A Study of Housing Conditions, Public Health Regulations on Housing and Their Health Implications in Lagos, Nigeria
Chapter One
PURPOSE OF THE STUDY
The purpose of this study is to examine the poor housing condition and health implication on residential dwellers in Ajeromi Ifelodun area of Lagos State and proffer solution to the problem comforting the area such as providing necessary infrastructures and facilities example, provision of pipe borne water, good training system, schools and electricity in other to improve the life of the people living in that area also to invite stake holders and government to come to their aid.
AIM AND OBJECTIVES
The aim of this study is to examine the poor housing conditions and its health implication on residential dwellers in Lagos State. To achieve the aim the following objectives will be pursued on residential dwellers:
- To examine the condition of poor housing structure in Lagos state
- To examine the problems encountered in the quality of these poor housing conditions
- To provide solution to the identified problem in the study area
- To identify the roles of poor housing conditions and its health implication on residential dwellers in Lagos
Chapter two
Literature review
Housing Conditions around the World
87 % of the world population has access to drinking water. Life expectancy has increased by 21 years since the 1950s. 87% of children are in primary school. The living conditions have improved in the world, but the poorest countries are still staying behind (Rita, 2011). The inequalities between the populations of rich and poor countries cannot be reduced to differentials in income. They also apply to very different living conditions, in particular concerning the access to fundamental goods (drinking water, food, health care, education, House …). Although much still has to be done to permit all individuals decent living conditions, the inequalities of accessing these goods seem to decline.
Almost 1 billion people currently live in slums, and this number is expected to grow by nearly 500 million by 2020 – if we‘re to ensure that no one is left behind in the future development agenda we need to determine whether progress is really reaching these marginalized groups. The scanty information available about the total number of households in the world living in neighborhoods lacking basic infrastructure (water, sanitary waste disposal, roads, energy) and basic urban services (health, education), and having difficulties in accessing employment, indicates that this reduction in 100 million ‗slum‘ dwellers far from solves the problem. The post-2015 agenda should continue a focus on the urban poor – but it should aim to define better the problems they are facing and to focus on more effective solutions (Eduardo, 2015).
Furthermore Eduardo (2014) states that a central concern of the post-MDG’s agenda must be the housing sector in developing countries, the main cause of the informal settlements. The root of the problem is that – but for a few exceptions – the formal housing sector (developers that comply with building and land-use regulations) produces fewer houses than needed to satisfy demand. In addition, the houses it produces are unaffordable for many low- and even middle- income populations owing to low income and the underdevelopment of local financial systems. Informal production of houses – outside regulations and mostly sub-standard – is a reality that will pertain in the developing world until the formal sector produces sufficient houses.
Government policies aiming at improving the lot of the poor in cities must focus on expanding the flow of affordable houses as well as improving the living conditions of existing informal settlements – the focus of most government efforts in pursuit of MDG 7. The objective should be to direct more resources to the housing sector and to improve its operations so that households in all income brackets find a housing solution and contribute according to their capacities in the production and financing of their homes.
In the past decade countries as different as Brazil, India and South Africa have expanded their interventions in the housing sector, launching new house-construction programmes in addition to upgrading existing settlements. Governments in the developing world have shown a marked preference for the direct production of houses by public entities to supply the needs of the poor.
Past experiences in the most diverse countries – Argentina, Morocco, and Indonesia among many others show that this approach is insufficient and usually miss-targets public resources.
Other countries have instead focused on leveraging private-sector resources and capacities to expand new housing production through direct one-off subsidies. Early adopters of the policy – Mexico, Chile, Costa Rica – started to reduce the housing shortage in this way, but such policies left out low-income households that could not save enough and did not have regular incomes to qualify for a mortgage loan. These countries resorted to the direct production of houses by public entities to cover the needs of these households, this time better targeting public resources to the very poor.
