One in five of all health care facilities have no basic water services.

We aim to change that.

Learn more about WHO and UNICEF’s work to improve WASH in health care facilities.

The latest data (2021) highlights major global gaps in WASH services


Half of health care facilities do not have basic hygiene services 


One in five health care facilities lack basic water services


One in ten health care facilities have no sanitation services 

Globally, 3.85 billion people lacked a basic hygiene service at their health care facility, 1.7 billion people lacked a basic water service at their health care facility, and 780 million people had no improved toilets at their health care facility

Based on 73 countries reporting on the practical steps in 2023, progress is greatest in establishing baselines (85%), updating and implementing health care waste standards (80%) and WASH standards (70%), and conducting situation analyses (66%). Although 64% of these countries have drafted costed roadmaps, only 15% have validated and are implementing them with dedicated resources.

Content of the 2023 Global Progress Report

  • Reporting on country progress in implementing national actions (“practical steps”) articulated in the 2019 World Health Assembly Resolution on WASH in HCF, including data from 73 countries;
  • Insights into successful approaches and challenges from country experiences in improving and sustaining WASH in health care facilities;
  • Key gaps for priority action at the global, national and facility levels to accelerate progress and support wider health efforts on improving quality of care;
  • Recommendations in three main areas of action to drive investment into sustainable and high quality services

We are often given the excuse that public health problems are too costly to fix, but we now understand that providing basic WASH and energy to health care facilities, while non-negotiable is also affordable. We have no excuses and time is running out. Basic infrastructure is a prerequisite to quality of care. and is essential for life-saving practices

WHO Director of the Department of Environment, Climate Change and Health, Dr Maria Neira, 2023.

Eight 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.

Related resources: Cambodia Situation Analysis and WASH Assessment in the Gaza Strip

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.

Related resources: Ghana National Strategy for WASH-IPC in HCF

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).

Related resources: Guidelines for Climate-Resilient and Environmentally Sustainable Health Care Facilities in Fiji

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.

Related resources: Case studies of WASH FIT implementation

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.

Related resources: Uganda HMIS Review Report

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.

Related resources: Zambia IPC-WASH Training Manual

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.

Related resources: Focus Group Discussions in Indonesia

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.

Related resources: Implementing the Clean Clinic Approach Improves Water, Sanitation, and Hygiene Quality in Health Facilities in the Western Highlands of Guatemala

Water, sanitation and hygiene is a fundamental human right. There is no place where such services are more important, than in health care facilities…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