biological • KAP Determinants/ Factors • Work place factors • Individual/ subject factors • Institutional factors 9 Gaps and Needs - Summary Areas of concern Needs Research • • • • • • • • • • • Training Capacity building Research directions; priorities; Multi-site researches Optimum coverage Vs Biased studies Emerging industries On-job training (in-service) Short-term trainings Post (BSc) training Access to basic instruments Focused training on this instruments Provision of basic lab Inspection and data base 10 Policy and regulation Organizational issues M & E of key indicators • Enterprise level • Enforcing provisions/ System establishment • Human resource development plan • Trained man power • Structural inefficiency • Establishing Key indicators? • Monitoring them? • Sustainable Data base • A system for dissemination 11 2. Findings - Air Pollution and Health in Ethiopia Indoor air pollution • Increased exposure • Limited studies on exposure and links with health effect Exposure factors: • Biomass fuel • Poorly managed housing (space) • HH behavior • Ecology • Education • Gender equity Ambient/ traffic air pollution • Increased exposure due to vehicles: Diesel Vs petrol Factors • Increasing number of vehicles • Volume of vehicles per road • Road infrastructure • Limited policy influence on aged vehicles • Proximity living 12 Major Gaps and Needs on Air Pollution • Organizational structure lacks: • Focus on Air Pollution • Coordination mechanism among key stakeholders • There is paucity of evidence/research • No strategic direction, priority research agenda, and established Key pollutants set on Air Pollution; • No basic, reference laboratories, research centers & facilities • Training centers on Air Pollution not available • Skill gaps on monitoring, data analysis • On-the-job-training, short-term and long-term training are limited • No regular Monitoring on AQ (Ambient/Indoor environs) on identified key indicators of AP 13 3. Findings – Climate change and health 14 Findings – Climate change and health • Agriculture • Water • Energy • Industry • Transport • Education • Health Climate-sensitive diseases/ Hazards • Vector-borne diseases: malaria, trypanosomiasis, onchocerciasis, Leshmaniasis • Soil-transmitted Helminthiases (STHs) • Water-borne diseases: schistosomiasis, diarrhoeal disease • Meningitis • Zoonotic diseases • Air Pollution • Nutrition and related impact • Extreme Events 15 Gap analysis - Climate Change & Health Organizational gaps Training gaps Research Gaps • • • • Structural anomalies Coordination Ownership diffused inadequately trained in the specific relevant techniques • Lack of training on special skill development • lack proper awareness and knowledge • In adequate research • Limited or no research capacity • Basic lab • No Data base 16 Gaps cont’d Climate Institutional capacity Policy capacity M&E • Lack of technology • No fitted human resource • Climate change and health linkage • Identified key indicators • Measurement 17 4. Policy and Organizational frameworks • The current policies and regulations in general seem OK Gaps • Duplication of efforts (MOH, EPA) • Linkage between policy/ regulation and system in enforcement, practice/ implementing/ ensuring provisions • Structural competency (M & E, lab, human resources, research) • Public awareness • Limited resources (logistics and finance) 18 Conclusion: Areas of concern Sustaining and actively • Harmonizing Policy and regulations Vs structure • Capacity building • Research on priority area • Training needs •M & E 19 Recommendations • Improving Linkage between Academia and service and production rendering Organizations • Establish the driving Engine Vs Hub 20 Progressing activities: SANA-GEOHealth Outputs for GEOHealth 1. Disseminations: Four major workshops 2. Printing SANA-GEOHealth 3. Publications: the focused Themes 4. Planning MOU with service providers/sectors Website of GEOHealth: http://eastafrica.geohealthhub.org/ 21 GEOHealth Retreat: Writing Review Manuscripts Nazreth (Adama) 26-28 Dec 2014 Thank You 23