بررسی روند تغییرات شاخص های بهداشت محیط در روستاهای شهرستان ارومیه طی سال‌های 1394-

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه مهندسی بهداشت محیط، دانشکده بهداشت ، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 مربی گروه مهندسی بهداشت محیط، دانشکده بهداشت، دانشگاه علوم پزشکی تبریز

3 3- استادیار گروه آمار زیستی و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی تبریز

4 1- دانشجوی کارشناسی ارشد، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی تبریز

10.22034/jess.2022.334315.1747

چکیده

هدف از این مطالعه بررسی روند تغییرات شاخص‌های بهداشت محیط در مناطق روستایی شهرستان ارومیه و تعیین راهکارهایی به منظور ارتقای وضعیت بهداشتی شاخص‌ها در بازه زمانی 1394-1398 می‌باشد. پژوهش حاضر از نوع گذشته‌نگر طولی می‌باشد که با استفاده از داده‌های موجود در گروه بهداشت محـیط مرکـز بهداشت شهرستان ارومیه در بازه زمانی 5 ساله انجام شد. شاخص‌های مورد بررسی در این پژوهش شامل درصد خانوارهای روستایی با دسترسی به آب آشامیدنی، شبکه لوله کشی عمومی، توالت بهداشتی، جمع‌آوری و دفع بهداشـتی فاضلاب، مواد زاید جامد، فضولات حیوانی، مطلوبیت نمونه‌های میکروبی و شیمیایی، درصد کلرسنجی مطلوب، مراکز تهیه، توزیع و فروش مواد غذایی و اماکن عمومی دارای معیار بهداشتی و کارکنان دارای کارت معاینه پزشکی معتبر بود.
روند تغییرات صعودی و نزولی شاخص‌های بهداشت محیط در روستاهای شهرستان ارومیه و استان آذربایجان غربی در بازه زمانی 5 ساله برابر و به ترتیب 50 % و 66/41 % بود. روند تغییرات 50 درصد شاخص‌ها‌ در روستاهای شهرستان ارومیه و 75 درصد شاخص‌ها در روستاهای استان آذربایجان غربی در بازه زمانی مورد مطالعه از لحاظ آماری معنی داری بودند. میانگین 7 شاخص (33/58%) در روستاهای شهرستان ارومیه نسبت به شاخص استانی پایین‌تر و میانگین 5 شاخص (67/41%) بالاتر می‌باشد. به‌طور کلی وضعیت اکثر شاخص‌های بهداشت محیط در روستاهای شهرستان ارومیه و استان آذربایجان غربی مطلوب می‌باشد. به‌استثنای شاخص‌های جمع‌آوری و دفع بهداشتی فاضلااب و فضولات حیوانی، میانگین‌ مطلوبیت 33/83% شاخص‌ها در روستاهای شهرستان ارومیه و استان آذربایجان غربی در بازه زمانی مورد مطالعه بیشتر از 75 درصد می‌باشد. به‌طور کلی نتایج حاصل از این مطالعه نشان داد که 50% شاخص‌های بهداشت محیط در روستاهای شهرستان ارومیه در یک دوره 5 ساله بهبود یافته‌اند. بهر حال مطلوبیت میانگین بیش از 50 درصد شاخص‌ها در مقایسه با میانگین استانی در سطح پایین‌تری قرار دارنـد و تـلاش مسـئولین را جهـت ارتقـاء شـاخص‌هـای بهداشت محیط می‌طلبد.

کلیدواژه‌ها


عنوان مقاله [English]

Investigating the trend of changes in environmental health indicators in rural areas of Urmia during the years 2015-2019

نویسندگان [English]

  • Gholam Hossein Safari 1
  • Ahmad Asl hashemi 2
  • Neda Gilani 3
  • Sanam Naghian 4
1 Department of Environmental Health Engineering, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Instructor of Department of Environmental Health Engineering, Faculty of Health, Tabriz University of Medical Sciences
3 3- Department of Biostatistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
4 M.S student of community based-education in the health system, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
چکیده [English]

Abstract
The purpose of this study was to investigate the trend of changes in environmental health indicators in rural areas of Uremia County and West Azerbaijan province during the years 2015-2019. The present study is longitudinal retrospective research that was conducted using the data available in the Environmental Health Department of the Health Center of Uremia County and West Azerbaijan province over a period of 5 years. Data analysis was performed using descriptive statistics indicators such as mean as well as Kolmogorov-Smirnov, Friedman and Wilcoxon one-sample statistical tests using SPSS software version 26. Studied indicators in this research include the percentage of rural households with access to drinking water, public plumbing network, sanitary toilets, Sanitary collection and disposal of wastewater, solid waste and animal excrement, desirability of microbial and chemical samples, Measurement of residual chlorine, food preparation, distribution and sales centers and public places with health criteria and employees of centers and places with a valid medical card. The average percentage of desirability of these indicators in the 5-year period in the villages of Uremia County was 99.04%, 92.44%, 81.82%, 65.24%, 80.32%, 98.61%, 95.32%, 79%, 97.28%, 78.84%, 78.92% and 86.22%, respectively. The upward and downward trend of environmental health indicators in the villages of Uremia County, as well as West Azerbaijan province in a period of 5 years was equal to 50% and 41.66%, respectively. The findings of the present research indicated that the trend of changes in 50% of the indicators in rural areas of Uremia and 75% in the rural areas of West Azerbaijan province was significant during five years. The average of 58.33% of the indicators in the villages of Uremia County was lower than the provincial index. Except for the indicators of desirability of water chemical samples, sanitary collection and disposal of animal waste, and food preparation, distribution, and sale centers with hygienic criteria, other environmental health indicators (75%) have a significant difference with the provincial index. The status of most environmental health indicators in the villages of Uremia County and West Azerbaijan province is favorable. Except for indicators of sanitary collection and disposal of wastewater and animal waste, the desirability of 83.33% of the indicators was more than 75% both in the villages of Uremia County and West Azerbaijan province during five years. In general, the results of the present study showed that 50% of environmental health indicators in the villages of Uremia have improved over a period of 5 years, but the desirability of more than 50% of indicators was lower than the provincial index. Therefore, the efforts and participation of authorities, villagers, Islamic councils, environmental health experts, and health workers are necessary to improve environmental health indicators.

