Navigating Environmental Sanitation and Health Communication in Nigeria: Challenges and Prospects

Navigating Environmental Sanitation and Health Communication in Nigeria: Challenges and Prospects

*Nonye Benedeth Ezeaka (Ph.D) & Chinenye Evelyn Bartholomew (Ph.D⁾

Department of Mass Communication, Chukwuemeka Odumegwu Ojukwu University Igbariam Campus, Anambra State, Nigeria

*Corresponding Author

DOI: https://dx.doi.org/10.47772/IJRISS.2025.9010272

Received: 19 January 2025; Accepted: 25 January 2025; Published: 18 February 2025

ABSTRACT

In Nigeria, environmental sanitation is a major health issue due to poor waste disposal, open defecate on, and insufficient sanitation facilities. These factors lead to the spread of waterborne diseases like cholera, typhoid, and diarrhea. Despite government efforts like the National Environmental Sanitation Policy and international initiatives like the Sustainable Development Goals, Nigeria still struggles to implement sustainable sanitation practices. This study investigates the link between environmental sanitation and health communication by examining the obstacles and opportunities for raising awareness and increasing compliance with sanitation practices in Nigeria. The study employs qualitative methods to analyze key sanitation issues. The study highlights the critical role of health communication in driving behavioral change, emphasizing the need for localized, culturally sensitive, and multimedia-driven communication strategies. Leveraging traditional media (radio, television), digital platforms (social media, SMS alerts), and community-based approaches can enhance public understanding and engagement in sanitation practices. Furthermore, public-private partnerships, increased investment in WASH (Water, Sanitation, and Hygiene) infrastructure, and the revitalization of community-led sanitation programs are identified as viable solutions for overcoming existing challenges. Practical recommendations tailored to the Nigerian context include the reintroduction of the monthly environmental sanitation exercise, stricter waste disposal regulations, the provision of public toilets in markets and motor parks, leveraging Nollywood and social media influencers for sanitation awareness, and establishing community-led sanitation task forces. These interventions, if effectively implemented, can significantly improve Nigeria’s sanitation landscape and reduce the burden of sanitation-related diseases. The study concludes that achieving sustainable environmental sanitation in Nigeria requires a multi-sectoral, participatory, and communication-driven approach that integrates policy enforcement, community engagement, and behavioral change strategies. Addressing these challenges will not only improve public health outcomes but also contribute to Nigeria’s broader development goals.

Keywords: Environmental sanitation, health communication, Nigeria, sanitation policy, waste management.

INTRODUCTION

Environmental sanitation is a fundamental determinant of public health, directly impacting the quality of life, disease prevalence, and overall well-being of communities (World Health Organization [WHO], 2022). It encompasses a range of practices, including waste management, water sanitation, air quality control, and hygiene promotion, all of which are essential for preventing the spread of infectious diseases (Eze & Okonkwo, 2023). In Nigeria, poor sanitation poses a serious public health problem. It contributes to high rates of sickness and death, especially in poor areas of cities and rural villages where people don’t have easy access to clean water or safe ways to get rid of waste (Ogunyemi & Adewale,2020), Diseases like cholera, typhoid fever, malaria, and diarrhea are often caused by bad sanitation and poor hygiene (Akinbami, 2012).  These diseases harm public health and hurt the economy by making it harder for people to work.

Despite efforts by the Nigerian government to address sanitation concerns through policies such as the National Environmental Sanitation Policy (Federal Ministry of Environment, 2021), the implementation of these measures has been hindered by several factors, including weak institutional frameworks, lack of infrastructure, financial constraints, and socio-cultural attitudes toward sanitation and hygiene (Adebayo, Yusuf, & Johnson, 2022). The growth of cities is making the problem of poor sanitation worse. Many people now live in informal housing without proper toilets. This makes them more likely to get diseases caused by unsanitary conditions (Obi, 2019).

