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HIV/AIDS家庭相关水与环境卫生关爱评价

时间:2009-04-01 00:00来源:改水中心 作者:环卫健教室 点击:
2006 年改水中心与世界卫生组织合作开展了《 AIDS 家庭相关水与环境卫生关怀项目》,工作主要内容包括: AIV/AIDS 及家庭接受的援助和需求,卫生知识掌握情况, AIV/AIDS 家庭的水和环境卫生设施及使用情况。
  

2006年改水中心与世界卫生组织合作开展了《AIDS家庭相关水与环境卫生关怀项目》,工作主要内容包括:AIV/AIDS及家庭接受的援助和需求,卫生知识掌握情况,AIV/AIDS家庭的水和环境卫生设施及使用情况。工作成果为完成中英文《AIDS家庭相关水与环境卫生关爱评价报告》。

 

摘要

通过采取分析文献、集中座谈、个人访谈、现场观察等方法,对湖南省张家界市和衡阳市、湖北省随州市和襄樊市共40HIV/AIDS家庭供水与环境卫生现状以及相关的艾滋病流行情况进行了现场研究,对相关政策、有关机构和能力等进行了分析评估。

 

水与环境卫生调研结果:

1、供水情况:在城市的HIV/AIDS家庭自来水饮用率为90.00%,而农村为0;城市有30%HIV/AIDS家庭人均日用水量不足40L,农村为65%。城市既便饮用自来水,但仍有2户因交不起水费,家庭被断水。农村主要是未经消毒和净化的手压井和小口井,水质水量难以得到保障。由于取水的不便,农村HIV/AIDS家庭用水量低于城市家庭。

2、环境卫生情况:在HIV/AIDS家庭农村使用的厕所类型以旱厕为主,占调查HIV/AIDS家庭的85%,这些厕所粪便暴露、臭味较重、卫生状况差。城区以家庭内水冲式和公共厕所为主,其中使用不方便、卫生条件较差的公共厕所占65%HIV/AIDS家庭由于经济条件差、居住环境差,导致了垃圾随意堆放、污水随意排放,环境卫生状况差。

3、个人卫生情况:能够每天多次洗手的城市HIV/AIDS45%,农村占15%;每天至少洗澡一次的,在城市80%,农村占40%;牙具、毛巾、脸盆单放专用的,城市HIV/AIDS也明显高于农村,但城市也有相当多的HIV/AIDS没有专用的洗漱用具。

 

存在的问题及建议

1、基层领导者对WSH对艾滋病家庭的重要性缺乏足够的认识;部门之间对HIV/AIDS家庭的WSH关怀缺乏协调和统筹。

 建议:各级政府要建立和完善政府领导下多部门参与的艾滋病预防控制机制;积极开展与国际组织的合作;完善有关防治艾滋病政策,制定对HIV/AIDS家庭实施WSH关怀的战略规划;进行供水与环境卫生方面的专业技术指导和培训,落实 HIV/AIDS家庭供水与环境卫生的关怀政策。

2、在一些地区对HIV/AIDS的社会歧视现象还很严重,在散发的城区和农村地区由于经费和人员不足、防控成本大、国家政策、健康教育以及进行关怀活动等难以落实,同时进行水与环境卫生改善的投资也不宜实施。

建议:由政府、NGO或社区组织管理,扶持有生产能力的AIDS患者和HIV感染者在自愿的基础上集中从事力所能及的生产活动,同时避免社会歧视、也降低防控成本,保证国家各项关怀政策的实施。可以采用集中建造自来水厂和集中建造卫生厕所的办法保障HIV/AIDS的生活和卫生需求。

3HIV/AIDS家庭生活饮用水水质水量不能保障,卫生设施简陋,个人卫生条件差,增加HIV/AIDS家庭的的生活负担,加剧了环境污染和传染性疾病的流行。

建议:加强部门之间和部门内部的沟通与合作,推动艾滋病家庭水与环境卫生综合防治工作的开展;建立监督指导体系,加强对HIV感染者和AIDS患者关怀工作的技术指导;探索在艾滋病家庭建立供水与环境卫生关怀示范区。在AIDS高发区,可以采用政府补助集中建自来水的办法和对建造卫生厕所提供技术指导和补贴的办法;在散发的地区可给艾滋病家庭提供简单方便的供水设施和卫生厕所设施。同时争取社会捐助,为AIDS家庭提供肥皂、毛巾等。

4、国际组织参与的艾滋病关爱活动内容还不完善,地方NGO组织和社区组织在供水与环境卫生关怀的作用没有发挥。

建议:在争取国际项目援助时,在项目建议书中明确对HIV/AIDS家庭的WSH的关怀计划;支持NGO组织在供水与环境卫生对AIDS家庭关怀工作,明确法律地位,充分发自身挥优势,努力营造有利于HIV/AIDS家庭关怀活动开展的社会环境。

 

 

Executive Summary

By means of literature analyses, focused discussions, individual interviews and field observation, field survey has been conducted on current situations of water supply, sanitation and hygiene as well as the prevalence of AIDS epidemic for 40 HIV/AIDS households in Zhangjiajie and Hengyang of Hunan and Suizhou and Xiangfan of Hubei, and related policies, agencies and capacity have been analyzed and studied.

