The Issue

Latest WHO/UNICEF data show that there are major global gaps in water, sanitation and hygiene (WASH) services in health care facilities.

3.85 billion people use facilities that lack basic hand hygiene services

1.7 billion people use facilities that lack basic water services

780 million facilities use facilities with no sanitation services.

Across the world’s 46 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.

WASH services in health care facilities, so often taken for granted, are needed more than ever to protect vulnerable patients and health workers.

Read the report

Explore the latest data

Least Developed Countries:


of health care facilities
have basic water services


of health care facilities have basic hygiene services


of health care facilities have basic sanitation services 


 of health care facilities have basic health care waste management services

Global data:


countries have basic water data (increase from 52 in 2020)


countries have basic hand hygiene data (increase from 21 in 2020)


countries have basic sanitation data (increase from 27 in 2020)


countries have basic healthcare waste management data (increase from 58 in 2020) 

What do we know work for countries to improve WASH?

Countries should undertake efforts at the sub-national and national level to implement the eight practical steps, and in particular:

  • Implement costed national roadmaps with appropriate financing
  • Monitor and regularly review progress in improving WASH services, practices and the enabling environment.
  • Develop capacities of the health workforce to sustain WASH services and promote and practice good hygiene.
  • Integrate WASH into regular health sector planning, budgeting and programming to deliver quality services.
Head of the Pediatrics Department Dr Ghazaryan vigorously disinfects her hands with sanitizer during a patient exam at Wigmore Clinic in Yerevan, Armenia on 8 November 2021. Like many countries, Armenia is confronted with the public health challenge of antimicrobial resistance (AMR). However, the country is taking steps to curtail the overuse of antimicrobials (antibiotics, antivirals, antifungals, and antiparasitics). With funds from the European Union, WHO’s Regional Office for Europe has assisted Armenia’s Ministry of Health to improve guidelines on the management and treatment of common infections (including community-acquired pneumonia, pharyngitis, urinary tract infections, ear infections), and COVID-19. WHO and the Ministry of Health are introducing these guidelines to primary health care providers throughout Armenia. The guidelines include information on the rational use of antimicrobials to help practitioners orient themselves quickly, and follow a unified approach to treatment, while also considering individual factors. Professionals like Doctor Hrachuhi Ghazaryan, Head of Pediatric Service at the Wigmore Clinic, have introduced these improved guidelines to over 1600 local general practitioners, family doctors and pediatricians, therefore raising AMR awareness. The pediatric service at the pediatric service at the Wigmore Clinic, in the center of Yerevan, was established in 2018. Since then, it has become one of the leading pediatric services in the country for treating complicated pediatric medical conditions. The team treats around 150 children as outpatients daily and cares for up to 20 children in the wards. Over the course of a year, around 1500 children are treated in the pediatric inpatient department. Wigmore Clinic is privately owned; however, most pediatric services can be accessed with a state-issued prescription. Their main goal is to provide high-quality, accessible health care for all children but because of the sharp rise in patients in the last two years, they consistently experience bed shortages during high morbidity seasons.

Metrics for success

Situational Analyses

By 2021, all countries have completed situational analyses


By 2026, 75% of countries have standards which seek to provide the safest and most climate resilient, low-carbon sustainable services

Integration with Health

By 2023, all countries have included WASH in health plans, budgets, and implementation efforts

Costed Roadmaps

By 2026, 80% of countries are implementing costed roadmaps with regular, dedicated resourcing

At least 80% of facilities have basic WASH services
Universal access to basic WASH services