According to Eduardo (2014) to eliminate sub-standard settlements, the post 2015 agenda should encourage governments to improve the functioning of the housing sector to reduce as fast as possible the current outcome of unmet housing needs alongside the more traditional objective of improving living conditions on existing informal settlements. Fulfilling this expanded goal requires a more complex set of policies and programmes than those currently in use. Three major areas of concern stand out.
CHAPTER THREE
Materials and Methods
Study Design and Study Area
This study is a Meta-Analysis of secondary data on Public Housing Studies that measures the Quantitative Health Outcomes (QHOs) of Nigerians as it relates directly to housing and its varied components. The materials sourced spans the entire country and cuts across all the geo-political zones in Nigeria. A web search on research databases such as Google Scholar, Academic Search Premier, and Family & Society Studies Worldwide was carried out on the following search terms: [1] Housing Policies in Nigeria [2] The impacts of housing on health in Nigeria and [3] Health-related policy gaps in the Nigerian Housing Programs. The studies used in this analysis also cuts across the thirty-six (36) federated states in Nigeria including the Federal Capital Territory (FCT), Abuja. This study lasted for a period of seven (7) weeks between the months of August 2021 and September 2021.
Target Population and Sample Size
Household with individuals and families were the main target in this study. 19,464 individuals participated in this study by answering structured questionnaires.
CHAPTER FOUR
Results and Study Findings
The table below gives a summary of the eighteen (18) papers identified for this this study:
Table 1: List of Papers Identified for this Study
CHAPTER FIVE
DISCUSSION, CONCLUSION and recommendations
Discussion
Poor housing and an unhealthy environment has long been used as a measure of economic status and health inequities among populations (Warr, et.al., 2009; Braubach & Fairburn, 2010; Briggs, et.al., 2008). This approach has also been used for strategic public health interventions as the spread of infectious diseases mostly starts from vicinities with poor housing and environmental standards. Researchers have endeavored over the years to identifying the association between housing and health; and to specifically identify the impacts of social interventions on housing (Egan, et.al., 2010). The increasing body of evidence now available have overwhelmingly points to the fact that housing has major impacts on the health of individuals and families (Baker, et.al., 2017). Some of the health challenges experienced directly in relation to housing may seem circumscribed and isolated, this however have greater impacts on the larger population. Several studies at different parts of the world has directly linked housing tenure as a measure of socio-economic standing to mortality, cardiovascular heart diseases (CVD), and mental health issues among studied populations (Park & Jung, 2019). The use of housing tenure however does not speak directly to the working and living conditions of individuals and families. Thus, researchers are now concerned with identifying the key impacts of the psychosocial environment within the home and the quality of the physical environment in which people live. Staying healthy is dependent on many factors among which housing is key. Myriads of elements and factors both within and outside the home affects health; and the space and environment in which people live plays a vital role in shaping their well-being. A healthy population produces a productive society, which directly translates into higher economic values and returns on the part of government. It has been reported that the sheer size and population of Nigeria presents a huge challenge due to its diverse ethnic and religious groups (Ayedun & Oluwatobi, 2011). This monstrous challenge is mirrored in the country’s varied patterns of housing structures and qualities, varied coverage in healthcare facilities and services, varied availability of social amenities, and varied health outcomes of the population. The weak system of governance in the country and the ethno-centric nature of political leadership has largely remained a major setback for the country in its universal housing and health coverage drive (Yagboyaju & Akinola, 2019).
From the analysis conducted in this study, 44.8% of the population live in buildings with poor structural standards. These buildings are characterized with poor foundations and cracked walls, dampened floors with leaky roofs, broken windows and doors, moldy paints both within and outside the building, and broken or moldy ceilings. All these elements combined have a negative collateral effect on the health of the house occupants. Both physical illnesses relating to upper and lower respiratory tracts infections and mental health issues are occasioned due the constant exposure to unfavorable elements within the home space. Several studies have linked poor housing environment to ill health, and the case in Nigeria is not different (D’Alessandro & Appolloni, 2020). Studies have also shown that an improvement or social interventions to improve the housing environment has tremendous effects at improving the health outcomes of the affected population (Lubell, et.al., 2007; Thomson, et.al., 2001).