 

Survey results of water and sanitation:

1. Water supply: the rate of drinking tap for HIV/AIDS households is 90.00% in cities and 0 in rural areas. 30% of the HIV/AIDS households consume less than 40 liters of water per capita per day in urban areas, 65% in rural areas. Even that, there are still two urban households who have been disconnected from the system due to failure to pay water tariff. In rural areas, hand pump well and borehole for submersible pumps are the main water sources, and the quantity and quality of that water is not guaranteed for not been disinfected or purified. Due to the inconvenience of fetching water, HIV/AIDS households in rural areas consume less water than their counterpart in urban.

2. Sanitation: in HIV/AIDS households of rural areas, most of the latrines are dry ones, accounting for 85% of the surveyed households. The feces are exposed, smelly and poor in sanitation. While in urban areas, household flush latrine and public latrine are the two major types, and 65% of the latter are with poor sanitation and inconvenient for use. Owing to the poor economic and living conditions, the rubbish and waste water produced by HIV/AIDS household are littered or discharged randomly, sanitation bad.

3. Personal hygiene: the rate of washing hands more than once every day for HIV/AIDS households is 45% in urban, 15% in rural; the rate of taking shower at least once a day is 80% in urban and 40% in rural. The proportion of owing personal toothbrush, towel and washbasin in urban is obviously higher than in rural, yet there is still quite a lot of people processing no personal washing items.

 

Issues and recommendations

1. The leaders lack sufficient recognition of the importance of water supply and hygiene to AIDS households; lack of coordination and unified planning on the water supply, sanitatin and hygiene in HIV/AIDS households among different departments.

 Recommendation: all levels of governments should establish and improve the AIDS prevention and control mechanism under the leadership of governments with multi-departments participation; actively seeking for international cooperation; improving corresponding policies related to AIDS prevention and treatment; making strategic plan for implementing water supply and hygiene care in AIDS households; conducting professional training and technical guidance on water supply, sanitation and practicing the proposed policy of water supply and hygiene care in HIV/AIDS households.

2. in some places, social discrimination against is very serious; in urban areas with spotted HIV/AIDS cases and rural areas, the national policies, health education and care activities are hard to be fully implemented due to shortage of financial and human resources and large cost for HIV/AIDS prevention and control.

Recommendation: the governments, NGOs and community-based organizations organize, manage and support the capable carriers and patients to engage in production within their capacity and out of their own willingness, avoiding social discrimination, reducing the cost and ensure the implementation of relate government policies. In areas with spotted cases or areas not suitable for centralized management, provision of water supply sanitation facilities for HIV/AIDS households should be guaranteed by government via subsidies.

3. The quantity and quality of drinking water in HIV/AIDS households can not be guaranteed, sanitary facilities are simple and personal hygiene bad, which intensified the burden of living for the HIV/AIDS households, promoted the prevalence of infectious diseases and environmental contamination.

Recommendation: intensifying the communication and cooperation between different departments and within the department, boosting the development of comprehensive prevention and control of water supply and sanitation for HIV/AIDS households; establishing surveillance and monitoring system, intensifying technical guidance on care for the HIV/AIDS; piloting the construction of demonstrative zone of water supply and sanitation care in HIV/AIDS households. In areas of high AIDS prevalence, constructing centralized water supply facilities by use of government subsidy and providing technical guidance and financial subsidy to sanitary latrine construction; in areas with spotted cases, simple and convenient water supply and sanitary latrine facilities may be provided to HIV/AIDS households; collecting social donations to provide soap and towels to AIDS households.

4the activities of international organizations participation in AIDS CARE can be further improved and expanded, local NGOs and community organizations have not given full play in water and sanitation care.

Recommendation: when seeking for international assistance, the proposal should has clear description on water, sanitation and hygiene care in HIV/AIDS households; supporting NGOs work in water supply, sanitation and hygiene care in AIDS households, clarifying the legal status, giving full play of its own advantages, striving to create suitable environment conducive to the Care activities.


 

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