OCCUPATIONAL/ENVIRONMENTAL HEALTH

 DIRECTORATE OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH/ STAFF HEALTH SERVICES

The Directorate of Occupational/Environmental Health/Staff Health Services is divided into three

1. Occupational Health And Safety Division
2. State Environmental Health Monitoring Unit (SEHMU).
3. Staff Health Services

 

1. OCCUPATIONAL HEALTH AND SAFETY

BACKGROUND

The Health, Safety and Welfare of Employees is of paramount importance to the State Government and as such the Directorate of Occupational/Environmental Health/Staff Health services is saddled with the responsibility of ensuring Health, Safety and welfare of all employees in both formal and informal sectors while erring Organizations are sanctioned as provided by the enabling laws.  This in turns reduces the incidence of occupational accidents and exposure of workers to dangerous and hazardous substances while at work, thus promoting a standard Occupational Health practice in the State and promoting Work Health.

 

The social and economic importance of work receives considerable attention because a primary function of work in any society is to produce and distribute goods and services. There is a continuous two-way interaction between a person and the physical and psychological working environment. The work environment may influence the person’s health either positively or negatively and productivity is, in turn, influenced by the workers state of physical and mental well-being.

 

Work, when it is well adjusted and productive, can be an important factor in health promotion. When work is associated with health hazards, it may cause occupational disease, be one of the multiple causes of other diseases or may aggravate existing ill-health of non-occupational origin. In developing countries where work is becoming increasingly mechanized, a number of work processes has been developed that treats workers as tools in production, putting their health and lives at risk.

 

Occupational health & Safety represents a dynamic equilibrium between a worker and his occupational environment. The main objective of occupational health & Safety is a healthy and safe working environment, a well-functioning working community, prevention of work-related diseases as well as the maintenance of employees working ability and functional capacity and promotion of their health.

 

MAIN BODY

The Occupational Health and Safety of the Ministry is saddled with the responsibilities of:

 

• Routine inspection of workplaces by trained enforcement officers to promote health and safety in workplaces
• Investigation and prompt response to Occupational/ Environmental and Public health complaints.
• Environmental Health and Sanitation
• Promotion of Food Safety and Hygiene Initiative
• Pollution Control and Management
• Training of students from schools of nursing, public/community health and medical school throughout the Federation.

 

1. Workplace Inspections: Inspections are part of the safety/loss prevention program. One of the best ways to identify these potentially fatal or harmful things is to conduct workplace inspections. Once hazards have been identified, they can be properly addressed. Through critical examination of the workplace, inspections carried by our Teams identify and record hazards for corrective actions. The unit plans, conducts, reports and if necessary carryout enforcement during inspections.

Joint occupational health and safety Teams help plan, conduct, report and monitor inspections. Regular workplace inspections are an important part of the overall occupational health and safety program.

• listen to the concerns of workers and supervisors
• gain further understanding of jobs and tasks
• identify existing and potential hazards
• determine underlying causes of hazards
• monitor hazard controls (personal protective equipment, engineering controls, policies, procedures)
• Recommend corrective action(s).

 

1. Promotion of Food Safety and Hygiene: Foodborne diseases are unpleasant and people expect that the food they eat is wholesome and safe for consumption. By promoting food safety and hygiene, food establishment must ensure that their Standard Sanitation Operating Procedures (SSOPs) are in place and adhered to. These SSOPs are as follows:
   • Good hygienic practices(GHPs) (layout, design, equipment, handling, waste management)
   • Good manufacturing practices (GMPs)
   • Cleaning and sanitising programmes
   • Water supply controls
   • Pest controls
   • Personnel/Staff training
   • Recall plans
   • Supplier audits
   • Packaging and labelling checks.

 

The Codex Alimentarius General Principles of Food Hygiene lays a firm foundation for ensuring food hygiene. This document highlights the key hygiene controls at each stage along the food chain from primary production through to the final consumer, and recommends a Hazard Analysis Critical Control Point (HACCP) approach wherever possible to enhance food safety. The HACCP approach is internationally recognized as essential to ensuring the safety and suitability of food for human consumption, and it enhances the potential for international trade

 

HAZARD ANALYSIS CRITICAL CONTROL POINT (HACCP) SYSTEM

“The way forward….from farm to fork!”