Nigeria incurs significant economic losses, estimated at $3 billion annually, due to inadequate sanitation practices, as reported by the World Bank (2020). This issue adversely affects the economy, households, and the healthcare system. Health communication is crucial in tackling these problems. It can foster awareness, shape behaviors, and encourage public compliance with effective sanitation methods (Obi, 2019). To address challenges in sanitation practices, Nigeria needs to implement effective communication strategies like public outreach campaigns, media efforts, and community involvement programs. These strategies can bridge the gap in knowledge and motivate people to follow proper sanitation habits (Eze & Okonkwo, 2023). However, certain obstacles hinder the success of these communication efforts, including misinformation, low public trust in government initiatives, and insufficient distribution of health information (Adebayo et al., 2022). Digital media, including radio, television, and grassroots activism, play a vital role in health communication. These platforms help shape public opinion, promote behavior changes, and enhance environmental sanitation practices. They are essential for achieving policy goals and initiating behavior change initiatives to address societal issues (Ezebuenyi & Ezeaka, 2015; Ezeaka & Nwodu, 2022).

This paper explores the nexus between environmental sanitation and health communication in Nigeria, focusing on the key challenges and opportunities for improvement. By examining existing policies, media interventions, and grassroots health communication strategies, this study aims to highlight effective approaches to mitigating sanitation-related health risks. The paper also underscores the importance of an integrated approach that combines government policies, media engagement, and community participation to achieve sustainable environmental sanitation outcomes. Addressing these challenges is critical for enhancing public health, reducing the burden of sanitation-related diseases, and fostering a healthier and more sustainable living environment in Nigeria (Ezeaka, Ezeoke, Nwodu & Umennebuaku, 2023; Ezeaka, & Umennebuaku, 2024).

Statement of the Problem

Environmental sanitation remains a critical public health concern in Nigeria, with far-reaching consequences for health, economic productivity, and overall quality of life. Despite global and national efforts to improve sanitation, Nigeria continues to face significant challenges in ensuring proper waste management, water sanitation, and hygiene practices. The country ranks among the nations with the highest burden of sanitation-related diseases, including cholera, typhoid, diarrhea, and malaria, which disproportionately affect vulnerable populations such as children, women, and low-income communities. The prevalence of open defecation, poor drainage systems, indiscriminate waste disposal, and inadequate access to clean water exacerbates the sanitation crisis, leading to frequent outbreaks of preventable diseases.

Despite the existence of various policies and programs aimed at improving sanitation, there is a persistent gap between policy formulation and implementation. Many sanitation initiatives suffer from weak enforcement mechanisms, limited financial investment, and lack of community participation. Moreover, rapid urbanization has led to overcrowding in cities, further straining existing sanitation infrastructure and worsening environmental health conditions. Rural areas are not spared, as many communities still rely on unsafe water sources and lack basic sanitation facilities, contributing to high morbidity and mortality rates associated with poor sanitation.

One of the major obstacles to improving sanitation in Nigeria is the ineffective communication of health and sanitation messages to the public. Many Nigerians remain unaware of the risks associated with poor sanitation due to inadequate public health campaigns, misinformation, and cultural barriers to behavioral change. In some cases, even when information is available, it is not effectively disseminated to marginalized and rural populations who need it the most. Traditional and digital media play a crucial role in shaping public attitudes toward sanitation, yet their potential remains underutilized in Nigeria’s health communication landscape. The lack of coordinated, evidence-based health communication strategies limits the effectiveness of public health interventions aimed at improving sanitation behavior.

Given these challenges, there is a need to examine the intersection of environmental sanitation and health communication in Nigeria to identify practical solutions for improving sanitation awareness and practices. This study seeks to investigate the barriers to effective sanitation management, the role of media and health communication in driving behavioral change, and potential strategies for enhancing public engagement in sanitation initiatives. Addressing these issues is crucial for reducing sanitation-related health risks and achieving sustainable public health outcomes in Nigeria.

