The World Health Organization (WHO) is piloting a program to train health professionals as advocates for clean air policies and programs with the ultimate aim to protect and promote people’s health and wellbeing. Health workers from all corners of Ghana met in Kumasi, Ashanti Region and provided input into the program design as the curriculum is scaled up. This successful pilot is expected to expand into a global program in 2023.
Health professionals shape the dialog on air pollution and health topics both through direct engagement within their communities and peer colleagues and also while influencing public policy agendas on personal and population-level interventions. WHO is piloting a program to train health workers to advocate for clean air measures in the communities where they work. The project is led by the Air Quality and Health Unit within the Department of Environment, Climate Change and Health. The global training curriculum is designed to be tailored at the regional and country level.
Pilot Workshop in Ghana
In Kumasi, Ghana, in June Kumasi, Ghana, in June 2022, a group of almost fifty health professionals gathered to test the program. They have been exposed to a set of training modules and multiple interactive sessions using a train-the-trainer approach which allowed them to gain the skills and knowledge to act as trainers with peer colleagues in the health sectors and the communities they serve. The material included introductory modules about air pollution and health as well as specific modules for clinicians addressing cardiovascular and respiratory diseases and the health effects of air pollution on children and pregnant women.
Clean Air as a human right
In August 2022, the United Nations General Assembly passed a historic resolution declaring that everyone on the planet has a right to a healthy environment, including clean air, water, and a stable climate. “We have made air – the thing that keeps us alive – the number one threat to our health,” said Martina Otto, Head of Secretariat, Climate and Clean Air Coalition. “By formalizing our right to clean air, this resolution is an important step towards protecting both people and planet.” The training toolkit being developed by WHO is designed to reach those planetary health goals.
99% of people worldwide breathe air that exceeds WHO global air quality guidelines. Regions and countries differ widely in their burden of air pollution, Low-and-Middle Income Countries being the ones whose population is most affected by this threat. In Ghana, this a serious concern for public health. Ghana’s annual ambient mean concentration of PM2.5 (35 ug/m3) largely exceeds WHO global air quality guidelines for particulate matter (PM). Transport, industry, waste burning as well as households’ heavy reliance on unclean fuels and technologies for cooking significantly contribute to air pollution exposure and important health outcomes in the population.
Health systems pay the price of illnesses that result from air pollution exposure, therefore the health sector has a vested interest in improving air quality. Tools provided by WHO, such as this training program can empower local health workers, in their own communities, in advocating for those policy changes while advising patients and individuals on exposure reduction strategies.
Lydia Owusu, a public health nurse and coordinator of Non-Communicable Diseases for the Ashanti Region of Ghana, says, “I see this training as the best and this the correct time for this program.” She’s excited that Ghana was selected for this pilot training workshop and is determined to make the program a success that can benefit other countries as well.
Caroline Okine, a public health nurse from the central region of Ghana appreciates how clear and specific the distributed materials were. She thinks that they will make it easier for her to share what she has learned from the workshop.
John Baffoe, a public health officer for disease control says that as a result of the training, “I’m equipped. I now have the knowledge to go orient my other staff and also be an advocate for clean air.”
Edward Owusu, from the Ghana Health Services in the central region of the country, appreciates that trainees had the opportunity to conduct field visits including to a smelting site, or a charcoal production, and to use air quality personal monitors while appraising firsthand the sources of air pollution in the Ashanti region. He notes that air pollution is one of the major causes of respiratory and cardiac problems. He says that “we know that one of the major causes of asthma, cardiovascular diseases, and other conditions are due to air pollution.” He believes this workshop is timely and hopes to implement the modules in the program to reduce regional exposure to air pollution.
Educate the health professionals
Learning goals for the materials include teaching the participants in recognizing the scientific evidence behind air pollution and health issues, including specific knowledge of pathogenetic mechanisms through which air pollutants undermine people’s health. The health professionals learned to recognize the health benefit of both ambient and household air pollution interventions at the population, community, and individual levels with particular attention to developing a clinical approach to air pollution. This latter was enhanced through the use of clinical case scenarios specifically designed to improve the clinical reasoning of health professionals, taking environmental risk factors into proper consideration when assessing the health status of a patient.
Health workers listened to presentations from WHO staff and other experts from the University of Ghana and WONCA – Global Family Doctors. and worked together in small groups to figure out how to best implement policy and clinical approaches to air pollution within their specific local contexts.
Presentation of the training module of air pollution health effects
Interactive session in breakout groups
Benefits of the project
This project provides much-needed capacity-building and training for health workers. A reduction in air pollution emissions is a “win–win” opportunity to simultaneously protect human health and the environment and to address the complex challenge of climate change, as the combustion of fossil fuels contributes to increasing the levels of some air pollutants.
Ben Sackey Benasco and Samantha Pegoraro guiding the program
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