• Overview
  • Resources

WASH in Healthcare Facilities: An Overview

This overview presentation provides fundamental background knowledge on WASH in HCF.  We recommend viewing this presentation before participating in or viewing topic specific webinar sessions.  The objectives of this overview presentation are:

  1. Describe the scope of water, sanitation and hygiene (WASH) in healthcare facilities (HCF).
  2. Consider why WASH is a crucial component of a HCF.
  3. Discuss linkages between WASH in HCF and other health topics.
  4. Review WHO/UNICEF’s global action plan to address WASH in HCF.
  5. Consider ways to take action to address WASH in HCF.

A PDF of this webinar’s slides and additional useful resources can be found in the resources tab.

WASH in HCF Overview

Overview Slides PDF

Resources Referenced

  1. Environmental Health Standards in Health Care-WHO, 2008

Written by WHO for use by healthcare management staff, WASH professionals in healthcare settings, and health promoters, this document outlines environmental health standards in HCFs.   It provides guidance to assess environmental health and plan improvements, develop and reach environmental safety standards, and support development and application of national policies related to environmental health in HCFs.

  1. Water, Sanitation and Hygiene in Health Care Facilities: Status in Low- and Middle-income Countries and Way Forward-UNICEF, 2015

This report represents the first global assessment of the provision of WASH in HCFs, utilizing data from 54 LMICs and 66,101 facilities.  It also emphasis the existing gap in knowledge of the status of WASH in HCFs worldwide.  It describes the initiatives put forth by WHO and UNICEF to promote action on improving the status of WASH in HCFs globally with a focus on policy, staffing and funding, risk-based prioritization, and monitoring and evaluation.

3. Environmental Conditions in Health Care Facilities in Low- and Middle-income Countries: Coverage and Inequalities-Cronk, et.al. 2018

Recognizing an evidence gap in the understanding of WASH inequalities across HCFs, especially in LMICs, this paper focuses specifically on assessing issues related to low WASH coverage.  It compiled monitoring data to assess inequalities is environmental conditions and WASH service levels.  Findings identified significant inequalities between rural and urban HCFs.

  1. WASH for MatFrom Joint Thinking to Joint Action: A Call to Action on Improving Water, Sanitation, and Hygiene for Maternal and Newborn Health-Velleman, et al., 2014

This policy brief provides evidence of how maternity ward WASH impacts maternal and newborn health.  It calls for greater integration of WASH and health policy, states adequate WASH as a pre-requisite for ensuring safe and quality healthcare, and illustrates the need for more implementation research for effective WASH improvements both at home and in HCFs.

  1. Availability and Satisfactoriness of Latrines and Hand Washing Stations in Health Facilities, and Role in Health Seeking Behavior of Women: Evidence from Rural Pune district, India-Steinmann, et al., 2014

This paper explores the role of the quality of WASH infrastructure in HCFs and how it impacts health seeking behavior, such as the decision to visit an HCF.  In Pune, Inda, WASH infrastructure was found to be an important component of overall HCF ‘cleanliness’, but not the dominating influencing factor in choosing an HCF.  Overall, women perceived private HCFs to be better equipped with WASH infrastructure than public and government run HCFs.

  1. Water, Sanitation and Hygiene Infrastructure and Quality in Rural Healthcare Facilities in Rwanda-Huttinger, et al,. 2017

This paper serves as an example of inequalities that may exist regarding access to WASH in HCFs between patients, staff and caregivers in LMICs.  In Rwanda HCFs, access to water largely met national standards, but fell short of WHO environmental standards for sanitation and hygiene.  Access to WASH infrastructure also varied for patients, staff, and caregivers.

  1. Unpacking the Enabling Factors for Hand, Cord and Birth-surface Hygiene in Zanzibar Maternity Units-Gon, et al., 2017

This paper highlights unsafe conditions that may exist in birthing rooms and maternity wards (such as untrained staff, lack of water for caregiver hand hygiene, and unclean birthing surfaces) which are associated with puerperal and neonatal, and sepsis.  The methodology of research and quality improvement strategy presented offer insight for developing effective strategies at both facility and MoH levels, which aim to improve infection prevention and control in maternity wards.

  1. Hospital-acquired Neonatal Infections in Developing Countries-Zaidi, et al., 2005

This review paper highlights the increased risk of infections faced by hospital-born babies in developing countries, due to poor infection prevention and control practices. Additionally, it discusses the challenges of treating such infections in low-resources settings, as well as challenges to developing and implementing effective interventions.  It also discusses the potential of evidence-based, low-cost, “bundled”, systems improvement approaches to improve infection prevention and control in hospitals

  1. Expert Group Meeting on Monitoring WASH in Health Care Facilities in the Sustainable Development Goals-WHO/UNICEF, 2016

Main outcomes from this expert group meeting report convened by WHO/UNICEF include recommended service ladders, normative definitions of core indicators for “basic” service, recommended core monitoring questions, and structure for mapping core questions to the service ladders.