Improving and managing WASH services require strong and consistent monitoring mechanisms to measure progress and direct efforts where needs are greatest. WASH in HCF is captured in the SDG framework within Goal 6. The terms “universal” and “for all” in Targets 6.1 and 6.2 highlight the need for expanding WASH monitoring from the household level to non-household settings, such as schools and healthcare facilities, as we progress from the MDGs to the SDGs.

Monitoring is required at both the global/national level and at the facility level. At present, a number of different survey instruments exist which need harmonizing. A short set of core questions that can be reported systematically to enable country comparisons is needed.

For global purposes, the challenge is to identify a minimal, or core set of indicators that map against the essential elements in WHO normative guidelines, and that can be collected with reasonable effort. Water, for example, has many uses in health care facilities, which makes it difficult to distill into a small number of questions. A set of service ladders are also needed.

For national and sub-national monitoring with additional capacities and interests, an expanded set of questions can guide monitoring of additional criteria beyond the “basic” service level. This expanded set of indicators, with greater scope and flexibility are being developed which would allow full (or nearly full) monitoring of normative guidelines.