How do we Achieve Universal Access to Equitable Sanitation & Hygiene By 2030? Driving focus on behaviour change to ensure good hygiene practice and educate on self-sufficient practices to reduce the spread of preventable disease such as diarrhoea. A lead2030 Challenge Supported By Reckitt Benckiser (RB), A ONE YOUNG WORLD INITIATIVE FOR GLOBAL GOALS FOR SUSTAINABLE DEVELOPMENT. set by the United Nations General Assembly in 2015. The SDGs are part of Resolution 70/1 of the United Nations General Assembly "Transforming our World the 2030 Agenda".
1. How do we
Achieve Universal Access
to Equitable
Sanitation and Hygiene
by 2030?
Elijah Ekah
Driving focus on behaviour change to ensure good hygiene practice and educate on self-sufficient
practices to reduce the spread of preventable disease such as diarrhoea.
2. Table Of Contents
ABSTRACT
INTRODUCTION
Background
Rural Environment
Statement Of Problem
REVIEW OF RELATED LITERATURE
Telecommunications and Development
Related Projects
FRAMEWORK OF THE INITIATIVE
E-government Framework
PROPOSED SOLUTION
Impact
IMPLEMENTATION OF INITIATIVE
Objective and Scope
Methodology for the Implementation
Centralized and Decentralized MCN Environment
Stakeholders
REFERENCE
3. Abstract
The government of Nigeria recognizes the importance of universal access to sanitation practice and hygienic environment for the
economical and political development, as well as promoting it's cultural diversity. However Nigeria lack expertise and infrastructure
to provide adequate and equitable sanitation and hygiene for all, expecially in Rural Area where large portion of the population has
scant access to hygienic environment and the resources needed to protect themselves against disease causing germs.
I propose a Mobile (sanitation & Hygiene) Competence Network (MCN) to facilitate the communication between people,
governments (i.e.Ministry of Environment), NGOs partners and community environmental workers in rural areas of Nigeria using
basic communication technologies. I believe in the benefits to the improvement of sanitation & hygiene practice in two ways by
providing
โ a tool to overcome geographical and technological boundaries to discuss specific sanitation & Hygiene-related issues and
access to professionals.
โ the national ministry of environment with awareness of the sanitation & hygiene situations in rural communities through real-
time information.
Introduction
Background
With a population of nearly 200 million (World Bank 2017) Nigeria is considered as one of the most important countries in the
African region due to its geographical position, connecting the biggest economies in Africa Yet due to years of international
sanctions, nigeria has been an outcast to the western world. Lack of infrastructure and the impossibility of importing foreign
innovation, has contributed to the delayed socio-economic development of the country in the last decades.
Nigeria is a resource-rich country but still suffers from inefficient economic policies and rural poverty. With a GDP of 375.8 billion
USD (2017), Nigeria is among the lowest performing country in West Africa approximately 32% of the population lives in poverty,
with an average income of 60-70 USD per month. Significant resources are concentrated in the commodities industries and are
concentrated in a few hands. Nevertheless, the government has initiated remarkable socio-economic.
Rural population refers to people living in rural areas as defined by national statistical offices. It is calculated as the difference
between total population and urban population. It is noteworthy that 70% of the population lives in rural areas. Possibly due to the
concentration of the labor force around the agriculture sector (70%). The industry sector employs only 7% of the population, while
services shows a 23% of the workforce.
Rural Environment
In order to improve environmental outcomes and make the environment accessible for everyone, the government has designed a
plan entitled (โNigeria Vision 2020โ) and it represents an aspiring 10-year plan to address challenges of the country.
Regarding rural environment development, the main goal is to reduce the gap between the environmental sanitation & hygiene
practice offered in urban areas as opposed to rural ones. Environmental knowledge have been upgraded due to recent epidemic but
worker remains too low for the amount of population they have to attend to. So in this context, a few worker in rural areas is
responsible for am entire villages and given the bad health, sanitation & hygiene infrastructure, many women give births without
professional aid. This has a big impact in the amount of morbidity and mortality of mother-and-child.
A number of national strategic plans also exists for particular domains but in relation to concrete problems regarding environmental
Knowledge delivery, the following issues were some of the identified by the Ministry of environment.