Theoretical Framework

The Health Belief Model (HBM) serves as a suitable theoretical framework for understanding environmental sanitation and health communication in Nigeria. Developed in the 1950s by social psychologists at the U.S. Public Health Service, the HBM is a psychological model that explains and predicts health-related behaviors by focusing on individuals’ perceptions of health threats and the benefits of taking preventive action. This model has been widely used in public health to design interventions that encourage positive health behaviors, making it highly relevant to sanitation and hygiene practices.

Core Constructs of the Health Belief Model (HBM)

The HBM is based on six key constructs that influence individuals’ decision-making processes regarding health behaviors:

1. Perceived Susceptibility – This refers to an individual’s belief about their likelihood of contracting a disease due to poor sanitation. If people believe they are highly susceptible to diseases such as cholera or typhoid due to poor waste disposal or open defecation, they are more likely to adopt better sanitation practices.
2. Perceived Severity – This relates to an individual’s perception of how serious a disease and its consequences can be. If people perceive that contracting a sanitation-related disease could lead to severe illness, hospitalization, or even death, they may be more inclined to engage in preventive sanitation behaviors.
3. Perceived Benefits – This involves an individual’s belief in the effectiveness of a recommended health behavior in reducing disease risk. If the public understands that proper waste disposal, handwashing, and clean water usage significantly lower the risk of disease, they may be more willing to adopt such behaviors.
4. Perceived Barriers – These are obstacles that prevent individuals from adopting healthy behaviors. In Nigeria, barriers to proper sanitation may include lack of access to clean water, poor waste management infrastructure, financial constraints, and cultural practices that discourage certain hygiene habits. Addressing these barriers through effective communication and policy intervention is essential for behavior change.
5. Cues to Action – This construct refers to external triggers that prompt individuals to adopt healthy behaviors. Effective health communication, such as sanitation awareness campaigns, media messages, and community engagement, can serve as cues to encourage proper sanitation practices.
6. Self-Efficacy – This refers to an individual’s confidence in their ability to successfully adopt and maintain a health-promoting behavior. If individuals believe they can effectively practice sanitation habits such as proper handwashing or waste disposal, they are more likely to do so consistently.

Relevance of the Health Belief Model to the Study

The HBM provides a strong foundation for analyzing how people perceive environmental sanitation and how health communication can influence their behavior. This model is particularly relevant to Nigeria’s sanitation challenges for the following reasons:

1. Understanding Public Perception of Sanitation Risks – By applying the HBM, this study assesses how Nigerians perceive the risks associated with poor sanitation and how these perceptions influence their behaviors. Identifying gaps in awareness helps design more effective health communication strategies.
2. Guiding Health Communication Strategies – The model emphasizes the importance of cues to action, such as media campaigns and community education, in promoting positive sanitation behaviors. By understanding what motivates individuals to take action, policymakers and health communicators can develop targeted interventions.
3. Addressing Barriers to Sanitation Compliance – The HBM highlights perceived barriers that prevent people from adopting proper sanitation practices. Identifying and addressing these barriers—whether they are financial, cultural, or infrastructural will enhance the effectiveness of sanitation initiatives.
4. Encouraging Sustainable Sanitation Practices – By emphasizing self-efficacy, the HBM suggests that when individuals feel empowered and confident in their ability to maintain good sanitation practices, they are more likely to continue these behaviors long-term. Health communication efforts should therefore focus on providing practical, actionable steps that individuals and communities can implement.
5. Enhancing Policy Implementation – Policymakers can use insights from the HBM to design sanitation programs that align with people’s perceptions, motivations, and challenges. By ensuring that sanitation policies are not only scientifically sound but also socially and culturally relevant, the likelihood of successful implementation increases.

