Frontline health facilities faltering without water, sanitation, hygiene and electricity – new WHO, UNICEF report

Categories - publications

Water, Sanitation, Hygiene, Waste and Electricity Services in Health Care Facilities: 2023 Global Progress Report highlights that an estimated 8 million people die annually in 137 low- and middle-income countries from poor-quality care, resulting in US$6 trillion in economic losses from poor health and premature mortality.  A major contributor to high quality health care is WASH services and electricity. Interventions such as improving availability of hand hygiene and drinking water stations, regular cleaning, functioning toilets and a regular on-site water supply which can improve services, staff performance, and dignity of health care facility users.

“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,” said Dr Maria Neira, Director of the Department of Environment, Climate Change and Health at WHO. “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.”

On average, basic WASH services cost only 60 US cents per person each year in the least developed countries, or just 6% of current annual government health spending. As the risk As the risk of  future pandemics, climate change, and geopolitical insecurity and conflict, investment is more critical than ever. Yet lack of financing remains an obstacle. Currently, just 12% of countries have more than 75% of funds needed to reach targets for WASH in health care facilities.

During childbirth, hygiene – and WASH services more generally – have critical impacts on the health of mothers and babies. Lack of WASH services increases the risk of infection, particularly sepsis, which can be deadly for children and mothers. More than 1 million women and girls indicated that WASH services are their second most important demand for quality reproductive and maternal health, after dignified and respectful care.

“Latest data reveals that 5 million children lost their lives before their fifth birthday from preventable causes, half of which were newborns,” said UNICEF Director of Water, Sanitation, and Hygiene and Climate, Energy, Environment and DRR Cecilia Scharp. “Many of these deaths are preventable by a solution as simple as safe water and soap. Safely managed water and sanitation services where babies are born will contribute to saving lives of millions of children and mothers each year.”

Approximately 43% of these newborn deaths occurred in sub-Saharan Africa, where only half of health care facilities have a water source on site. In addition, global progress in reducing maternal mortality stalled between 2016 and 2020. If the world continues on this trend, it will not meet the Sustainable Development Goal to reduce preventable maternal mortality by more than 1 million lives by 2030.

An online tracking mechanism is providing valuable insights on where country progress is greatest, with over 70% of 73 reporting countries having established baseline data, updating and implementing health care waste and WASH standards, including with a climate resilience focus. However, less than 1 in 5 countries have undertaken national infrastructure improvements or are tracking and using WASH data within health management information systems.

In order to rapidly improve WASH, waste, and electricity services in health care facilities, WHO and UNICEF call on partners to come together to implement the recommendations of this new report by:

  • Addressing financial obstacles.
  • Integrating WASH, waste and electricity services into health planning.
  • Developing and empowering the health workforce to deliver and maintain WASH, waste and electricity services, and practising good hygiene
  • Strengthening accountability by regularly monitoring and reviewing progress.

Representatives from over 30 countries are convening in Amman, Jordan today as the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) co-host a global summit on Water, Sanitation, and Hygiene (WASH) and waste management in health care facilities, providing a vital platform to discuss the report’s findings, consolidate country insights, and strategize with health leaders on implementing key recommendations and scaling up solutions.

Read the report here.

Executive Summary (French)

Executive Summary (Arabic)