โข Need to improve rural environmental coverage.
โข Need of a systematic plan for human resources for environment.
4. โข Excessive workload of basic environmental workers.
โข Need of quality data for National environment Information Systems.
Statement of the Problem
Taking into account all the above mentioned facts and figures, it is observable that the main challenges regarding rural environment
in Nigeria have to do with the lack of evidence based solutions in order to:
a) Improve the retention of environmental workers in remote and rural areas by providing them with necessary tools which can
support their activities.
b) Improve the process of data gathering in order to provide the national environment information system with relevant and timely
information to make decisions.
REVIEW OF RELATED LITERATURE
Telecommunications and Development
Telecommunication technologies have played an important role in the development of systems and network which facilitate tasks
across all fields. It is proven that internet connectivity have a positive impact on the economic growth of societies. They are
potentially powerful instruments to strengthen environment Information systems, with the introduction of electronic environment
information records and transmission of factual data, among other uses. These technologies show great promise in low- and middle-
income countries, such as Nigeria, whose organizational and database systems face infrastructural, technical and human resource
constraints. This is evident in the growing number of interventions in countries facing similar challenges and their positive results.
The study of telecommunications and their impact on economic growth in Africa shows a positive correlation between teledensity
and GDP growth. It concludes that โhaving achieved economic growth realized from the use of fixed-line communications, this is the
best time for the region to better understand the power of mobile telecommunications, to eradicate poverty by making available the
benefits of new technologies, particularly in information and communications.
Related Projects
A recent report from UNICEF implies that one of the most practical and cost-effective way of meeting the Millennium Development
Goals is the use of mobile telecommunications as a key tool in within projects aim at reaching poor and under-served populations.
Literature shows that even low-tech information and communication technologies (i.e. text-based mobile phones), can facilitate the
promotion of environmental knowledge and the delivery of basic services to more remote locations, while maintaining economic
feasibility.
The UN has organized a Compendium of mHealth in which several projects regarding system applications utilizing mobile phones
for the improvement of health have been carried out around the world. They are organized by primary application area and the most
important function, they try to offer.
- Education and Awareness: these projects usually involve different types of communication with the community. The case of
mHealth, a pilot study in Kenya, shows how people were eager to use this SMS-based system to learn about family planning and
support of contraceptive choices.
- Remote Data Collection: the use of phones in hard reach areas has been implemented in different countries with the purpose of
collecting information, generally through alphanumeric codes or images, which are then processed and statistical information about
mortality and morbidity is measured.
- Remote Monitoring: in Tanzania a project started by the Pennsylvania State University allows doctors to connect with children in
developing countries via mobile phones. The doctors can access a patientโs health record remotely and through a web portal,
monitor the childrenโs health.
- Communication and Training for Healthcare Workers: the purpose of these type of projects is to empower health workers and
give them access to quality knowledge through mobile phones. In Pakistan, a speech-recognition based system is being used for
health workers who are semi-literate in order to access the information they are seeking in order to better treat / diagnose a patient.
5. - Disease and epidemic outbreak tracking: the rationale for using mhealth solutions when disease outbreaks occur has to do with
the timely transfer of information. FrontlineSMS is a software application used for sending and receiving group SMS, used to carry
out surveys or to simply keep in touch with fieldworkers.
- Diagnostic and treatment support: In Argentina, a system has been implemented which allows data acquisition of patients
unable to assist to specialized medical centers. Mobile devices with portable acquisition systems, such as ECG or arterial blood.
FRAMEWORK OF THE INITIATIVE
E-government Framework
E-government is understood as the support and enhancement of civil rights and duties in the information and knowledge society.
Technology provides the means for inclusion of the citizens even in early stages of clarification and planning by the public entities. In
the case of environment, it is the improved information and timeliness, together with the adequate control and documentation
systems that can overcome the obstacles of accessibility and coverage.
The execution of information, communication and interchange processes within and between governmental institutions (such as the
Ministry of Environment and its most remote rural area ministry) can provide a stronger and more interconnected environment
information system Database.