Health issues relating to the consumption of contaminated and adulterated foods has been a major concern for citizens of the world and many governments and international organisations has focussed much attention on addressing these safety concerns by enacting regulations and enforcing standards.

The Hazard Analysis Critical Control Point (HACCP) system is a scientific approach to process control. HACCP can be applied to every aspect of the food chain, from initial preparation to packaging to distribution and is required by the Lagos state Ministry of Heath for specific food items such as meats and liquids as an effective food safety system. Some of the many food service institutions that utilize HACCP food safety systems are Restaurants, Convenience Stores (C-Stores), Hospitals, Nursing Homes, Assisted Living Facilities, Hotels, Food Manufacturers and Food Distributors.

For successful implementation of a HACCP plan, management must be strongly committed to the HACCP concept. A firm commitment to HACCP by top management provides company employees with a sense of the importance of producing safe food.

HACCP is designed for use in all segments of the food industry from growing, harvesting, processing, manufacturing, distributing, and merchandising to preparing food for consumption. Prerequisite programs such as current Good Manufacturing Practices (cGMPs) are an essential foundation for the development and implementation of successful HACCP plans. Food safety systems based on the HACCP principles have been successfully applied in food processing plants, retail food stores, and food service operations.

It is designed to prevent the occurrence of problems by assuring that controls are applied at any point in a food production system where hazardous or critical situations could occur. Hazards include biological, chemical, or physical contamination of food products.

In the development of a HACCP plan, five preliminary tasks need to be accomplished before the application of the HACCP principles to a specific product and process. The five preliminary tasks are given in below:

 

The seven principles of HACCP, which encompass a systematic approach to the identification, prevention, and control of food safety hazards include:

• Conduct a Hazard Analysis
• Determine Critical Control Points
• Establish Critical Limits
• Establish Monitoring Procedures
• Establish Corrective Actions
• Establish Recordkeeping and Documentation Procedures
• Establish Verification Procedures

HACCP AUDIT TEAM

To make sure that establishments operate effective HACCP systems, with the government will focus on verification that HACCP plans are working as intended. A team of Occupational Health and Safety Inspectors would play a verification role to ensure that appropriate HACCP plans are in place, are being implemented properly, and are achieving the desired food safety results. This verification exercise will be carried out in the areas of record review, visual process verification, and product sampling.

 

Below are a few frequently asked questions in relation to food safety:

 

1. What is food safety?

This is a scientific discipline describing handling, preparation and storage of food in ways that prevents food borne illnesses.

 

2. What is HACCP?

Hazard Analysis and Critical Control Point. It is a systematic preventive approach to food safety from biological, chemical, and physical hazards in production processes, through identifying where hazards might occur in the food production process that can cause the finished product to be unsafe, designs measurements to reduce these risks to a safe level by putting in place stringent actions and strictly monitoring and controlling each process.

 

3. What are HACCP plans?
   This is a written document that outlines the hazards associated with a product, incoming materials, ingredients and process steps and how they are controlled. It also identifies the processes that are critical to ensuring food safety. The HACCP plans determine critical control points in a specific operation of food handling.

 

4. Why is HACCP Important?
   HACCP is important because it prioritizes and controls potential hazards in food production. By controlling major food risks, such as microbiological, chemical and physical contaminants, the food industry can better assure consumers that its products are as safe as good science and technology allows. By reducing foodborne hazards, public health protection is strengthened.

 

5. What are the Principles of HACCP?

Principle 1: Conduct a hazard analysis.

Principle 2: Determine the critical control points (CCPs).

Principle 3: Establish critical limits.

Principle 4: Establish monitoring procedures.

Principle 5: Establish corrective actions.

Principle 6: Establish verification procedures.

Principle 7: Establish record-keeping and documentation procedures.

 

6. Can HACCP be applied to any size or type of facility?
   HACCP can be applied throughout the food chain to any type of food process. The principles of HACCP are the same; the nature of the operation will determine the particular hazards and related procedures to address them.

 

 

7. Who can use HACCP?

All businesses involved in the food supply chain from producers to retailers can use HACCP. It can be applied throughout the food chain from primary production to final consumption (from farm to fork) and its implementation should be guided by scientific evidence of risks to human health.In addition, the application of HACCP systems can aid inspection by regulatory authorities and promote international trade by increasing confidence in food safety.

