Environmental Health & Community Services

Whereas there are three (3) main areas of environmental health practice, (health improvement, health protection and health services), Matsapha focuses on:

Food Hygiene and Safety

Focus is given to handling, preparation, and storage of food in ways that prevent foodborne illness. About 100 food outlets operate within the town. Activities undertaken by Council to monitor compliance include inspection of food outlets as well as seizure and condemnation of unwholesome food and expired items.

Occupational Health and Safety

This includes conditions and factors that affect the wellbeing of employees, temporary workers, contract workers, visitors and any other person in the workplace. As an industrial town, the municipality educates, monitors firms’ practices, procedures, processes and identifies associated risks and modalities for managing them.

Informal Trade Management and Control

The Local Authority has organized informal trade by providing small business enterprise zones from which informal traders operate. To organize and manage this important sector sustainably, Council has developed an informal trade Policy and draft Informal Trade Bye-laws.

Conformity Assessment

All new business outlets require a Trading License and the Department facilitates this by issuing favourable health reports in the form of Health Clearance Certificates as per the requirement of the Public Health Act No. 5 of 1969 section 26 (4). This function is done in Partnership with the Ministry of Commerce Industry and Trade (MCIT).

Following the de-linking of the health report from the trading license application process by the MCIT, Council has resolved to strengthen the inspection of business premises in order to ensure that no business outlet operates without a health clearance certificate/health report.

The introduction of the Matsapha-wide Inspection exercise was meant to ensure that all business outlet within the urban area are inspected at least once a year to ensure compliance with legislation and conformity to national standards. Abatement of nuisances has also been a challenge within the urban area as portrayed by illegal dumping, stray animals, open burning, etc.

Council is also responsible for the regulation and control of land degradation through chemical and other hazardous substances spillage. The polluter pays principle is strictly applied by Council against anyone who pollutes the environment.

In the quest to keep Matsapha clean, on a daily basis our work force picks litter along all the streets of Matsapha. This is then disposed of at the landfill. Also, Council has installed pedestrians litter bins strategically around the town to curb littering.

Designed in 1995 the Matsapha Landfill is based on an engineered cell system with a maximum capacity of 229 944 total compacted tonnage, occupying a volume of 320 000 m3. The total area of the landfill is approximately 5 hectares.

This area caters for storing top soil and cover material, composting and engineered landfill cells and a leachate pond. On a daily basis, general waste is deposited, compacted and covered. The weighbridge is also another component of landfill which facilitates for levying for the use of the landfill.

The SHERQ Office is responsible for coordinating the Quality, Environmental, Health, Safety, Risk management programmes (ISO Systems) and related issues within the Matsapha Town Council. The unit is also responsible for ensuring that the business complies with all relevant SHERQ legislation, company policies and procedures, minimum requirements and permit requirements. The office must ensure that the quality management system (ISO 9001.2015) is implemented and maintained by Matsapha Town Council.

In 2014, the municipality established the community social services unit following a baseline survey conducted in 2011. The 2011 Baseline Survey for the Prevalence of HIV in Matsapha, which was commissioned by the Matsapha Town Council, presented a bleak picture of the prevalence of the HIV epidemic in the urban area. The daytime population of the municipality consists primarily of lower income factory workers who disperse to the peri-urban informal settlements at night and a large number of casual job seekers who flock into Matsapha on a daily basis in pursuit of employment opportunities. Hence the population is characterized by mobility, which is conducive for HIV to spread. The survey also found that 60% of the population did not have access to health and HIV services, condoms, nor information about how to prevent and treat HIV and TB.  Additionally, the survey found high rates of TB among settlement residents. The majority of private companies also lacked HIV policies and programs.

Reaching this adult transient population to reduce the risk and vulnerability to HIV/TB and improve the overall health and productivity of the workforce presented formidable challenges. To this end, the Municipality sought assistance from partners and eventually a public-private partnership to establish mobile and outreach health services. USAID, Coca-Cola Eswatini, and the Matsapha Town Council partnered to share their respective strengths, experiences, technologies, methodologies, and resources (including human, in-kind, and monetary) to address these challenges to support a healthy productive population in Matsapha. Improving access to HIV and health services for the population of greater Matsapha was highlighted in the Matsapha Town Council 2013-18 Integrated Development plan.  The intention of this partnership was to launch a mobile health and outreach program that will be sustained by the Matsapha Town Council.

The PPP Mobile Clinic project has been consistently offering sexual reproductive health care services to the population under the Kwaluseni constituency for more than three years. The project operates through a mobile health care unit which targets numerous service delivery points including the industrial area and the peri- urban clustered areas.

Furthermore, it mainly focuses on PPP and treatment and care whereby it uses the national referral system to refer clients for further treatment and care should the need to do so arise. The project has formed and sustained relations with numerous health facilities in and around Kwaluseni where clients are referred on a continuous basis. However, clients are given the freedom to choose any facility they prefer to be referred to, even when it is outside the Kwaluseni area.

