A 3-year project (January 2015-December 2017), Supporting Water, Sanitation & Hygiene (WASH) in Healthcare Facilities (HCF) in Mali, is currently underway to support sustainable access to safe water for an estimated 66,000 individuals accessing health clinics in rural districts of Koro (Mopti circle) and Bla (Ségou circle) in Mali.  The project is a joint effort between the Ministry of Health, WHO, WaterAid and the US CDC with financial support from the Hilton Foundation. The targeted areas were selected because they contain many of the “poorest of the poor” and face challenges accessing safe and sustainable water. Nationally, 61% of facilities have poor water quality (water turbidity and lack of chlorination), 24% have an insufficient quantity of water and 68% have insufficient handwashing facilities.

The objectives of this project (which focuses on both local as well as national efforts) are to 1) conduct a situational analysis on WASH in health care facilities and recommend actions to improve access; 2) provide short- and long-term WASH services in health care facilities; 3) build capacity to operate and maintain long-term safe, sustainable water services and monitor and evaluate our intervention; and 4) increase planning and coordination between local governments and implementing partners to strengthen the enabling environment.


Infrastructure improvement and behaviour change

WaterAid and CDC have made significant improvements in WASH infrastructure in the selected facilities, including the rapid installation of 76 hand hygiene and drinking-water stations, 15 boreholes with safe, elevated storage and 10 dual chamber incinerators. Efforts have been made to use local technologies that also are environmentally friendly (i.e. solar energy for water pumping). CDC is conducting a health evaluation to determine the impact of these improvements on maternal and newborn mortality. While it is still early to assess behavior change, awareness raising and training activities conducted, coupled with water hardware, have had an impact on handwashing and healthcare waste management among healthcare workers and patients. In addition, the patients and their families have solicited demonstrations of good hygiene practices in their communities.


Capacity building

A number of trainings involving nearly 100 people have taken place on hand hygiene, health care waste and more broadly use of WASH FIT (Water and Sanitation for Health Facility Improvement Tool)  to prioritize, maintain and further improve WASH in health care facilities. A national trainer of trainers took place in May 2016 to disseminate the tool further among other partners working to improve WASH in health care facilities including the Red Cross, UNICEF, USAID and Terre des Hommes. Key lessons learned from the training include the importance of providing hands-on skill development within facilities, supporting ongoing learning and exchange among the facilities, and having more technical support for health care waste which is often a neglected issue.


Policy dialogue

In early 2016, WHO facilitated the establishment of a national taskforce on WASH in HCF to share lessons learned, tools and better synergize efforts with existing Government initiatives. The task force meets every 3-4 months. In addition, WHO facilitated a national workshop on transitioning to the Sustainable Development Goal on water and sanitation in March 2016 which included dedicated sessions to WASH in HCF as the WHO/UNICEF Joint Monitoring Programme will now be regularly reporting on access to WASH in HCF. A team from Mali took part in an 8-country West African regional WASH FIT workshop (Senegal, June 2016) at which they shared an update of implementing WASH FIT and further developed their national action plan on WASH in HCF. A mid-project workshop took place in November 2016 with participants from national, regional and district level. Participants shared updates on progress to date, highlighting successes and challenges, and worked on action plans for the remainder of the project. 


Updated 1 March 2017.