 

8. What kind of industry needs the HACCP Certification?
9. Fruits & Vegetables
10. Dairy Products
11. Meat & Meat Products
12. Fish & Fishery Products
13. Spices & Condiments
14. Nuts & Nut Products
15. Cereals
16. Bakery & Confectionary
17. Restaurants/fast food operations
18. Hotels

 

9. What are the Major Food Hazards?
   The major hazards predominant in the food industry is the microbiological contaminations such as; salmonella, E.coli 01257:H7, Listeria, Campylobacter and Clostridium botulinum, also is the physical hazard and Chemical hazard from pesticides, antibiotics and cleaning chemicals. HACCP is designed to focus on and control the most significant hazards.

 

10. Is HACCP New?
    The introduction of HACCP for food safety is not a new phenomenon in the world. It was first used in the 1960s by the Pillsbury Company to produce the safest and highest quality food possible for astronauts in the space program. The National Academy of Sciences, National Advisory Committee for Microbiological Criteria for Foods, and the Codex Alimentarius have endorsed HACCP as the best process control system available today.

 

11. Why the need for HACCP In Nigeria?

Lagos State is the fastest growing State in West Africa in population, economic and business relevance, hence, the need to imbibe advance food safety culture to secure the health, welfare and safety of the populace.

 

12. When was HACCP introduced in Lagos?

Sequel to the food strengthening programme organized by the Federal Government in collaboration with the FAO for all the States in Nigeria, with the mandate to implement the food security framework through implementing of the bill established upon the Codex Alimentarius in all States in Nigeria.

 

13. What are the benefits of HACCP?
14. Increased food safety
15. Meet customer/retailer requirements
16. Maintained and improved market access
17. Constant reinforcing of best practices by staff during food handling
18. On-going efficient oversight
19. HACCP is required by legislation
20. Once implemented, reduced operational costs
21. Reduced waste
22. Reduced recalls
23. Reduced liability, possibly reduced liability premiums
24. Improved product quality and consistency
25. Increased consumer confidence in food safety
26. It drives continuous improvement

 

14. How Does HACCP compare to the Current Food Production and inspection programs? :

The current food inspection program is based on a “see, smell and touch” approach that relies more on detection of potential hazards than prevention. Today, microbiological and chemical contamination, which cannot be seen, are of greater interest. The Ministry of Health recently recommended HACCP for the State’s food industry.

 

15. How much will it cost to implement a HACCP system?
    Costs vary greatly among facilities. Start-up costs are usually those associated with the planning, development and implementation of the HACCP system and do not recur. Generally, the more products and processes involved in an operation, the more complex the HACCP system will have to be.

 

 

16. Are There Established HACCP Guidelines and Plans for the FoodIndustry To Use?
    There are seven HACCP principles that must be followed to implement HACCP. Every food production process in a plant will need an individual HACCP plan that directly impacts the specifics of the product, identifying the principles and developing of a functional HACCP plan that is process and production specific.

 

17. What is HACCP certification?
    The Lagos State Government through the Ministry of Health will issue Certificates as formal recognition that a facility complies with specified HACCP requirements after review of HACCP Plan and audit of food establishments to determine compliance.

 

18. What are the steps for certification?

Upon the submission of the HACCP Plan or Food Safety Policy Document, the documents shall be reviewed and the premises will be audited. HACCP certificates will be issued to establishment that are compliant.

 

19. How often will the certificate be issued?

The Certificates will be issued every two years after verification exercise to ensure compliance.

 

20. At what cost is the certification to the food industry?

The certification process comes with charges which are affordable and it will be stated on the acknowledgement letter from the Ministry of Health at the receipt of your HACCP plan.

 

21. Will there be penalties for failure to submit the HACCP plan?

Yes. There will be consequences against organizations working below the food safety standards within Lagos State, which includes failure to present their HACCP plan and certificates.

 

22. What is the duration of the HACCP Certification?

The process from the receipt of the HACCP/FSP Plan to review, audit and issuance of certificates will take the minimum of a month if all requirements are met.

 

23. Where do I submit my HACCP Plan?

The HACCP plan should be addressed to The Permanent Secretary, Ministry of Health, The Secretariat, Alausa, Ikeja.

 

 

 

 

For more information, visit: www.

The Director of Occupational Health/Staff Health Services

The Ministry of Health

Folarin Coker Staff Clinic

The Secretariat,

Alausa, Ikeja.

