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

Across the world’s 46 Least Developed Countries, the problem is much 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.

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).

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, 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

Follow our Twitter feed for updates

WASH FOR HEALTH wash_for_health
@DrMariaNeira: Here we are! @COP27P the whole Global Health Community is mobilized! From @DrTedros to the most isolated health care profesional! All here as decisions will have a big impact on our health! @WHO
h J R
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@danrodmanjones: Thank you @ingerashing @SaveCEO_Intl for highlighting impacts on women, children & adolescents' health when they don't have clean water, decent toilets & hygiene. It's astonishing to me how little this is talked about in #globalhealth, yet it's so vital to #HealthForAll. #WHS2022
h J R
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@globalhealth_de @WorldHealthSmt @WHO @DrRudiEggers @PaulZubeil @BMG_Bund @allegranzib @OECD @ChariteBerlin & @DrMariaNeira concludes addressing the elephant in the room - all this against a reality where 3.8billion people (yes 3.8 billion) access health care without basic hand hygiene facilities - no IPC & no quality care without investment in #WASH in health care
h J R
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@globalhealth_de: New WHO page on infection prevention and control (IPC) Country Stories was announced in the #WHS2022 session on making the business case for investments in IPC in #healthcare 🔗WHO page 🔗Session @WorldHealthSmt @WHO #investinhealth
h J R
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@claireekt: For use at national and sub-national level, this new tool can be used to track processes & the quality of strategies and plans. A simple, easy to follow tool that provides prompt questions to cross sector #handhygiene improvement #GlobalHandwashingDay2022
h J R
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@HandwashingSoap: Today is #GlobalHandwashingDay! The time to accelerate hand hygiene is now - and it requires collective action to enact real change. As we move beyond COVID-19 to our new normal, we must #UniteforUniversalHandHygiene. Share what you're doing this Global Handwashing Day below!
h J R
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@unicef_bissau: Happy #GlobalHandwashingDay! Building on the progress made from previous years, we must #UniteforUniversalHandHygiene to ensure hand hygiene access and practice for everyone, everywhere. #WashYourHands
h J R
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@claireekt: Today I had the privilege to present on this new, unique tool. More importantly heard from leadership in Nigeria & Ethiopia who say they wish they had the chance to use the tool earlier. The insights into those who are involved in making real progress in communities is inspiring
h J R
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@HandwashingSoap: Check out the Hand Hygiene Acceleration Tool here: Countries can use this tool to #UniteforUniversalHandHygiene, tracking processes to develop #handhygiene roadmaps and assessing the quality of content in those strategies and plans #GlobalHandwashingDay
h J R