Taking into account the main processes from the perception of the citizen is important in order for the ministry of environment
administration offices to understand that the involvement of the citizen is required for the improvement of outcomes. Specially in the
domain of public sensitization / campaign, it becomes evident that prevention is better than cure. And also that neglect in one
process will affect subsequent processes. Technology can be used as the platform to improve the delivery of environmental services
in all of its different stages.
PROPOSED SOLUTION
As seen above, we have encountered that one of the main problems facing rural area in Nigeria has to do with the lack of
Awareness, Data, Communication, Training Tools, Knowledge and Support for both the rural dwellers and the rural area
environmental workers, which results in high turnover rates. According to the WHO Global policy recommendations, the different
interventions used to tackle this obstacle are:
- Safe and supportive working environment
- Outreach support
- Career development programs
- Professional networks
- Public recognition measures
In this initiative, i propose to use Information Technologies for creating an environment intervention with the purpose of creating a
Mobile (sanitation & Hygiene) Competence Network (MCN) to facilitate the communication between people, governments
(i.e.Ministry of Environment), NGOs partners and community environmental workers in rural areas of Nigeria. This system will also
be used for collecting information, which will provide the national environment information system database with a deeper insight on
the environmental conditions of hard to reach areas.
MCN is a flexible, App., Internet, SMS-based communication system intended to be used as a Mobile Competence Network and
suitable for areas with very limited mobile phone network coverage. The strength of MCN is that it allows users to send structured
information in a compact manner by using prearranged codes which specify the semantics of information. A codebook explains each
code that can be used in a message for a specific purpose. This system extends the functionality provided. The business logic of the
MCN is that it orchestrates the exchange of messages based on user interests and contextual information.
Impact
Topic-based social Network: It allows Community environmental Workers (CEW) to send and receive messages among their
colleagues concerning the environment indicators or topics they are interested in.
6. Micro-conference Organizer: allows CEW to arrange meetings with colleagues with similar interests via SMS. Recipients can
confirm their participation by replying to the message
Micro Data Collector for Rural Areas: Environmental workers are given a codebook and a GSM mobile phone through which they
can collect information easily and fast (i.e. number of cases of a certain environment in a specific area).
IMPLEMENTATION OF INITIATIVE
Objective and Scope
The goal of this initiative is to evaluate the feasibility of use and results following the implementation of a Mobile (sanitation &
Hygiene) Competence Network (MCN) system in rural areas of Nigeria. Within the scope of this pilot project, the system is intended
to be implemented in multiple rural area of Nigeria, which account for an approximate total of 774 Local Environmental Centers with
all environmental personnel involved.
Methodology for the implementation
The first stage of the initiative implementation consists of assessment of the existing technology to predisposition of environmental
personnel and identification of possible new functionalities for the system. This information will be gathered using semi-structured
interviews as well as structured questionnaires. The objective of the assessment is to understand how to better adapt the designed
system into working units.
Once this assessment is finalized, the next stage is, iteration focuses on the technical design and development of the system,
incorporating the findings from the assessment and carrying out a first test with active users.
The final iteration involves the implementation of the system across all 774 Local Environmental Centers and the identification of
opportunities as well as adverse events that could compromise the effectiveness of the initiative. At the end of the estimated time-
frame of the implementation, all the results will be gathered in a comprehensive report and the information collected during the
implementation can be analyzed. This will shed light on the possibilities of scalability of the project.
Centralized and Decentralized MCN Environment
A MCN environment can consist of a network of independent servers. Each server is autonomous, with its applications bundles
instances and database instances, The standby server as read only access. A primary server has all or a subset of the application
bundles of a standby server and the corresponding database instances installed, to be able to replicate its data.
MCN environment can be established for the following requirements:
โข Enhance reliability: To prevent a single point of failure, two or more server can have the same application bundles installed.
โข Scalability: If the number of users is affecting the performance of a single server, a second server can be installed that contains
the same application bundles.
โข Reflect organizational structure: MCN servers can be organized in a hierarchical manner, in which a child server is a primary
server that replicates its data to the parent server, which is its standby. The hierarchical structure adhere to the organization of the
environment information system
7. Stakeholders
The importance of identifying all relevant stakeholders involved in these initiatives, it has to do with the possibility to address
potential conflict of interests. The participants involved belong to the private and public sectors. The analysis of interest is useful in
essence to understand how can each sector best direct the financial, technical, and operational responsibilities of implementing
infrastructure in a cost-effective fashion.