 

Or

 

Or send an email: foodsafety.moh@lagosstate.gov.ng

 

Or

 

Kuforiji, Adebayo Felix                                 –              08034279776

Adebayo, Oluseye                          –              08023973689

 

STATISTICS FOR OCCUPATIONAL HEALTH

AREAS	STATISTICS
ACHIEVEMENTS	·         High level of awareness on occupational health  practice by employer of labour ·         Reduction of accidents in workplaces. ·         Total number of 38 occupational and public health complaints were received and treated to logical conclusion. ·         Commencement of Harmonized Inspection of Workplaces of which OHS Officers play pivotal roles and the Steering Committee chaired by the Ministry of Health (Dr. Layeni Adeyemo) ·         Active participation in the review of National framework and bill on food safety and hygiene. ·         Inauguration of the State Food Safety and Hygiene Management Committee. ·         Implementation of Hazard Analysis and Critical Control Points in Food Safety. ·         Training of 180 Students from schools of Nursing, Public/ Community Health and Medical School.
SUMMARY OF INSPECTION FROM MARCH 2016 TO FEBURARY 2017 (Total numbers of 2,977 workplaces which include Industries, Factories, Eateries, and Bakeries etc. were inspected)	·         Total Number found satisfactory        – 1998 ·         Total Number found not satisfactory    – 979 ·         67% of workplaces inspected complied with State Public Health and Bye Laws.
BREAKDOWN OF ESTABLISHMENTS INSPECTED FOR YEAR 2016	·         Hotels                                  – 1158 ·         Eatery / Restaurants         – 478 ·         Factories                             — 578 ·         Water                                  – 435 ·         Bakery                                 – 128 ·         Cold room                            – 75 ·         Others                                  – 124

 

YEAR	2014	2015	2016
SATISFACTORY	1322	1461	1524
NON- SATISFACTORY	1066	987	757
TOTAL	2388	2448	2281
% COMPLIANCE	55.4%	59.7%	66.8%

COMPARISON OF PERFORMANCE FROM YEAR 2014 TO YEAR 2016 FOR OCCUPATIONAL HEALTH AND SAFETY UNIT WORKPLACE INSPECTIONS

 

 

 

 

 

 

 

 

 

 

 

2. STAFF HEALTH SERVICES

 

1. BACKGROUND INFORMATION

In the last twenty years (20years) the Staff Clinic has been a functional Division under the Directorate Occupational Health /Environmental Health/Staff Clinic of the Ministry.

The Staff Clinic is a statutory component of Occupational Health Services which promotes and standardises health, safety and welfare of workers in their respective workplaces in Lagos State. The Staff Clinic thus provides for the healthcare needs of staff during office hours.

Its operations were initially carried out from a bungalow which has now been replaced by an ultra-modern staff clinic named Folarin Coker Staff Clinic Complex.

The Staff Clinic component was upgraded and named Staff Health Services to accommodate both preventive and curative services for all members of staff in 2012.

 

1. COMPONENTS OF STAFF HEALTH SERVICES

 

1. Staff Clinic proper which provides

• Outpatient Services
• Observation of patients during office hours

1. Screening of Public Servants: – This commenced in the year 2011 as a welfare Initiative of the Governor. Public Servants are sent to any of the 15 (Fifteen) Screening Centres (Designated General Hospitals) (See annexe I) closest to their residence for a full comprehensive medical screening, after which they are referred to existing specialist clinics as the case may be.

• Top Government Officials Health Screening: Screening of Top Government Officials is conducted yearly. The beneficiaries are 354 officials in number. It involves a full comprehensive wellness test and colonoscopy- see annex III. This screening is reserved for the following categories of Government Officials:
• State Executive Council Members
• House of Assembly Members
• High Court Judges (Honourable Judges)
• Body of Permanent Secretaries
• Traditional Rulers (First Class, second class, third class) and White Cap Chiefs.
• Special Advisers (Non-Cabinet Rank)
• Director Generals

1. Insurance Claims Support: To verify injuries sustained during working hours and directly related to the scheduled duties of the staff.
2. Pre-admission and pre-employment screening.

 

1. THE SERVICES OFFERED BY THE CLINIC

The Folarin Coker Staff Clinic Complex was commissioned on July 18, 2013. It is the first of its kind in Nigeria and West Africa as a whole.

The unit provides daily clinic services; both on out-patient and observation basis to all Lagos State Civil Servants that presents and its operation hours are 8am- 5pm after which the ambulance services operates till 8pm, week days only.

