APPLICATION OF AN INTEGRATED ENVIRONMENTAL HEALTH RISK ASSESSMENT FRAMEWORK IN SELECTED NIGERIAN CHILDCARE FACILITIES: RISK CHARACTERIZATION, CORRECTIVE ACTION PRIORITIZATION, AND A PROPOSED INSPECTION AND ENFORCEMENT SYSTEM

Background: Risk-based inspection can help regulators direct limited resources toward childcare facilities with the greatest environmental health concerns. This study applied a previously validated 72 item, six domain environmental health risk assessment framework to selected childcare facilities and developed a proposed corrective action and inspection prioritization system. 
Methods: The framework was applied to 30 childcare facilities across six states or regions, three facility settings, and four ownership types. Composite and domain level scores were summarized descriptively. Each facility's highest scoring domain was identified as its priority domain. High- and Critical risk facilities were ranked for corrective action, and a provisional risk tiered inspection and escalation model was developed. 
Results: Mean composite risk score was 44.7 (SD 11.3). Urban facilities had the highest mean score (47.2), followed by peri urban (45.4) and rural facilities (41.5). Community-owned facilities had the highest mean score (50.8), while faith based facilities had the lowest (40.6). Structural and Physical Safety was the most frequent priority domain (9 of 30 facilities). Thirteen facilities (43.3%) were classified as High or Critical risk. 
Conclusion: The framework identified facility- and domain-specific priorities and offers a structured basis for corrective action prioritization. Because the analysis uses the same 30-facility sample as the validation study and the proposed inspection system has not been piloted, the findings and operational model should be treated as descriptive and provisional.