Thyolo Health Services, Malawi

Thyolo Health Services Thyolo Health Services Thyolo Health Services Thyolo Health Services Thyolo Health Services



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 is 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.