Right to adequate housing is of central importance for the enjoyment of all economic, social and cultural rights. Individuals as well as families are entitled to adequate housing regardless of age, sex, economic status, race, religion or other affiliations. This is because its availability is fundamental to living in dignity and to good health, good quality of life and general well-being. In spite of this inseparable link between good housing and health, over 100 million people world wide are homeless while more than a billion live in shelters that are not only inadequate but are also detrimental to health. Housing and health have become a topical issue in public health discourse for a very long time in view of the existence of increasing evidences as regards the potential effects of inadequate conditions of living premises on the inhabitants.
The direct effects of poor housing condition may be difficult to prove in view of many other interrelated factors which are often present with poor housing. This not with-standing, enough evidence about relating certain ill health to specific poor housing status[2-5].
Housing conditions refer to the totality of external influences, natural and man-made which impinges on man and affects his well being. This includes the life-support systems that make the housing unit to be comfortable for the inhabitants. A good house must possess the appearance and general layout, must be attractive, comply with the general custom and habits of the people without which it may be turned into slum.
For many decades especially in Europe, conditions in individual housing were considered in terms of fitness for human habitation and from to time, standard of fitness were formulated and recommended. The first minimum standard of fitness was issued by the Minister of Health in England. Many countries particularly the former British colonies fashioned out their own regulations after the British model. Nigeria is one of such countries. Every dwelling and dwelling unit intended for use as a human habitation, occupancy or use, or held for use as human habitation, is expected to comply with all the minimum standards of fitness for human habitation in accordance with the applicable laws and building codes. The Public Health Laws of Nigeria of 1959 as applicable in different parts of the country (still in force) also stipulate conditions expected of a dwelling place[9,10]. In particular section 6 (a-m) state in clear terms nuisance conditions which their existence in a dwelling renders the dwelling insanitary, unsafe for health and which may require specific remedial measures to abate the nuisances.
Specific provisions of such regulations stipulate that human habitations are
not expected to be so damp, so ill-ventilated, not littered with refuse, or
lack essential sanitary facilities including adequate toilet facilities. Houses
are expected to be accessible by road, have secured drainage systems, have facilities
for prompt and sanitary solid waste management, have regular and safe water
supplies, among other things.
Ensuring compliance with the stipulated standards require first and foremost an education regarding the link between poor housing and health and the need to ensure hygiene of dwellings. It also requires a commitment to country and regional planning, regular inspection of houses/monitoring to ensure continuous compliance with standards and the availability of enabling environment to support good housing. Economic and social factors (in particular income level) are fundamental determinants of housing conditions in developing countries. In Nigeria, Environmental Health Officers (EHOs) previously known as Sanitary Officers or Public Health Superintendents working in the local governments has the responsibility to inspect all premises especially residential ones for the purpose of detecting and abating nuisances.
The Nigerian governments over the years initiated various moves to improve housing based on the resolutions adopted at the first United Nations Conference on Human Settlement held in Vancouver, Canada in, 1976. Apart from providing some regulations, the country has also formulated a National Housing Policy in 1991 which outlines strategies to ensure the provision of decent housing for the people. It must be understood that the issue of ensuring that the people live in healthy houses should not be a matter of policy alone but must be carried into action so as to limit risks to which the people are exposed. Constant monitoring of compliance against standards is surely one way of achieving this. It is against this background that this study was carried out to assess the status of housing being inhabited by the people whose economic and social lives transcend beyond their place of abode.
MATERIALS AND METHODS
This study was carried out in Ile-Ife in the south western part of Nigeria. The town is an ancient but rapidly developing city with a lot of commercial activities but has no major industry. It is a fast growing university town with a population of about 180,000 and about 40,000 student population and 10,000 public servants from different parts of the country and the world. The town also attract some foreigners by virtue of being a university town as well as the existence of some international institutions such as the African Regional Centre for Aerospace Surveys and the Regional Centre for Technology Management.
The city is typical of most other towns in Nigeria and the conditions of housing existing there are believed to be similar. Human settlements consisted of a collection of housing units which are called compounds. A compound could have as many as between 50 and 200 households. Housing units in the city constituted the study unit from which every 5th house was selected systematically after the first house was selected at random. Two hundred and thirty-four houses were selected for study. Relevant information was collected by direct observation of level and status of compliance to a set of predetermined minimum criteria for dwellings as set out in the standard of fitness for dwellings and relevant regulations. In addition to the observation, the head of each household was interviewed to answer specific questions relating to the study. Physical inspection of premises was carried out to determine adequacy or otherwise based on selected criteria. Adequacy of premises was taken to mean meeting the minimum requirement for each of the parameter used for assessment thus no categorisation was done as relate to degree of adequacy or otherwise.
RESULTS AND DISCUSSION
The assessment of the status of housing in the study location revealed not too impressive conditions under which people live. Housing conditions are generally believed to be poor in many places in Nigeria. From a total of 234 dwellings assessed for the purpose of the study, 69% had approved building plan while most of the traditional ones were without any approved plan (Table 1). The fact that most of the buildings have approved building Plan could not make for continuous maintenance of the hygiene and sanitation of the premises. It could also be inferred that such approval did not take into cognisance the need to comply with very important aspects of existing regulations. A situation in which 69% of the houses had approved plan and more than 70% of the premises have inadequate free space due to overbuilt is suggestive of the fact that some basic standards of fitness were compromised at the approval stage or better still that unauthorised alteration of approved premises through illegal construction is a common practice in the area. The importance of approved plan in promoting sound housing status cannot be overstressed. Apart from ensuring that minimum requirements are met before construction, it also makes for effective control of the development of slums.
