Water, sanitation and hygiene in health care facilities

The term “WASH in health care facilities” refers to the provision of water, sanitation, health care waste management, hygiene and environmental cleaning infrastructure, and services across all parts of a facility. “Health care facilities” encompass all formally- recognized facilities that provide health care, including primary (health posts and clinics), secondary, and tertiary (district or national hospitals), public and private (including faith-run), and temporary structures designed for emergency contexts (e.g., cholera treatment centers). They may be located in urban or rural areas.

Why WASH services are a priority in health care facilities

The availability of WASH services, especially in maternity and primary-care settings where they are often absent (3, 4), supports core universal health care aspects of quality, equity, and dignity for all people. Basic WASH services in health care facilities are fundamental to providing quality care and for ensuring that primary health commitments, as detailed in the Astana Declaration, are achieved (5,6). It can also improve health outcomes at the community level.

Make childbirth and primary care safer

More than one million deaths each year are associated with unclean births, while infections account for 26% of neonatal deaths and 11% of maternal mortality (7,2). Most of these deaths are concentrated in low- and middle-income countries where the rates of health care associated infections (HCAI) are twice that of high-income countries (8). An estimated 15% of patients in low- and middle-income countries develop one or more infections during a hospital stay (8). Many of these patients are women who come to health facilities to deliver. If a woman lives in a country with a high rate of neonatal mortality, her infant faces a risk of sepsis- related neonatal mortality 34 times greater than in countries with a low rate of neonatal mortality (9).

Although not all HCAI can be traced to inadequate WASH services, evidence shows that lack of access to WASH in health care facilities may significantly compromise safe childbirth and access to primary health care (4). A recent review of nationally-representative health care facility data from four East African Countries found that fewer than 30% of delivery rooms had access to water (10). Previous estimates from United Republic of Tanzania (3), India, and Bangladesh (4) noted similar gaps. In short, far too many pregnant mothers are required to bring their own water to wash themselves and their baby following birth.

Source: Water, sanitation and hygiene in health care facilities: practical steps to achieve universal access. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.

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