 

• Free consultation: The Clinic is manned by four (4) qualified Medical Officers, who conduct prompt medical consultations on all patients that present at the clinic. The medical officers also manage all emergencies and stabilise the patients prior to referral (if required). The Director Cadre medical officers attend to senior staff and reviews cases as necessary. The Medical team is supported by six (6) senior |Nursing Officers and two (2) Nursing officers.
• Laboratory investigations: The Clinic has a state-of-the-art laboratory that is equipped to conduct all basic investigations such as Widal test, Full Blood Count, Blood Sugar Test, Electrolyte and Urea, Cholesterol and Retroviral Screening/ Infective Screening. In addition, RDT (Rapid diagnostic test) is carried out for malaria cases.
• Eye clinic: The Clinic is also domicile to the Staff clinic but is under the Directorate of Medical Administration and Training/Programmes. The Eye Clinic has a Consultant and supported by a Deputy Director and one Senior Medical Officer. They are supported by 1 Optometrist and Three (3) Senior Nursing Officers. They clinic is similarly well- equipped as seen in the Secondary Eye Care Centres.
• Dental clinic: The Folarin Coker Staff Complex houses a fully functional Dental Unit that was commenced in 2013. It is equipped with a dental infrastructure and dental equipment as well as 3 Dental Medical Officers, rotational Dental Nurses as well dental therapist from Health Service Commission and LASUTH. The unit has successfully catered for >1000 patients since its inception.
• X-ray services: Equipped with a functional and modern infrastructure.
• Pharmaceutical services: The Clinic has a pharmacy where treated patients are given prescribed medications. These drugs are at no cost to the civil servant.
• Speciality clinics: A weekly Psychiatric Clinic is being run by skilled in-house mental health Medical Officer.
• Physiotherapy Clinic : Daily during the Week.
• Referral Services: This is carried out through LASAMBUS and patients are taken to the next level of care, either secondary or tertiary as applicable.

 

1. SATELLITE CLINICS

The Directorate also caters for staffs that are not within the immediate Secretariat premises and offers onsite healthcare these Parastatals.

The following Parastatals have in-house clinics with medical personnel from Staff Health Services, but due to staff shortage, these clinics are managed by Senior Nursing Staff who administer first aid and refer patient accordingly.

• Lagos State Transportation Management Agency (LASTMA) Clinic: Staffed by Two (2) Senior Nursing Officers.
• Printing Corporation: Staffed by One (1) Senior Nursing Officer.
• Lagos Television: Staffed by Three (3) Senior Nursing Officers.
• Round House Clinic
• Lagos State House of Assembly: The Clinic is manned by Two (2) Senior Nursing Officers and One (1) rotational Nursing Officer from Folarin Coker Staff Clinic. The Clinic is also staffed twice weekly (Mondays and Thursdays) by Two (2) Senior Medical Officers from Folarin Coker Staff Clinic Complex.
• Old Secretariat Staff Clinic: The Clinic is manned by Four (4) Senior Nursing with one (1) Visiting Medical Officer from Local Government.

 

1. E. BASIC STATISTICS

Since inception, the clinic has been effective in the management of both communicable and non-communicable diseases with increased patient utilisation over the period of years.  Top 5 conditions seen at the clinic include Malaria, Hypertension, Upper Respiratory Tract Infections, Gastrointestinal tract infections, and Diabetes Mellitus.

 

 

ATTENDANCE
	2010	2011	2012	2013	2014	2015	2016	2017	TOTAL
Total Nos. of Patient seen	8392	7648	7002	9979	7361	7620	13765	6797	68564

 

 

GENDER
	2010				2011		2012			2013			2014			2015			2016			2017 AS AT JUNE			TOTAL
Total No of Male Attendance	3889				3672		3274			4776			5744			3640			7427			3144			35566
Total No of Female Attendance	4503				4021		3728			5,197			6186			3980			7135			3643			38393
DISEASES ENTITY
DISEASES ENTITY		2010				2011			2012			2013			2014			2015			2016		2017 AS AT JUNE			TOTAL
Total No of Malaria Cases		2833				2067			1992			3859			2828			2769			5586		1721			23655
Total No of Upper Respiratory Tract Infections Cases		814				819			601			1064			1364			777			1359		1163			7961
Total No of Gastro Intestinal Tract Infections		703				573			376			824			1028			830			1118		715			6167
Total No of High Blood Pressure		1869				1306			1182			1243			1612			836			1521		322			9891
Patient on i/v Drip/observation		63				81			129			359			454						458		190			1734
Total No of Urinary Tract Infections		104				140			52			57			108			123			213		93			890
Diabetes		115				155			101			131			136			144			195		71			1048
Asthma		67				54			38			26			89			23			48		34			379
Total No of Cases Ref. To Hospital		146				515			412			579			707			502			637		60			3558