Stakeholders Incentive
Initiative Developer Delivery of services, operational efficiencies, program expansion, achieving mission
Mobile Service Provider Increased revenue from traffic, subscriptions, expand network
Community Health Worker More efficient and effective delivery of environmental services, recognition
NGO Advance organizational mission, attract funding
Government: Ministry of Environment More efficient environmental care provision, effective government
Rural Dweller/Citizen Improved Environment Outcomes
National Environment Information System Increased data flow and better overview of environment outcomes in rural areas
8. REFERENCES
N. Tin, S. Lwin, N. N. Kyaing, T. T. Htay, J. Grundy, M. Skold, T. O'Connell and S. Nirupam, "An approach to health system
strengthening in the Union of Myanmar.," Health Policy, vol. 95, no. 2-3, pp. 95-102, 5 2010.
A. B. Labrique, L. Vasudevan, E. Kochi, R. Fabricant and G. Mehl, "mHealth innovations as health system strengthening tools: 12
common applications and a visual framework," Global Health: Science and Practice, vol. 1, no. 2, pp. 160-171, 2013.
S. Mishra and I. P. Singh, "mHealth: A developing country perspective," Making the ehealth connection, pp. 1-9, 2008. T. A.
Sanner, L. K. Roland and K. Braa, "From pilot to scale: Towards an mHealth typology for low-resource contexts," Health Policy and
Technology, vol. 1, no. 3, pp. 155-164, 9 2012.
P. Petrucka, S. Bassendowski, H. Roberts and T. James, "mHealth: A Vital Link for Ubiquitous Health," Online Journal of Nursing
Informatics (OJNI), vol. 17, no. 2, 2013.
A. Chib, H. Wilkin and B. Hoefman, "Vulnerabilities in mHealth implementation: a Ugandan HIV/AIDS SMS campaign," Global health
promotion, vol. 20, no. 1 suppl, pp. 26-32, 2013.
H. Chhor, R. Dobbs, D. Nguyen Hansen, F. Thompson, N. Shah and L. Streiff, Myanmar's moment: Unique opportunities, major
challenges, 2013.
J. Barrington, O. Wereko-Brobby, P. Ward, W. Mwafongo and S. Kungulwe, "SMS for Life: a pilot project to improve anti-malarial
drug supply management in rural Tanzania using standard technology.," Malar J, vol. 9, p. 298, 2010.
Increasing Access to Health Workers in Remote and Rural Areas Through Improved Retention: Global Policy Recommendations,
World Health Organization, 2010, p.72.
Improving maternal and newborn access to services in Ghana, World Health Organization, 2013.
Andreas Meier and Henrik Stormer. eBusiness & eCommerce: Management der digitalen Wertschopfungskette. Springer, 2nd
edition, 2008.
Peter Haas. Gesundheitstelematik: grundlagen, anwendungen, potenziale. Springer, 2006.
Bo Bergman, Duncan Neuhauser, and Lloyd Provost. Five main processes in healthcare: a citizen perspective. BMJ Qual Saf, 20
Suppl 1:i41{2, 4 2011.
Laurie Garrett. The challenge of global health. foreign a_airs, pages 14{38, 2007.
Vital Wave Consulting. mHealth for development: the opportunity of mobile technology for healthcare in the developing world. UN
Foundation- Vodafone Foundation Partnership, 2009.
The Future of Nursing: Leading Change, Advancing Health. National Academy Press, 2011.
Sue Horrocks, Elizabeth Anderson, and Chris Salisbury. Systematic review of whether nurse practitioners working in primary care
can provide equivalent care to doctors. BMJ, 324(7341):819{823, 4 2002.
Carol Torgan. The mhealth summit: Local & global converge, 11 2009. URL http://www.caroltorgan.com/mhealth-summit/.
Stefan Schulz, Boontawee Suntisrivaraporn, Franz Baader, and Martin Boeker. Snomed reaching its adolescence: ontologists' and
logicians' health check. Int. J. Med. Inform., 78 Suppl 1:S86{94, 4 2009.