Health and Wellness is an organized program that is designed to support employees (and, sometimes, their families) and the community at large as they adopt and sustain behaviours that reduce health risks, improve quality of life, enhance personal effectiveness. The program is based on employee and community needs. There is a need to establish a core set of interventions from an available menu of options that involve a mix of programmes (education and coaching). These include, body health screening, policy formulation and implementation, support systems and counselling, and those programs that target physical activity, nutrition, and alcohol and tobacco abuse.

This program advocates that all workplaces in Matsapha must have a running effective wellness program. This program must ensure that HIV/AIDS and TB form part of the agenda of the health issues to be addressed. In most cases it is advised that there should be an officer designated for the Wellness program activities implementation for its effectiveness. A comprehensive wellness program focuses but not limited to the following dimensions:

• Physical Wellness: ability to maintain a healthy body through physical activity (exercise), diet, and relaxation.
• Social Wellness: ability to relate to and connect with other people.
• Spiritual Wellness: ability to establish peace and harmony
• Occupational Wellness: ability to get personal fulfilment from chosen career field
• Intellectual Wellness: ability to have open minds for new ideas and experiences applicable to personal and work life
• Environmental Wellness: ability to recognize our own responsibility for quality air, water, and land
• Financial Wellness: ability to have satisfaction with current and future financial situations
• Emotional Wellness: the ability to understand ourselves and cope effectively with challenges life can bring

Benefits of a wellness program to a Company

• Reduction of sick leave
• Healthy and motivated staff
• Reduction of Staff turnover
• Increased workplace morale and productivity
• Improved company image and employer of choice
• Long serving employees, preserving organizational culture

Setting up and aligning Wellness Program Systems: the program works on wellness guided by the Swaziland National Wellness and Disease Management Systems (SZNS SANS 16001:2013). The standard has been adopted from the South African National Standards. Trainings on the standard in Swaziland are done by the Swaziland Standards Authority (SWASA). As part of implementation and setting up of a wellness program the following systems and documents must be put in place and The Health and Wellness Coordinator does give technical guidance and expertise.

Evidence Based Programming, (Knowledge, Attitudes, and Behaviours and Practices Survey). The Wellness Program activities are crafted to align with and address identified practices and knowledge gaps on the ground. This model measures, tracks, and modifies progress in line with the baseline information. Health screenings are further conducted to substantiate the findings of the survey. Therefore, before any wellness program is established a KABP survey must be conducted, results of which will be used for the running of the program. Wellness program priorities differ from company to company hence the need to carry out a business case analysis for each company.

A wellness program is reviewed every 24 months therefore a KABP survey is done every 2 years. In-house Program Coordination and Support. There is a need to identify, capacitate and strengthen individuals to serve in the support structures for the program. These are the Wellness Program Officer or Focal Person, Steering Committee, and Wellness Champions (Peer Educators). These people, working closely with management, constitute the backbone of the program by fulfilling strategic goals and objectives of each body, together working towards a shared program goal of developing and sustaining healthy behaviour amongst employees.

Management Capacity Building, a day of enlightening management on the program’s underlying principles, components and their role in implementation is very important. This process lubricates for effortless management support and participation in the program. This further allows the employers to find ways of ensuring that their employees benefit from services provided by their medical aids (e.g. Swazi Medical Aid Scheme Wellness Screening services)

Wellness and Disease Management Policy Development or Review: the program also assists the wellness steering committee to develop or review any current wellness policy in the light of the KABP Survey findings to legitimize all efforts geared towards improving employee health. A wellness policy should be in line with the National Wellness Policy covering all health conditions. Other policies such as workplace sexual harassment policy and gender policy are further developed if they are not well captured in the Wellness Policy

Internal information, education, and life coaching: the Health & Wellness office facilitates workplace based information sharing and education forums. These sessions comprise formal and informal discussions in topical areas of concern for employees. Employers are further encouraged to dedicate some time for monthly or quarterly employees wellness sessions. Employees are also encouraged to form their wellness support groups with the assistance of the Wellness Champions.

A corporate health and Wellness calendar is made available yearly by the Health and Wellness Coordinator in consultation with the Ministry of Health.

On-site health products and wellness clinic services, this program will also coordinate the operations of two health service providers in Matsapha which are AHF and TLC (Mobile Clinic).

The program covers the distribution of condoms and lubricants to all worksites, provision of mobile or onsite wellness clinic screening services which are inclusive of blood glucose, blood cholesterol, blood pressure, body mass index, HIV testing and counselling services, TB screening, syphilis screening, VIA, and prostate cancer risk assessment. SWABCHA is obligated to provide a comprehensive report of activities conducted to each workplace.

Key services and products provided through the Health and Wellness program are based on the Trans-theoretical Model of Behaviour Change towards Social Behaviour Change Communication (SBCC). The model assesses an individual’s readiness to act on a new healthy behaviour, and provides strategies, or processes of change to guide the individual through the stages of change to action and maintenance.

Health and Wellness also focuses on lifestyle and disease management.

A Lifestyle management focuses on reducing health risks, risky exposures to HIV and TB, stress management, alcohol abuse, smoking, obesity, lack of exercise, low condom usage to mention a few, this supports the employees in reducing those risks and prevents the development of chronic conditions. The disease management component is designed to help employees who already have chronic disease (non-communicable disease condition), the goal of such is to help these employees take better care of themselves.

