203.1 94KB Xiiff rary C M WHO/EOS/94.37 and Sanitation Cantr* Tel.:+31 70 30 689 60 Distribution: limited Fax: +31 70 35 8S9 14 English only JL HEALTH OPPORTUNITIES IN WATER RESOURCES DEVELOPMENT A two-week course to promote collaboration between middle-level officials from various ministries for the incorporation of health safeguards and health promotional measures in water resources development projects Akosombo, Ghana 26January-11 February 1994 organized by the joint WHO/FAO/UNEP/UNCHS Panel of Experts on Environmental Management for Vector Control, the Danish Bilharziasis Laboratory and the Health Impact Programme of the Liverpool School of Tropical Medicine in collaboration with the Ministry of Health, the University of Ghana and the Environmental Protection Council PEEM Secretariat World Health Organization Geneva, 1994 t The issue of this document does not constitute formal publication. It is not issued to the general public and all rights are reserved by the World Health Organization (WHO). Views expressed do not necessarily reflect the policies of the four United Nations agencies participating in PEEM. It should not be reviewed, abstracted, quoted or translated without the written permission of the World Health Organization. No part of this document may be stored in a retrieval system or transmitted in any form or by any means - electronic, mechanical or other- without the prior written permission of WHO. WHO/EOS/94.37 Distribution: limited English only TABLE OF CONTENTS page SUMMARY 6 REPORT OF THE COURSE Introduction 9 The course programme 11 Preparations for the course 12 Innovative features 13 Evaluation 15 Follow-up 18 ANNEXES Annex 1 List of participants, tutors, organizers, resource persons 21 and observers Annex 2 Course programme and materials 31 Annex 3 Planning and preparations 41 Annex 4 Advice for contributors 47 Annex 5 Guide for Task 4 55 Annex 6 Evaluation 73 Annex 7 Generic Terms of Reference for h 87 assessments LIBRARY IRC 'O Box 93190, 2509 AD THE HAGUE Tel.: +31 70 30 689 80 Fax: +31 70 35 899 64 BARCODE: | 4.0 JO LO: ~ About PEEM The joint WHO/FAO/UNEP/UNCHS Panel of Experts on Environmental Management for Vector Control (PEEM) was established in 1981 to create a framework for inter- agency and inter-institutional collaboration with a view to promoting the extensive use of environmental management for disease vector control as a health safeguard in the context of land and water resources development projects and for the promotion of health through agricultural, environmental, human settlement, urbanization and health programmes and projects. The collaboration originates from memoranda of understanding between three agencies (WHO, FAO and UNEP) covering the areas of prevention and control of water- borne and water-associated diseases in agricultural development, rural water supply and waste water use in agriculture, forestry and aquaculture. In 1991 the three agencies were joined by UNCHS and PEEM's mandate was expanded accordingly to include human settlements, urbanization and urban environmental management including urban water supply, sanitation, drainage and solid waste disposal. The current Medium-term Programme of the Panel covers the period 1991-1995 and contains activities under three headings: promotion, policy modification and technical cooperation; research and development; and, training of various target groups. The Secretariat of the Panel is located at WHO headquarters in Geneva, Switzerland. About DBL Established in 1964, the Danish Bilharziasis Laboratory (DBL) is a private foundation working on water-related, vector-borne parasitic diseases that prevail the tropics. It specializes in training, research and technical cooperation and offers its expertise in these areas in collaboration with partner institutions in the developing countries. Today DBL is officially associated with the Faculty of Natural Sciences of the University of Copenhagen and is financed primarily by the Danish International Development Assistance (Danida) of the Ministry of Foreign Affairs. The core of DBL's training programme consists of its course activities, including Diploma courses offered in Denmark and Certificate courses organized in a number of countries in Africa. About HIP The Health Impact Programme was established in 1990 at the Liverpool School of Tropical Medicine with the financial support of the Overseas Development Administration. Its objectives are to promote health impact assessment of development projects as part of environmental impact assessment The Liverpool School of Tropical Medicine is a charity established in 1898 to provide education and training, and technical assistance and to carry out research with a view to promoting improved health, particularly for peoples of the less developed countries. It is affiliated with the University of Liverpool and it is a post-graduate centre of excellence in the field tropical medicine. Each year it welcomes over 500 students from more than 50 countries. Research at the School is funded by many bodies including ODA, MRC, WHO, EU and Wellcome Trust. It is involved in field research throughout the tropics. Page 4 Health opportunities in water resources development ACKNOWLEDGEMENTS The organizers of the course would like to gratefully acknowledge the support received from the Danish Ministry of Foreign Affairs/Danish International Development Assistance (Danida), through their budget allocation to the Danish Bilharziasis Laboratory, and from the Liverpool School of Tropical Medicine through its Health Impact Programme, which is financed by the Overseas Development Administration. They would also like to express their appreciation for the significant inputs by the local course coordinators, Dr E. Laing, Emeritus Professor of the University of Ghana and Dr A. Issaka- Tinorgah of the Ministry of Health, and their respective staff, and for the support received from the WHO representation in Ghana. The field visit was made possible thanks to the cooperation of Dr Victor Okoh, Volta River Authority, the staff of the Akuse Hospital, the management of the Kpong Irrigation Project and members of the community at Atro-Binya. SUMMARY -* The second PEEM/DBL/HIP training course "Health opportunities in water resources development" was held at Akosombo, Ghana from 26 January to 11 February 1994 for 24 middle level managers from seven different Ghanaian ministries/authorities. Over a two-week period, the participants worked on four tasks considered crucial to ensure the incorporation of human health considerations into the planning of water resources development projects. The objective of this trial course was to develop the capacity of each participant, irrespective of his/her sectoral affiliation, to adequately participate in the intersectoral decision-making process of water resources development projects, in particular: to contribute to the decision on the need for a health opportunity assessment, determine the adequacy of the assessment report, including recommendations on health protective and promotional measures, assist in the formulation of terms of reference for a health opportunity assessment and prepare for the intersectoral monitoring of the project. These four capabilities had been identified by the organizers as essential if sustainable development of natural resources is to be ensured from a human health perspective. The long-term objective of the collaboration between PEEM, DBL and HIP in this area is to develop a training course aimed at building the capacity of all public sectors with a view to their participation in and contribution to intersectoral decision-making in the planning and design of natural resources development projects. This will allow governments to adequately address the human health dimension of sustainable development in a coordinated and integrated way. As a consequence, the burden on the health sector resulting from adverse health effects of development will be minimized and opportunities offered by projects to improve people's health will be more effectively used. The final product of this collaboration will consist of guidebooks for the organizers, non-expert tutors and local experts and task guides for the participants. The course aims at professionals of relevant public sectors working at the level where policy is translated into action. Efforts are directed towards making the course easily replicable without the need to mobilize substantial external resources. It should also be sustainable in case local or regional training centres want to institutionalize it and its scope should be broad so it can be adjusted to £ local conditions and locally perceived needs. Report of a training course in Ghana Page 7 Based on the evaluation of the first course (Zimbabwe, September 1992) the programme of the second course was completely redesigned. Passive knowledge transfer (which had resulted in information overload) was replaced by active, problem-oriented learning. Costs were reduced and methods of running the course were further developed in such a way that at the end of the trial period its country-level replication may be carried out independently of major external inputs. There was, in other words, a major shift from the content-oriented approach of the first trial course to a process-oriented approach of the one reported on here. Three preparatory meetings were held to define the new course concepts and structure, prepare instructions for the authors of task guides and review the task guide drafts, develop a detailed