Poor environmental sanitation has been associated with poor health outcomes in all parts of the world. The physical environment outside the physical building structure accommodates a host of agents that directly affects the health of individuals and families. From the data analyzed in this study, 52% of the study participants live in environments with poor sanitation. These environments are characterized with poor water drainage and sewage systems, bushy environments, public dumping of refuse in open spaces, and poor road networks (Udoh & Uyanga, 2013). These combined elements largely favor the spread of infectious diseases such as Cholera and Malaria. The indiscriminate dumping of refuse causes environmental pollution with the attendant growth of diseases carrying vectors and rodents. A proper regulation on the disposal of community wastes and sewage is urgently needed in Nigeria in order to protecting the health of the citizens.
Historically, the lack of good hygiene practices has led to the spread of infectious diseases causing pathogens that has led to many epidemics in the past (Bartram & Cairncross, 2010). From the data analyzed in this study, a staggering 82% of the study participants indicate that they do not practice good hygiene. This was largely occasioned by the lack of water system toilets and the lack of portable drinking water. The study participants’ reports on resorting to the use of contaminated and untreated stream water for cooking, washing, and drinking. The participants make use of the available open spaces in the environment for defecation and the disposal of other hazardous wastes. Little wonder when it was reported in the National Strategic Health Development Plan (NSHDP) for the period between 2010 and 2015 that the health status of Nigerians is among the worst in the world; and that the health status of the Nigerian population has declined (Uzochukwu, et.al., 2015). Several studies have linked poor hygiene to infectious disease spread. Diseases such as Typhoid, Cough, Tuberculosis (TB), and Cholera are easily spread within communities when there are no good hygiene practices.
Many rural and urban settlements especially in LMICs as Nigeria lacks many basic social amenities such as treated pipe-borne water, good road networks, electricity, and healthcare facilities (Lanrewaju, 2012). 46% of the participants in this study lack one or more of these basic social amenities. The ethnic disparity and the bigoted nature of political needs assessments in Nigeria has made for a spread of basic social amenities that are not even. Politicians sometimes use their political influence to locate important social amenities in proximities to their local ethnic settlements. The ethno-centric incline guiding the political leadership space in Nigeria remains one of the major challenges to poor housing and poor healthcare coverage. With almost half of the study population (46%) not having access to basic social amenities such as good roads and healthcare facilities, the citizens are left to wallow in pain before they can get help. The economic cost of providing individual power for basic electrical uses further dampens the chances of the citizens from being able to obtain their own homes. The power generators used to produce electricity by these participants also releases carbon dioxide into the environment; thus, leading to environmental pollution. The inhalation of the released carbon dioxide can cause lung diseases and sometimes-instant mortality resulting from carbon monoxide poisoning (Ede, et.al., 2013). It is therefore imperative that government makes the necessary provisions for a mandatory construction of standard healthcare facilities in proximity to every community.
The health impacts of housing on health cannot be overemphasized. From the data analysis carried out in this study, 38.5% of the participants reported one or more form of ill health within the study period. The majority of this participants reported suffering from Malaria, Cough, Skin Rashes, Asthma, Bronchitis, Typhoid, Cholera, and Diarrhea etc. The study which cuts across the six (6) geo-political zones in Nigeria gives a fair representation of the entire Nigerian population; thus, making room for an acceptable level of generalization of the findings of this study. An important aspect of the impacts of housing on health that is yet to be explored in Nigeria is the impact that housing has on mental health. Further studies are required to fully explore the ramifications of the mental health challenges occasioned due to poor housing. Studies to understand the psychosocial impacts on housing interventions and the health outcomes of Nigerians are also urgently needed to help inform and guide future housing policy formulations (Opoko & Oluwatayo, 2014). More studies are also needed in all parts of the country to fully understand the dynamics and confounding factors existing within the complex intercept between housing and health.