1. PUBLIC SERVANT SCREENING STATISTICS

	SCREENING CENTRE	2011	2012	2013	2014	2015	2016	TOTAL
1	AJEROMI G.H	0	1063	1272	0	0	0	2335
2	ALIMOSHO GH	655	2325	1166	19	179	172	4516
3	APAPA G.H	57	483	708	13	44	6	1311
4	BADAGRY GH	154	4626	2171	0	0	0	6951
5	EPE GH	114	2450	767	2	0	0	3333
6	GBAGADA GH	468	3135	491	4	0	0	4098
7	IBEJU-LEKKI G.H	36	352	760	1	2	0	1151
8	IFAKO-IJAIYE GH	598	5243	1323	302	187	94	7747
9	IKORODU GH	186	6705	896	11	0	0	7798
10	ISOLO G.H	49	1856	760	6	0	0	2671
11	LAGOS ISLAND GH	830	5194	1186	15	0	0	7225
12	MUSHIN G.H	95	2280	833	10	0	0	3218
13	ORILE- AGEGE GH	498	4294	2420	515	1	201	7929
14	SOMOLU GH	309	2903	787	16	24	3	4042
15	SURULERE GH	427	1648	1052	33	5	0	3165
	TOTAL	4,476	44,557	16,592	947	442	476	67,490

 

 

 

 

 

 

 

• TOP GOVERNMENT SCREENING

A Total Target Population of 354 Officials

40. DTEC FIGURES: Total Screened 2013- till date at Diagnostic and Therapeutic Endoscopy Centre- 142 Officials (40.1% of Target Population).

B.BTHDC FIGURES: Total Screened 2013- till date at Bola Tinubu Health and Diagnostic Centre (BTHDC) – 168 Officials (47.4% of Target Population).

N.B. All Officials have been given letters but some are yet to present at the screening centres due to personal/time constraints.

1. SWOT ANALYSIS

Strengths:

• Well Structured Infrastructure
• Architectural Beauty
• Staff Appreciation
• Accessibility
• Prompt and timely medical management
• Increase patient Utilisation
• Effective in Management in both Communicable and Non-Communicable Diseases
• Reduction in Disease Incidence

Weaknesses:

• Staffing issues; certain units can be observed to have limited personnel thereby affecting job efficiency and workflow.
• Inadequate funding which affects availability of drugs and laboratory consumables. (Only one approval has been given for each screening exercise)
• Hesitancy of staff towards medical screening due to fear of witch-hunting or lay off from Government.

Opportunities:

• Expanding of Services to include required specialities such as Radiologist (to manage reporting of X-rays and Ultrasounds).
• Introduction of health education talks into the services to further reduce incidence of non-communicable diseases.

Threats:

• Logistics delays in release of funds for implementation and for procurement of drugs and other consumables.
• Staff Impatience whilst waiting for services to be rendered.

 

1. WAYFORWARD:

There is further need for enlightenment of staff on the benefits of yearly medical screening and it should not be regarded as a means of witch-hunting of staff. Staff should also be counselled about the exercise as a worthy venture so they do not see the hospital waiting time as a waste of time.  Considerations should be given to mobilising of staff for the Public servants medical screening as a means of encouraging participation and compliance.

 

1. CONCLUSION:

In conclusion, the establishment of the Folarin Coker Staff Clinic has contributed significantly to the health and welfare of Lagos State Public Servant in the provision of quality and timely healthcare in a conducive setting.

It has ultimately reduced the incidence of communicable and non-communicable diseases which eventually prevents untimely death.

Likewise, the Public Servant Screening programme has been a laudable initiative as it helps to ensure the early detection of disease(s) in the work force that may not present with signs or symptoms thus reducing the spate of medical emergencies affecting the Government employees which may lead to sudden death, thus ultimately ensuring a healthy and motivated workforce.

