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Exploring decision-making for environmental health services: perspectives from four cities
1Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, U.K. caroline.hunt@lshtm.ac.uk
Reviews on Environmental Health
|August 12, 2000
Summary
Environmental health indicators (EHIs) are tools for monitoring, but local decision-making on environmental health priorities is complex. EHIs are unlikely to be used unless integrated with local needs and representation.
Area of Science:
- Environmental Health
- Public Policy
- Community Engagement
Background:
- Growing investment in environmental health monitoring and the development of environmental health indicators (EHIs).
- Limited research on how communities and service providers make decisions regarding environmental health priorities and the role of indicators in this process.
Purpose of the Study:
- To explore local decision-making processes for environmental health services.
- To test the feasibility of using community-based EHIs to improve communication between environmental service providers and recipients in developing countries.
Main Methods:
- A project conducted in four developing-country cities to assess the use of community-based EHIs.
- Qualitative insights into decision-making dynamics and the influence of contextual factors.
Main Results:
- Environmental health service decision-making is complex and iterative, not strictly linear or rational.
- Contextual factors like service provider morale, inter-agency collaboration, community priorities, and provider-community relations significantly influence decisions.
- Environmental health indicators (EHIs) were not a primary driver of decision-making in the studied contexts.
Conclusions:
- Environmental health indicators (EHIs) are unlikely to be adopted into decision-making processes without integration into local agendas.
- Strong local representation and community buy-in are crucial for the effective implementation and utilization of EHIs.