2022-06-07-世界卫生组织-Environmental_Health_Madagascar_2022_country_profile_2页_190kb

Health and Environment Scorecard: Madagascar

Core Content Overview

The document presents a health and environment scorecard for Madagascar, highlighting key challenges in air quality, water and sanitation, climate change, and other environmental health factors. It provides data on the extent of the problem, health impacts, and existing policies or resources.

Key Issues and Health Impacts

Air Pollution

• Extent of the Problem:
  • PM2.5 levels in Madagascar are 4 times the WHO air quality guideline value.
  • The annual mean PM2.5 concentration is 18 μg/m³, compared to the WHO guideline of 5 μg/m³.
• Health Impact:
  • 40% of deaths from stroke and ischaemic heart disease are attributed to air pollution.
  • Air pollution causes many other diseases and adverse health outcomes.
• Policies:
  • Legal standards for PM2.5 exist, but compliance is unclear.
  • No data is available on policy implementation.

Household Energy and Cooking

• Extent of the Problem:
  • 99% of the population lacks access to clean fuels and technologies for cooking.
• Health Impact:
  • Household air pollution is a major contributor to respiratory and cardiovascular diseases.
• Policies:
  • A national policy on household energy exists, but implementation is lacking.

Water and Sanitation

• Extent of the Problem:
  • 79% of the population lacks access to safe drinking water.
  • 90% of the population lacks access to safe sanitation.
• Health Impact:
  • 65% of deaths from diarrhoea are caused by unsafe drinking water, poor sanitation, and inadequate personal hygiene.
• Policies:
  • Limited financial resources are available for implementing national water and sanitation plans.
  • Safe drinking water and sanitation services are not yet operationalised.

Climate Change

• Extent of the Problem:
  • Under a high emissions scenario (RCP8.5), 72% of days in Madagascar are expected to be "hot days" by 2050.
  • A heat death rate of 25 per 100,000 people is projected for the 65+ age group by 2050, compared to 1 per 100,000 people before 1990.
• Health Impact:
  • Climate change is expected to significantly increase the risk of heat-related illnesses and deaths.
• Policies:
  • No national health and climate change plan or strategy is currently in place.

Definitions and Scenarios

• Hot Days: Defined as days where the maximum temperature is among the top 10% of warmest days recorded historically (1961–1990) at a specific location for a specific time of the year.
• High Emissions Scenario (RCP8.5): A Representative Concentration Pathway used for climate change projections, indicating a high level of greenhouse gas emissions.

Additional Environmental Health Factors

• Chemicals:
  • Data on lead paint controls and poison centres is available, but no national strategy for chemical regulation is mentioned.
• Radiation:
  • No national radon regulations are in place.
  • Data on melanoma and other skin cancer deaths is available, but no legislation on artificial tanning sunbeds is noted.
• Occupational Health:
  • Data on the burden of disease from long working hours and work-related injuries is available.
  • Madagascar has ratified some ILO conventions (C155, C161, C187), but occupational health and safety programs for health workers are not well established.

References

• Air Pollution: WHO global air quality guidelines (2021), WHO SDG Indicator 11.6.2 (2016 data), WHO household air pollution data (2019), WHO air pollution data portal (2016), UNEP 2021: Regulating air quality.
• WASH (Water, Sanitation, and Hygiene): WHO and UNICEF Joint Monitoring Programme (2020 data), WHO water, sanitation and hygiene burden of disease (2016), WHO GLAAS 2018/2019 cycle.
• Climate Change: Honda et al. 2014, WHO: Climate change and country profiles.
• Chemicals and Radiation: WHO International Health Regulations core capacity scores (2020), WHO mortality data on unintentional poisonings (2019), UNEP Minamata Convention on Mercury (2021), WHO radon data (2019), WHO legislation on artificial tanning sunbeds (2021).
• Occupational Health: ILOSTAT (2022), WHO/ILO Disease burden from long working hours (2016), WHO/ILO Joint estimates of work-related disease burden (2016), WHO occupational health and safety programs (2021), ILO ratifications of C155, C161, and C187 (2021).