The non-susceptibility of most premises to dampness (79%) should normally be
expected to contribute to the enhancement of better sanitary conditions of the
premises. This is in view of the fact that it would limit the occurrence of
nuisances within the premises as such houses are expected to limit the proliferation
of house dust mite, among other things.
|| Adequacy of selected indices in the dwellings
|| Factors influencing Sanitary status of the Premises
Though most dwellings were not damp, they were also difficult to be kept clean.
The general state of cleanliness was poor as evident from the inadequacy of waste disposal facilities in most of the buildings. Excreta disposal facilities had a higher coverage in the city as most premises (70.8%) had at least one form of toilets or the other within a reasonable distance from the premises while about 29% had no form of toilet at all. This is similar to what was recorded in a study carried out in some small towns in Nigeria in 1999 in which 25% of houses were found not to have any form of toilet but contrary to a similar observation of 15% in a study carried out in Lagos. The presence of toilets alone may not be able to actualise the objectives of health protection as the necessary complementing hygiene education as regards correct and exclusive use of latrines are equally important.
Regular sanitary inspection by the local health authority was found unbelievably low (27.4%) in the city. A situation where most premises were not inspected for the purpose of detecting and abating nuisances at least once in two months leave much to be desired. The reasons for this may be varied but generally the country is known to have acute shortage of Environmental Health Officers (Sanitary Officers) working in the local governments areas. There is therefore the need to vigorously pursue the objectives of housing inspection so that the existence of conditions unfavourable for healthy living within living premises could be detected on time and abated summarily within the provisions of relevant regulations. One fundamental step in this direction would be to make available a sizeable number of sanitary officers to engage in routine inspection of premises.
Considering the influence of some specific factors on the sanitary conditions of the premises (Table 2), literacy level on the part owners/occupiers was found to have significantly influenced the level of the overall hygiene conditions of the premises as only 7.7% of the premises of literate people were not found in sanitary condition as opposed to 92% in non literate occupier or owners (p<0.05). This is not too surprising as access to education determine to a large extent access to relevant information which ultimately influence level of awareness of implications of insanitary conditions in living premises. The study location being a university town, educational status determine to a large extent the chance of securing a salaried job with regular income which has been found to have significantly influenced the level of sanitary conditions as well. This finding corroborated the conclusion drawn by Martin in which he concluded that a wide range of socio-economic factors influence greatly the conditions of houses and their ultimate effects on health.
It was observed that the more economically viable a house owner is, the better is the sanitary conditions in the house and the more likely is the provision of necessary facilities that will enhance sanitary maintenance of the premises. Improving housing condition and promoting health would therefore require a radical approach targeted towards social and economic upliftment. It is becoming increasingly clear that it may not be easy to provide basic facilities in homes and also ensure continuous maintenance of the hygiene of the premises if peoples access to regular and sustainable income is not guaranteed. Also important is the fact that access to both formal and informal education must be increased in the interest of public health and safety especially in homes.
Inspection of premises for the purpose of detecting and abating nuisances seem
to have positively influenced the sanitation of living premises as 81% of those
sanitarily maintained premises were inspected at least once within the last
one month preceding the study. This claim could be justified based on the fact
that about 84% of the insanitary premises were never inspected during the same
period. The public health significance of housing inspection cannot be over
emphasised. This is in view of its helping to identify conditions prejudicial
to health of the occupants and rectifying the situation in line with the provisions
of the existing health regulations.
The authenticity of the information offered by the respondents as to whether the premises were inspected in the last one month or not could not be established as there were no proof of such inspection in the premises neither could that be corroborated from the records of the local health office as their routine inspection book did not indicate the address of each premises. The availability of home-based records in which health profile of every household could be entered is in this instance indicated. At the inception of Primary Health Care (PHC) implementation in the country in the late 1980s, it was contemplated that a home based record would be placed on the door steps of every household which could facilitate the entry of some health and related events including date of sanitary inspection and the summary of the status of such inspection. PHC programmers in the LGAs might need to reconsider the value of providing such home-based records to facilitate effective monitoring of health of the people and their places of abode. It could also be suggested that necessary legislative provisions be made to ensure that houses are inspected routinely and regularly and a certificate of fitness issued by the local authority in the interest of public health and general safety.
Housing status is generally poor in the town as most houses fell short of minimum standards of fitness. Though the study could not assess the adverse affects of such inadequacies on health of the inhabitants, the short and long term effects on health could be assumed to be enormous. With about 71% of the residential premises which were in sanitarily maintained, housing condition is not only poor but it is grossly inadequate.
Specific socio-economic factors were found to have association with the observed status, economic status and the regularity of inspection by the EHOs to detect nuisances.
Improving housing conditions in the country would require first a systematic approach directed towards general, social and economic improvement. In doing this specific attention must be given to awareness creation as regards the implications of unhygienic environment as well as promoting general improvement in the socio-economic lives of the people. Also important is the need to increase access to education (formal and informal) so that the necessary supportive environment to actualise and sustain sanitation and hygienic maintenance of dwellings could be established. It would also be necessary for local health authorities to develop a system whereby it will be possible to monitor health conditions of dwellings on a continuous basis. In this regard, the use of home based health and sanitation monitoring cards could be explored.