Technical Assistance (TA): this program provides TA to management in an effort to build institutional capacity for the development and implementation of Workplace Policies, programing and all relevant systems required by the SZNS SANS 16001:2013. The Health and Wellness Coordinator have been trained for the implementation of the standard. A generic policy guide on workplace wellness in the workplace aligned to the National Workplace Wellness Policy is available for adaptation.

Adaptation process includes formulation of a steering committee, review policy guide, planning for staff awareness sessions, signing and publication of the document. A costed implementation plan/strategy will also have to be developed to action the policy. This Program further assist companies to monitor, evaluate, report, and document all wellness program initiatives. Wellness Focal Persons forums are also hosted for sharing of best practises.

Workplace Prevention and Awareness Sessions: management and employees are reached in small groups with messages and information on wellness in their work stations. The sessions cover social and health issues that affect individuals in and outside their work life and hence affecting their productivity in the workplace or vice versa.

Social dialogues cover issues from marriage and relationships, stress and depression management, sexual reproductive health, preparing for retirement, personal finance management, and gender issues inclusive of Gender based violence and sexual harassment.

Direct health issues will include mostly prevention and management of major chronic illnesses like cancer, diabetes, tuberculosis, heart problems, TB, HIV and AIDS, and other health issues of public concerns as directed by the Ministry of Health. Dialogues are initially facilitated by Health and Wellness Coordinator, at times external resource persons, and later capacited Wellness Champions can take over on the topics. These sessions run for 1 -2 hours depending on the needs of the clients.

Wellness Champions Program: this program assist in the appointment and training of Wellness Champions to the maximum proportion of 1:5 employees and encourages male and females to be represented as well as representation from the shop floor to senior management. A guideline is given. In most instances a representation per department or workstation is required.

This Program has developed a 4-day training manual that helps to standardize all trainings. Peer Educator training covers areas including: HIV/AIDS and TB, Sexual Reproductive Health, prevention and management of major chronic illnesses, redefinition of femininity and masculinity, facilitation and communication skills and basic counselling skills. These trainings should be reviewed yearly. In addition the training develops the decision making skills of the participants whilst empowering them to be able to make client referrals, provide commodities such as condoms and deliver services such as psycho social support.

A two-day refresher is recommended after 6 months of the initial training for de-briefing and the rejuvenation of the team.

Additionally there should be an Annual Wellness Champions (Peer Educators) Day for experience sharing, learning, and celebrations.

Social Behaviour Change Communication Material Development: relevant SBCC materials are developed as per the information and message that will have to be communicated. A bottom up approach is used when developing or reviewing materials. The process seeks to empower beneficiaries to identify barriers to behavioural and social change and what is required to address these barriers and take action. Some of the materials are developed with the assistance of the Ministry of Health for the private sector companies.

Condom Distribution and Awareness Campaign: this program commits to supply both male and female condoms at your door-step. In line with the government regulations, condom demonstration sessions on correct use of condoms will be conducted aimed at improving actual condom use beyond uptake. Condoms can also be fetched from Matsapha Town Council offices at no cost.

Mobile Wellness Clinic: the mobile or onsite Wellness Clinic provides a range of screening services with the aim of preventing and management of particularly non-communicable diseases. These clinical wellness services include blood glucose, blood cholesterol, blood pressure, Tuberculosis, HIV screening, Body Mass Index, Syphilis screening, VIA, and Prostate Cancer Risk Assessment in a matter of minutes together with a counselling session. The counselling ensures that clients are given all the necessary attention they deserve. Referrals and linkages for further diagnosis or treatment is done at the convenience of the client. Clients who need to conduct male circumcision are referred to specific private doctors at no cost. A client record card is issued and used to record the results of the screenings conducted.

Physical wellness: this program promotes physical wellness amongst employees. An aerobics instructor is provided by The Health & Wellness Coordinator to facilitate a session on aerobics onsite or as per the requirements of the company.

Those who need The Health & Wellness Coordinator to speak on the importance of physical fitness, an instructor or trainer is provided to conduct the session. Linkages with qualified dieticians and/ nutritionist is made where necessary. Furthermore, this program encourage all employees and the surrounding communities to actively participate in various sporting events to keep their bodies fit and safe from diseases.

Family Health and Fun Day: numerous service providers and partners get to be invited to set up information desks and provide services by The Office of the Health and Wellness during either the sports days or family days. The role of The Office of the Health and Wellness is to assist the companies to have an effective family or sports day.

General Counselling: this program provides general counselling for concerned groups or individuals. Cases can be handled anonymously at the convenience of the client. Particular cases may require referral to external service providers including but not limited criminal cases, medical and spiritual.

As a coordinating assembly Matsapha through the office of the Health & Wellness Coordinator, the program also extends to the following activities:

• Community committees
• Youth participation formation structures

Engagement of hard to get populations e.g. key populations (the disabled, transactional sex workers, LGBTI)