The Health Belief Model provides a valuable lens for understanding the relationship between environmental sanitation and health communication in Nigeria. By analyzing how people perceive sanitation-related risks, barriers, and benefits, this study proposes more effective communication strategies to improve sanitation behaviors. Incorporating the HBM into sanitation interventions help bridge the gap between knowledge and action, ultimately leading to better public health outcomes in Nigeria.

LITERATURE REVIEW

Environmental Sanitation in Nigeria

Environmental sanitation is a critical public health issue in Nigeria, influencing health outcomes, economic productivity, and overall societal well-being. Poor sanitation has been linked to the spread of waterborne diseases such as cholera, typhoid, diarrhea, and malaria, which disproportionately affect children and low-income communities (World Health Organization [WHO], 2022). According to the United Nations Children’s Fund (UNICEF, 2021), Nigeria accounts for a significant proportion of global open defecation, with millions lacking access to proper sanitation facilities. Despite the introduction of various sanitation policies and programs, such as the National Environmental Sanitation Policy, challenges in enforcement, funding, and community participation continue to hinder progress (Federal Ministry of Environment, 2021).

Rapid urbanization has further strained sanitation infrastructure, leading to the proliferation of informal settlements with inadequate waste disposal systems (Eze & Okonkwo, 2023). In rural areas, the absence of potable water and modern sanitation facilities contributes to persistent health risks (Obi, 2019). Addressing these issues requires a holistic approach that integrates sanitation policies, infrastructural development, and effective health communication strategies (Ezeaka, Ochuba & Bartholomew, 2025; Ezeaka, Nwodu & Bartholomew, 2025).

Health Communication and Behavioral Change in Sanitation

Health communication plays a crucial role in promoting sanitation awareness and encouraging behavioral change. Effective communication strategies such as public health campaigns, community outreach programs, and digital health interventions can significantly influence sanitation practices (Adebayo, Yusuf, & Johnson, 2022). Studies have shown that when sanitation messages are communicated clearly and tailored to specific cultural contexts, they are more likely to be adopted by target audiences (World Bank, 2020).

However, health communication in Nigeria faces several challenges, including misinformation, low literacy rates, and limited access to digital communication platforms in rural areas (Akinbami, 2021). While traditional media such as radio and television remain influential, digital media and social networks have emerged as essential tools for promoting sanitation awareness (Ogunyemi & Adewale, 2020). The effectiveness of health communication depends on the ability to reach diverse populations with accurate, engaging, and actionable messages. Communication can be a game-changer in a number of important areas by utilizing communication tools and approaches effectively (Ezeaka & Ochuba, 2024; Ezeoke, Ezeaka & Nwodu, 2020).

METHODOLOGY

This study uses a qualitative research method that analyzes existing data to examine the complexities and opportunities faced by environmental sanitation and health communication in Nigeria. Secondary data were obtained from peer-reviewed journal articles, government reports, policy documents, newspaper articles, reports from international organizations such as the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), and empirical studies on sanitation and public health in Nigeria.

The study used secondary research method to critically examine and provide a balanced and evidence-based discussion on Nigeria’s sanitation landscape, avoiding overgeneralizations by contextualizing the identified challenges and prospects with specific examples from diverse regions of the country.

Challenges of Environmental Sanitation and Health Communication in Nigeria

Despite efforts to improve environmental sanitation and public health awareness, several persistent challenges hinder effective implementation and behavioral change. These challenges include:

Weak Policy Implementation and Enforcement

Although Nigeria has established sanitation policies, enforcement remains weak due to corruption, poor governance, and inadequate funding (Federal Ministry of Environment, 2021). Many local government authorities lack the capacity to enforce sanitation laws, resulting in indiscriminate waste disposal, open defecation, and pollution of water sources (UNICEF, 2021). Without strong enforcement mechanisms, compliance with sanitation regulations remains low.

