Thyolo Health Services, Malawi

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In Thyolo, the provision of environmental health services is aimed at addressing all environmental (physical, chemical, and biological) factors external to a person, and all the related factors impacting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect the health of humans and animals and is targeted towards preventing diseases and creating health-supportive environments.

The provision of environmental health services is done in four pillars; disease control, water, sanitation and hygiene (WASH), built environment, occupational health, and food safety and hygiene (FSH). While providing services from the above pillars, attention is also taken into consideration on how climate affects and impacts the pillars. 

Under each pillar of environmental health, the following services are offered:


1. Disease control


Investigation of disease outbreak

Data management
Disease surveillance
Reporting of disease outbreaks
Disease contact tracing
Control of vectors and vermin


2. Water, sanitation, and hygiene (WASH)

Ensuring the provision of safe water through water chlorination
Community sanitation
Institution sanitation
Public places sanitation
Health promotion activities in the community
Sanitation meetings with the community

Promotion of water point hygiene
Waterpoint inspection

Disease Control and Surveillance Assistants
Fig 1: Disease Control and Surveillance Assistants. 

3. Built environment, occupational health 


Inspection of workplaces
Identification of hazards and risks
Inspection of new settlements

4. Food safety and hygiene (FSH)


Food inspection
Monitoring of food fortification at the household and market levels
Promotion of intake of fortified foods
Inspection of food premises
Inspection of other premises such as slaughter slabs
Investigation of foodborne outbreaks


5. Opportunity in Environmental Health in Thyolo


Availability of Political will
Enabling environment
Well-structured from the district to the community
Community structures
Availability of human resources at all levels of implementation

Successes and Challenges in Environmental Health in Thyolo




Timely response to disease outbreaks

Provision of basic environmental health services




Inadequate or lack of partners


  • There are very few partners in Environmental Health to support the District Health Officer in the implementation and therefore provision of environmental health services.
  • For example in Water, Sanitation and Hygiene WASH) which is one of the four pillars of Environmental Health, there is only one partner which supports the district in community sanitation and health facilities water, sanitation, and hygiene.
  • There is no partner in the other pillars three pillars of the environmental health of food safety and hygiene, disease control, and occupational health.



  • Provision of environmental health services at any level in the district is dependent on the mobility of environmental health staff. However, there are inadequate enablers of transport for staff.
  • Although staff at the community level, Health Surveillance Assistants (HSAs) are periodically provided with push bicycles from stakeholders, not all of them were provided with the push bicycles. In addition, most of the push bicycles these HSAs are old and worn out.
  • There are inadequate means of mobility for Environmental health officers (EHOs) and Assistant Environmental health officers (AEHOs) who have the vital role of supervision of environmental health services, projects, and HSAs. There are fifteen (15) Environmental health officers (EHOs) and Assistant Environmental health officers and only two of them have motorcycles for their duties. The rest borrows from colleagues when they intend to perform their duties. This usually compromises their work.
  • District supervisors at the department level do not have readily available means of transport for the implementation of their duties. The department does not have a vehicle(s) for their work.



  • Implementation of environmental health services requires monitoring at any intervals, therefore there is a need to have the equipment and its accessories. Unfortunately, there are few officers with data monitoring equipment.
  • There is a need to have more computers (desktops & laptops) for data management.

Application and enforcement of legislation and laws


  • The implementation of environmental health services is guided by laws, legislations, guidelines, and standards. There is a gap in the interpretation and enforcement of these laws, legislations, guidelines, and standards by Environmental health officers (EHOs) and Assistant Environmental health officers.




  • At one point of the implementation of environmental health services, the need to use equipment will be required. However, there is no equipment to be used in the course of performing duties such as measuring tapes, thermometers, timers, and others.