But for sustainability more funding and adequate personnel are required.

Annexe 1: LIST OF PUBLIC SERVANT SCREENING CENTRES

1. A total of Fifteen General Hospitals are engaged operationally for Public Servants Medical Screening; these are:

• General Hospital Lagos
• General Hospital Somolu
• General Hospital Ikorodu
• General Hospital Alimosho
• General Hospital Epe
• General Hospital Surulere
• General Hospital Badagry
• General Hospital Orile-Agege
• General Hospital Gbagada
• General Hospital Isolo
• General Hospital Ifako-Ijaiye
• General Hospital Mushin
• General Hospital Ajeromi
• General Hospital Apapa
• General Hospital Ibeju- Lekki

 

Capacity at all fifteen (15) facilities were extensively improved by way of equipment supply, consumables and reagents as well as training of dedicated selected members of staff (medical officers, nurses, medical laboratory scientist, laboratory technologist and medical records) for the screening exercise.

1. Designated Screening Centres for Top Government Officials

• Bola Tinubu Health & Diagnostic Centre (BTHDC) LASUTH
• Diagnostic Therapeutic Endoscopy Centre (D&TEC), Ikoyi

Annexe II: LIST OF LABORATORY TESTS CARRIED OUT IN PUBLIC SERVANT SCREENING PROGRAMME.

The following Basic and specialised tests are carried out on staff, depending on age and sex;

• FBC (Full Blood Count)
• Blood Sugar (Fasting or Random)
• Urea and creatinine
• Chest X-ray
• Urinalysis
• Mantoux Test for Tuberculosis
• Breast Examination
• Cholesterol and Triglycerides (for Men and Women >45 yrs.)
• PSA (Prostate Specific Antigen) for Men > 45 yrs.
• Cervical Visual Inspection with Acetic Lugol’s Iodine for Women > 45yrs.
• Electrocardiogram when indicated

Other Supportive Services given:

• Health Talks/Counselling
• Distribution of Behavioural Communication change materials

 Guidelines in Screening Centres

• The Screening Centre of Choice is as determined by staff and not related to birthday anymore but rather one closest to their residence or workplace.
• Constitute a Screening team comprising of a medical officer, nurse, laboratory scientist and medical records as a core team.
• Appointment/clearance cards are issued by the Ministry of Health (Staff Health services) according to the nominal roll using staff oracle number as a criteria, thus preventing infiltration of the program by non- members of staff. Staff without oracle numbers can however access the screening program through the issuance of duly signed and stamped letter of introduction to the screening centres by the authorised officer of the Ministry.
• Appointment/Clearance cards are presented at the screening centre of choice by the staff for the medical check-up.
• First visit- registration, Chest X-ray and Mantoux tests
• Second visit- all blood tests are done
• Third visit- (usually 7 days after the second visit); the medical officer reviews the results of all investigations done with the staff and subsequently refers for further evaluation or issues a medical certificate of fitness.
• Reports are generated in triplicate; for the screening centre, the patient and for the staff clinic (Ministry of Health). This is collated as the monthly summary by the Staff health Services.

 

 

 

 

 

 Justification of Investigations

INVESTIGATIONS	CATEGORY OF STAFF	JUSTIFICATIONS
Urinalysis	All Staff/Yearly	Screening for renal complications of hypertension & diabetes. Renal disease, Urinary tract infection, hepatobiliary pathology
Full Blood Count	All Staff/Yearly	For Anaemia, Infection/Inflammation, Assessment of general well-being
Urea	All Staff/Yearly	For renal pathology
Fasting /Random Blood Sugar (Glucose)	All Staff/Yearly	For Diabetes
Chest X-ray	All Staff/Yearly	Respiratory-Pulmonary, cardiovascular conditions
Mantoux (Tuberculin) Test	All Staff/Yearly	For Tuberculosis
Cholesterol & Triglycerides	Men and women > 45yrs with/without Diabetes or Hypertension	For Hypercholesterolemia
Visual Examination & Acetic Acid on Cervix	Females of Reproductive age group	For Cervical Cancer
Prostate Specific Antigen (PSA)	Men> 45yrs	For Prostate Cancer

 

Annexe III

TOP GOVERNMENT OFFICIALS SCREENING TESTS

The screening exercise includes:

Full Wellness Test for Male & Female

• Physical examination
• Full Blood Count & ESR
• Diabetes Screening (Fasting Blood Sugar, 2-Hour Post Prandial Glucose, Glucose Tolerance test)
• Kidney Function Test (including Urea and Creatinine)
• Liver Function Test
• Lipid Profile (Cholesterol)
• Uric Acid
• Urine and Stool Analysis
• Lung Function test
• Chest X-ray
• Resting ECG
• Breast Awareness
• Ultrasound (Abdomen and Pelvis)
• Breast Examination, Mammography, Pap Smear (for women)
• Rectal Examination and Prostate- Specific Antigen (PSA)(for men)
• Endoscopy/Colonoscopy

3. STATE ENVIROMENTAL HEALTH MONITORING UNIT (SEHMU).

 

The State Environmental Health Monitoring Unit (SEHMU) was inaugurated on the 21^st august, 2000 after executive mandate given by the state Governor then, His Excellency Asiwaju Ahmed Tinubu to the Ministry of health to take over the duty of ridding Lagos highways and roads of corpses and other related hazards.

 

Environmental and personal is paramount to the existence of any living being. Thus, the government is saddled with the responsibility of ensuring that the citizenry enjoys a healthy environment that is free from threat to human life.

The State Environmental Health Monitoring Unit (SEHMU) which is saddled with responsibility of:-

1. Removal of corpses/dead bodies from highways, street, disaster/accident spots, designated hospitals within the state to protect Public Health thus preventing epidemics.
2. Pest control services such as disinfection and general sanitation measures at pick up sites, disaster spots, offices and residents.
3. To improve the quality of the environment thereby promoting good health of the citizenry of Lagos state remembering the adage that “Health is Wealth’

 

 

STATISTICS FOR STATE ENVIROMENTAL HEALTH MONITORING UNIT (SEHMU)

AREAS	STATISTICS
ACHIEVEMENTS	·         Prevention of epidemics within the State. ·         Prompt removal of corpse from high way, street, disaster spots and strategic locations in the State. ·         Promotion of environmental aesthetics ·         Prompt response at disasters spots.
BREAKDOWN OF SEHMU ACTIVITIES FOR YEAR JANUARY 2016 TO FEBRUARY 2017	·         Road transport Accidents  – 139 ·         Destitute                                –  477 ·         Sick                                       –  901 ·         Sudden deaths                      – 32 ·         Stillbirth                               – 654 ·         Gun shots                             – 4 ·         Drown                                   – 29 ·         Burns                                     – 27

 

 

 

 

 

 

 

TOTAL NO OF CORPSES CARTED BY SEHMU BETWEN 2014 TO 2016 FROM HEALTH FACILITIES AND STREETS OF LAGOS

	2014	2015	2016	TOTAL
GENERAL HOSPITAL LAGOS	81	119	152	352
MASSEY STREET CHILDREN	306	180	233	719
LAGOS ISLAND MATERNITY HOSPITAL	488	431	572	1491
ONIKAN HEALTH CENTER	179	102	4	285
ORILE AGEGE GENERAL HOSPITAL	20	10	144	174
OTHER HOSPITALS	370	212	250	832
STREET OF LAGOS	641	590	682	1913
GRAND TOTAL	2085	1644	2037	5766

 

 

 

AGE DISTRIBUTION OF CORPSES CARTED BY SEHMU BETWEEN 2014 TO 2016 FROM HEALTH FACILITIES AND STEETS OF LAGOS

	2014	2015	2016	TOTAL
UNDER 1 YEAR OLD	825	303	415	1543
UNDER 5 YEARS OLD	52	2	12	66
5 – 17 YEARS OLD	86	19	7	112
TOTAL NO OF ADULTS	1122	850	1040	3012
GRAND TOTAL	2085	1174	1474	4733

 

 

 

 

SEX DISTRIBUTION OF CORPSES CARTED BY SEHMU FROM 2014 – 2016 FROM HEALTH FACILITIES AND STREET OF LAGOS

SEX DISTRIBUTION	2014	2015	2016	TOTAL
TOTAL MALE	1294	1062	1300	3656
TOTAL FEMALE	791	582	738	2111
GRAND TOTAL	2085	1644	2038	15561

 

Workplace inspections is the best source of obtaining relevant data about health hazards. There is no substitute for observation of work practices, use of chemicals and physical agents, and the apparent effectiveness of control measures.