Cultural and Social Barriers

Cultural beliefs and traditional practices significantly influence sanitation behaviors in Nigeria. Some communities have long-standing habits that hinder the adoption of modern sanitation practices (Obi, 2019). For example, in certain rural areas, open defecation is still considered acceptable, and attempts to change these behaviors face resistance due to deeply ingrained cultural norms (Eze & Okonkwo, 2023). Effective communication strategies must consider these cultural factors to encourage behavioral change ( Ezeaka, 2024; Ezeaka & Nwafor, 2022). For instance:

Northern Nigeria: Cultural and religious beliefs may prevent women from using public toilets, resulting in more people defecating in the open.

Southern Nigeria: Residents often distrust government waste collection services, opting for traditional methods like burning or dumping in nearby areas.

Urban Slums: Attitudes towards waste management are influenced by poverty and lack of proper

infrastructure, rather than traditional customs.

Misinformation and Low Public Awareness

Many Nigerians lack adequate knowledge of the risks associated with poor sanitation due to misinformation and inadequate public health campaigns (Adebayo et al., 2022). In some cases, myths and misconceptions about sanitation persist, leading to unsafe practices (Ogunyemi & Adewale, 2020). Additionally, health messages often fail to reach marginalized and rural populations, leaving many unaware of best sanitation practices (Obiora, 2022).

Economic Constraints and Infrastructure Deficiencies

Poverty remains a significant barrier to improved sanitation, as many households cannot afford safe water, toilets, or proper waste disposal services (World Bank, 2020). Moreover, the high cost of infrastructure development limits government investment in sanitation facilities, particularly in rural and low-income urban areas (Akinbami, 2021). Without adequate infrastructure, sanitation-related diseases continue to thrive, placing additional burdens on healthcare systems. For instance: Infrastructure Disparities in Urban and Rural Areas: In Urban Areas, issues include overcrowding, rapid population growth, and poor waste management. Cities like Lagos and Kano face uncontrolled waste disposal, clogged drainage systems, and pollution, leading to flooding and disease.

Rural Areas: Lack of access to sanitation facilities and clean water sources, rural residents use polluted water and defecate openly, putting them at risk for waterborne diseases. The absence of toilets in rural schools limits hygiene education for children (Ezeaka, Ezeoke & Nwodu, 2020). To tackle the uneven distribution of resources, tailored interventions are needed. For instance, rural areas require expanded access to essential services like water, sanitation, and hygiene (WASH), while urban areas demand stricter waste management regulations and better infrastructure.

Limited Access to Effective Health Communication Channels

Although digital media and social platforms have the potential to enhance sanitation awareness, access remains limited in rural areas due to low internet penetration and high data costs (Ogunyemi & Adewale, 2020). Traditional communication methods, such as radio and community-based education programs, are often underutilized in public health campaigns (Adebayo et al., 2022). Ensuring widespread access to effective health communication is crucial for driving behavioral change. Access to information about proper sanitation varies widely in Nigeria:

In cities, sanitation messages through mass media may not reach those living in poor neighborhoods, due to limited education or lack of technology access.

In rural areas, traditional communication methods (e.g., town criers) are still important, requiring health campaigns to combine both digital and traditional channels to effectively reach communities.

Prospects for Improving Environmental Sanitation and Health Communication

Despite these challenges, there are significant opportunities for improving sanitation and health communication in Nigeria. Some key prospects include:

Strengthening Policy Implementation and Public-Private Partnerships

Enhancing policy enforcement and increasing government investment in sanitation infrastructure can improve environmental sanitation outcomes (Federal Ministry of Environment, 2021). Public-private partnerships can also help mobilize resources and expertise to develop sustainable sanitation solutions (World Bank, 2020). Countries that have successfully improved sanitation, such as Rwanda and South Africa, have leveraged strong policy implementation and multi-sectoral collaboration (UNICEF, 2021).

