The establishment and enforcement of national policies and standards for WASH in health care facilities provides an important foundation for improving services. WHO Essential Environmental Standards in Health Care (2008) serve as a basis for establishing national standards and there are several examples of governments (e.g. Mongolia, Laos, Vietnam) which have recently adapted these to their own contexts and needs. The standards cover: water quality, water quantity, water facilities and access to water, excreta disposal, wastewater treatment and disposal, health-care waste disposal as well as other environmental issues.
A number of tools are being developed to help implement these standards at the facility level. WHO have developed WASH FIT. This tool (previously named WASH Safety Plan), which is based on the Water Safety and Sanitation Safety Approaches, provides a range of ready-to-use tools to help identify risks and prioritize improvements for water, sanitation and hygiene (WASH) services, and related safety aspects, in small health care facilities in low income settings. WASH FIT has been used in Chad, Liberia and Mali. A formal review process of the methodology is taking place in the first quarter of 2016. A final version of the document will be published in English and French in Q3, 2016.
At the Global Meeting in March 2015, a number of facility assessment and improvement tools were presented. These tools have been tested and implemented in a variety of settings including Ethiopia, Rwanda, Uganda, Zanzibar, India and Cambodia. A summary of these tools and their implementation can be found in the Global Meeting Report (Geneva 2015).