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Introduction

Water, sanitation and hygiene (WASH) in health care facilities are fundamental for the provision of quality, people-centered care. Such services also reduce health care-related infections, increase trust and uptake of services, increase efficiency and decrease cost of service delivery and improve staff morale. All major initiatives to improve global health depend on basic WASH services in health care facilities.

In low- and middle-income countries, WASH services in many health care facilities are absent. Data from 54 countries, representing 66,101 facilities show that 38% of health care facilities do not have an improved water source, 19% do not have improved sanitation and 35% do not have water and soap for handwashing. This lack of services compromises the ability to provide safe and quality care and places both those providing and those seeking care at considerable and preventable risk.

It is becoming increasingly obvious that major health goals cannot be achieved without a strong focus on quality care.  This is especially true in health areas where progress has been slow, such as reducing maternity and neonatal mortality and preventing infectious disease outbreaks such as cholera. The health focused Sustainable Development Goal (Goal 3) provides an important platform by which to address quality as do a number of global strategies including those on Universal Health Coverage and the Every Newborn Every Mother action plan. 

One important and foundational element within the health systems building blocks is water, sanitation and hygiene services (WASH).  While this may seems obvious, often aspects of WASH and the accompanying practices of handwashing, cleaning, safe waste management and other critical infection prevention and control practices are lacking. In both high and low-resource settings, whether the goals is to reduce antimicrobial resistance or maternal and newborn mortality or both, aspects of WASH and infection prevention and control can and should be improved.

 

Urgent action is needed to improve WASH services and practices in health care facilities globally. WHO, UNICEF and partners committed at a global meeting in March 2015 to address the situation.

The vision is to provide access to WASH services in all facilities, in all settings by 2030, with a special attention to the needs of women, girls and children.