Community-Led Total Sanitation (CLTS) Programs

Community engagement initiatives, such as CLTS, have proven effective in reducing open defecation and promoting hygiene practices in rural communities (Obi, 2019). These programs encourage communities to take responsibility for their sanitation needs, leading to long-term behavioral change (Eze & Okonkwo, 2023). Expanding CLTS initiatives across Nigeria can help address cultural barriers and improve sanitation compliance.

Integration of Traditional and Digital Media for Health Communication

A combined approach that leverages traditional media (radio, television, community outreach) and digital platforms (social media, mobile apps, SMS campaigns) can enhance sanitation awareness (Adebayo et al., 2022; Ezebuenyi & Ezeaka, 2015). Studies have shown that multimedia health campaigns are more effective in reaching diverse populations and sustaining behavioral change (Ogunyemi & Adewale, 2020).

Health Education and School-Based Sanitation Programs

Incorporating sanitation education into school curricula can help instill proper hygiene practices from an early age (Akinbami, 2021). Children can serve as change agents, influencing household sanitation behaviors and promoting long-term adoption of hygiene practices (World Bank, 2020).

Investment in Water, Sanitation, and Hygiene (WASH) Infrastructure

Expanding WASH infrastructure, particularly in underserved communities, can significantly reduce sanitation-related diseases and improve public health (Federal Ministry of Environment, 2021). International development organizations and donor agencies can support Nigeria’s sanitation efforts by funding infrastructure projects and providing technical assistance (UNICEF, 2021).

CONCLUSION

Existing literature highlights the significant challenges facing environmental sanitation and health communication in Nigeria, including weak policy enforcement, cultural barriers, misinformation, economic constraints, and limited access to effective communication channels. However, there are also promising opportunities for improvement, such as policy strengthening, community-led sanitation programs, multimedia health communication strategies, school-based education initiatives, and increased investment in WASH infrastructure. Addressing these challenges through a multi-sectoral approach will be crucial for achieving sustainable sanitation and public health outcomes in Nigeria.

RECOMMENDATIONS

1. Revitalization of Monthly Environmental Sanitation Exercise

The Nigerian government should reintroduce and strictly enforce the monthly environmental sanitation exercise, which was once a nationwide practice. State and local governments should ensure mandatory participation by households, businesses, and markets, with penalties for non-compliance while traditional rulers and community leaders should be empowered to oversee compliance at the grassroots level, especially in rural areas.

2. Ban on Indiscriminate Waste Dumping with Community-Led Waste Collection Systems

A strict ban on roadside and open dumping of waste should be enforced in cities like Lagos, Abuja, Onitsha, and Kano, where improper waste disposal is a major issue. Local governments should support community-led waste collection initiatives by providing waste bins and designated disposal points. Also, introduction of waste-to-wealth programs, where communities can exchange plastic and recyclable materials for monetary incentives, should be implemented.

3. Provision of Public Toilets in Markets, Motor Parks, and Religious Centers

Open defecation is a serious problem in Nigeria, particularly in markets, motor parks, and religious centers. Government-private partnerships should facilitate the construction of affordable and well-maintained public toilets in these locations. Also, a small user fee can be introduced for maintenance, with local sanitation workers employed to ensure hygiene compliance.

4. Use of Nollywood and Social Media Influencers for Sanitation Campaigns

Since Nollywood movies and social media influencers have a massive impact on Nigerian audiences, they should be engaged in sanitation and hygiene awareness campaigns. Celebrities, musicians, and content creators should be incentivized to produce engaging sanitation-related content in local languages. TikTok, Facebook, WhatsApp, and Instagram campaigns can help spread messages on proper waste disposal and hygiene practices, especially among youth.

5. Creation of Local Sanitation Task Forces with Youth and Vigilante Groups

Community-based sanitation task forces, comprising youth groups, vigilante associations, and NYSC members, should be established to monitor and report sanitation violations. These task forces should work with local government environmental officers to ensure waste management compliance in their communities. Incentives such as stipends, training, and recognition programs should be introduced to encourage active participation.

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