A quarter 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 (2020) 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 health care facilities have no water services.


10% of health care facilities have no sanitation services.

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.

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
@claireekt: #SDG6 monitoring initiative seeks advisory group members. Read more on the TOR, closing date 23 Sept https://t.co/2RVyNLbBN6
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@claireekt: Revisting a range of strategy documents to consider ToC & targets/indicators - how do we link #infectionprevention M&E with other areas? Can countries perform data collection? Balance of process, outcomes, impact...Re-reading #WASH ToC too https://t.co/mrrK9cE7gw #globalmeeting
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@WorldVisionGH: The very reason @WorldVisionGH is dedicated to providing water, sanitation, and hygiene services to rural communities that lack them. Find out more: https://t.co/FkP9F6c7ro @WASH_FOR_HEALTH @WorldVisionUN #WASH #Ghana #transformation
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@washfid: The @WHO-@UNICEF Joint Monitoring Programme (JMP) has launched an updated report on #WASH services in Healthcare Facilities (#HCF). For the 1st time, we have a global estimate on hygiene services in #HCF. You can also check your country files https://t.co/H2z73j8R1q #WWWeek https://t.co/EBamx6d1Cw
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NEW @WHO @UNICEF report: ½ of health care facilities globally lack basic hygiene services with water & soap or alcohol hand rub. Around 3.85 billion people use these facilities incl 688m who receive care at facilities with NO HYGIENE SERVICES AT ALL https://t.co/R7LFnTIZft?
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@WHO: Without access to basic hygiene services, more than 3.8 billion people face greater risk of infection while using these facilities. Read more 👉https://t.co/93upvEkbkd https://t.co/yoLWYAS46h
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@WHO: Hygiene in healthcare facilities is key to pandemic recovery, prevention and readiness. The basics include: 🚰 safe water 🚽 clean toilets 🚮 safely managed waste Read more 👉https://t.co/93upvEkbkd https://t.co/bP9qLBMrZx
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