FUNDAMENTALS
FIRST

WHO and UNICEF have released a new comprehensive summary of global progress on improving WASH in health care facilities.

READ THE REPORT

This new report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services.

This means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.

Report recommendations

Implement costed national roadmaps with appropriate financing.
Monitor and regularly review progress in improving WASH services, practices and the enabling environment.
Develop capacities of the health workforce to sustain WASH services and promote and practice good hygiene.
Integrate WASH into regular health sector planning, budgeting and programming to deliver quality services, including COVID-19 response and recovery efforts.

8 Practical Steps to
Achieve Universal Access to Quality Care

1. Conduct situation analysis and assessment

Conduct situational analysis of enabling environment for WASH in health care facilities (specifically health and WASH policies, governance structures, institutional arrangements, funding streams and stakeholders). Assess WASH coverage and compliance.

2. Set targets and define roadmap

Set detailed targets (with a national costed roadmap) to address gaps, and estimate costs (capital investments, rehabilitation and recurrent costs). A joint WASH and health taskforce or technical working group is an effective mechanism to help set these targets and develop a roadmap.

3. Establish national standards and accountability mechanisms

Develop standards (a set of requirements that dictate the infrastructure and resources necessary to provide sustainable WASH services) and implement using accountability mechanisms (regulation, accreditation, licensing, community scorecards, feedback mechanisms).

4. Improve infrastructure and maintenance

Select, install, operate, maintain and improve WASH infrastructure, (including through use of WASH FIT) to ensure sufficient, functioning WASH services are available.

5. Monitor and review data

Track the status or progress of WASH interventions by monitoring and reviewing indicators on a regular basis, including through national health monitoring information systems.

6. Develop health workforce

Invest in a well-trained and well-supported health workforce to enable health systems to perform well and to respond appropriately to challenges.

7. engage communities

Give community members and organizations agency in decision-making and management of services to ensure that health care facilities provide the level of care that citizens deserve and expect.

8. Conduct operational research and share learning

Generate evidence to understand the problem and what to do about it and scale-up proven improvement approaches.

The pandemic is a reminder of the intimate and delicate relationship between people and the planet. Any efforts to make our world safer are doomed to fail unless they address the critical interface between people and pathogens, and the existential threat of climate change, that is making our Earth less habitable.

- WHO Director-General Dr Tedros Adhanom Ghebreyesus. Address to the 73rd World Health Assembly (18th May 2020).

Water, sanitation and hygiene is a fundamental human right. There is no place where such services are more important, than in health care facilities, especially during the COVID-19 pandemic which is ravaging our communities. I call on all countries and national authorities to act now and invest in universal WASH in health care facilities.

- Madam Fabiola Yáñez, First Lady of Argentina

Water, sanitation and hygiene services in health facilities are the most basic requirements of infection prevention and control, and of quality care. They are fundamental to respecting the dignity and human rights of every person who seeks health care and of health workers themselves.

- Antonio Guterres, UN Secretary General

During these unprecedented times, it’s even more clear how fundamental WASH is for prevention of infections and improving health outcomes. We must work even closer together to ensure that WASH is included in all interventions and at scale. COVID-19 provides a new entry point to build on