The data analysis conducted using simple descriptive statistics, analysis of variance (ANOVA), and the Pearson’s correlation and regression analysis indicates a significant relationship between housing and its impacts on health (r=0.99, p-value =0.01). Further analysis also shows a strong positive relationship with the R2 at 99% and a Significance F at 0.0099. In addition, the correlation coefficient at the point of Intercept indicates a Positive Relationship at 2.869. Thus, this results shows a very strong positive and significant correlation between housing and its impacts on health (r=0.99, p-value =0.01) in Nigeria.
Conclusion
Housing and Health are interrelated; and living in houses that are poorly built affects the health of individuals and families negatively. The socio-economic impacts and costs of assessing healthcare though seemingly circumscribed always have a larger impact on the economy and well-being of the nation. Social interventions to improve housing for citizens at different parts of the world has yielded very good results with improved health outcomes (Jacobs, et.al., 2010; Butler, 2018). Homes, either owner-occupied or rented does not improve health outcomes especially if the physical environment in which such housing are located does not make for a harmonious environment conducive to health and wellness. The health status of Nigerians has been on a steady decline due many intrinsic and extrinsic factors directly relating to housing. The psychosocial space within the home and the physical environment in which people live affects their health and well-being. As can be seen in this study, many factors such as structural building standards, the quality of the environment and its sanitation, the level of individual and family hygiene, and the availability of basic social amenities all have direct impact on the health of individuals and families. As indicated by Taylor(2018), stability as to having a home, quality and safety of the building, affordability as to being able to afford a home, and the quality of the neighborhood and the physical environment with the attendant requisite infrastructures all combines to affecting healthcare costs and health outcomes. While housing is a basic human need, health remains a basic human right; as without health, the burden, loss and cost incurred in productivity will invariably be translated to the national economy. The Nigerian government though has made tremendous efforts over the past decades at closing the housing deficit gaps in Nigeria; the government still has a long way to go at ensuring equity in the distribution of basic social amenities, including housing among its citizens. The ethno-centric leadership styles with skewed allocation of available resources should be jettisoned for a more inclusive style of leadership where equity and justice for all will be guaranteed. The health of Nigerians is being impacted negatively due to the quality of housing and the physical environment in which they live (Olukolajo, et.al., 2013; Udoh & Uyanga, 2013). Government should put in more efforts at coming up with housing policies that incorporate the health and safety components of housing projects. More housing and health policy experts are also needed to help in ratifying proposed housing policies in Nigeria. And while stricter adherence to the WHO Housing Guidelines and the Nigerian National Building Code is strongly advocated, large-scale Social and Epidemiological studies are needed in Nigeria to fully understand the ramifications of the impacts of housing on the health of the citizens.
Recommendations/Suggestions
In view of the findings in this study, the followings recommendations/suggestions are given to the government of Nigeria:
- Policy on the Structural and Design standards of housing units
- Regulatory provisions on the mandatory use of Standardized and approved Building Materials
- Policy on the provisions of Environmental Standards for Waste Disposal and Management
- Policy Provisions for the regulation and control of Noise Pollution
- Regulatory provisions for the Prevention of Fire Hazards by Individuals and Families
- Regulatory provisions on the Standards for Environmental and Neighborhood Designs
- Mandatory Regulatory Standards for the creation of neighborhood recreational centers and Walkways
- Mandatory Regulatory provisions for Periodic Public Housing Inspections and Maintenance Checks
- Mandatory Regulatory standards for School Structural Planning, Locations and Designs
- Mandatory Regulatory standards on the provision of Community Healthcare Centers
Acknowledgement
The author will like to specially acknowledge the supports of Dr Charles Mkandawire and Dr Cristina Isabel Armenta both of UNICAF University for their kind guidance and supports.
Declaration
The author receives no funding support for this work.
Conflict of Interest
The author declares no conflict of interest.
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