Introduction
Environmental health is one of the main challenges of sustainable development in most countries. The most important health priorities of most countries, especially developing countries in rural areas are sanitary collection and disposal of solid waste, animal waste as well as access to drinking water and sanitary toilets. Environmental health indicators are very essential because they reflect the changing state of people's living environment and the existing health threats. Studies indicated that environmental quality can affect health status and costs. Therefore, improving the environmental situation will have positive effects on the health of the community. The health of individuals in society has positive effects on the standard of living of people, and measuring health indicators is one of the most desirable and appropriate approaches to assess the level of health in a society. Rural society, which accounts for more than 27 percent of the country's population, plays a key role in the country's economic and social life. Given the importance and position of rural society in the country and the problems and challenges that this society faces in the development process, recognizing and analyzing the features of rural development planning in the country is necessary. In the process of rural development planning, attention to rural environmental health is essential and can lead to improving the quality of rural environmental health. Environmental health indicators are very important because they reflect the changing state of people's living environment and the existing health threats. The environmental health status of an area can indicate the status of development or underdevelopment of that area.
Improving environmental health indicators in rural areas, in the implementation of rural health development and with the aim of reducing the risk of infectious diseases, play a critical role in improving the quality of life and health of villagers with inter-sectoral cooperation and public participation. In the Islamic Republic of Iran, many programs related to the rural environment have been implemented since 2006. Nevertheless, the evidence suggests that the level of health in rural areas is low. The production of information and indicators on various aspects of health is essential and must be addressed. Assessing and monitoring people's health is one of the most significant principles of public health science, and the health status of a community is measured based on the indicators of the health of that community and the rate of change of these indicators over time.
At present, health information related to the environmental health status of rural areas is regularly prepared in the form of statistical forms and health indicators. Despite the great value of these health indicators, the trend of changes in environmental health indicators in rural areas over time has been less analyzed and limited scientific articles have been published in this field. Therefore, according to the mentioned cases, this study was conducted to investigate the trend of changes in environmental health indicators in the villages of Uremia County during a 5-year period (2015-2019).

Methodology
Uremia County is located in the northwest of Iran, which has 39 comprehensive rural health service centers and 6 urban-rural health service centers, and in total has 200 health houses with 315 health workers and 625 villages. The present study is longitudinal retrospective research that was conducted using the data available in the Environmental Health Department of the Health Center of Uremia County and West Azerbaijan province over a period of 5 years. The data collection tool was a checklist with a list of desired indicators. These indicators are standard values that are calculated and recorded in accordance with the guidelines for environmental and occupational health. These indicators have been selected by environmental health experts and included in this list, so the tools of this study had the necessary validity and reliability. The 12 environmental health indicators studied in this research are the percentage of rural households with access to drinking water, public plumbing network, sanitary toilets, Sanitary collection and disposal of wastewater, solid waste and animal excrement, desirability of microbial and chemical samples, Measurement of residual chlorine, food preparation, distribution and sales centers and public places with health criteria and employees of centers and places with a valid medical card. After collecting data, the indicators were compared with existing provincial indicators. Finally, the data were analyzed using descriptive statistics indicators such as mean as well as Kolmogorov-Smirnov, Friedman and Wilcoxon one-sample statistical tests using SPSS software version 26.
Conclusion
The results of this study showed that the trend of changes in 6 environmental health indicators (50%) in the villages of Uremia County and West Azerbaijan province in 2015 compared to 2019, was upward and the trend of changes in 5 indicators (41/66%) was downward. The maximum improvement in the villages of Uremia County was related to the index of public places with health criteria with 10.5% and the maximum decrease was related to the index of access to the public drinking water network with -4.1%. While the maximum increase in the villages of West Azerbaijan province was related to the index of measurement of residual chlorine with 23.5% and the maximum decrease was related to the index of desirability of water chemical samples with -11.7%. The trend of changes in 50% of the indicators in the villages of Uremia County and 75% of the indicators in the villages of West Azerbaijan province was significant during five years. Also, the finding indicated that the average of 7 environmental health indicators (58.33%) in the villages of Uremia County was lower than the provincial index and the average of 5 environmental health indicators (41.67%) was higher. The highest increase was related to the index of water chemical samples with 8.36% and the highest decrease was related to the index of sanitary collection and disposal of animal waste with -3.35%. Except for the indicators of chemical samples of drinking water, sanitary collection and disposal of animal waste and centers of preparation, distribution and sale of food with hygienic criteria, other indicators of environmental health (75%) in the villages of Uremia have a significant different with the provincial index. In general, the results of present study showed that 50% of environmental health indicators in the villages of Uremia have improved over a period of 5 years, but the desirability of more than 50% of indicators was lower than the provincial index and need to be upgraded.

کلیدواژه‌ها [English]

  • Rural Areas
  • Health Worker
  • Environmental Health Indicators
  • Uremia County
  • West Azerbaijan Province