Health is wealth. To enjoy this wealth, there are certain conditions, which are increasingly being ignored or compromised for lack of a proper system. Healthcare facilities may be primary, tertiary, public, private, specific, or temporary, but they cannot be properly exercised if adequate water, sanitation, and hygiene (WASH) amenities, including waste management and environmental cleaning services, are not in place.
In the absence of WASH services, infection prevention and control are severely compromised. Consequently, efforts to improve maternal, neonatal, and child health are undermined, giving birth to unnecessary use of antibiotics, thereby causing antimicrobial resistance to spread.
Joint Report by WHO and UNICEF
According to a joint report, published by the WHO and UNICEF, WASH services in many facilities across the world are missing or substandard. As per data from 2016, an estimated 896 million people globally had no water service at their healthcare facility. More than 1.5 billion had no sanitation service. One in every six healthcare facilities was estimated to have no hygiene service. Similarly, waste management and environmental cleaning was not adequate across the board.
Global Targets
In order to reach the global targets, a World Health Assembly (WHA) Resolution, passed in May 2019, can be expected to accelerate domestic investments so as to reach the global targets. These targets include—(i) ensuring that at least 60 per cent of all healthcare facilities have basic WASH services by 2022; (ii) at least 80 per cent have the same by 2025; and (iii) 100 per cent of all facilities provide basic WASH services by 2030.
Therefore, efforts are being made in WHO’s South-East Asia region to tackle the problem and achieve related Sustainable Development Goal (SDG) targets. At a WHO-supported meeting in New Delhi, it was particularly outlined that improving WASH services in healthcare facilities is crucial to accelerating progress towards each of the region’s ‘flagship priorities’, especially the achievement of universal health coverage. Improvement in WASH services would enhance the quality of primary healthcare services increasing equity and bridging the rural-urban divide.
Measures to be Taken
Now, all the member states should implement each of the WHO and UNICEF recommendations, which are as follows:
(i) Health authorities should conduct in-depth assessments and establish national standards and accountability mechanisms, because lack of baseline data limits authorities’ understanding of the problem. Health authorities should create clear and measurable benchmarks to improve and maintain infrastructure for facilities.
(ii) Health authorities should increase engagement and work so that a culture of cleanliness and safety may develop.
(iii) Information campaigns, targeting facility administrators, should be made public as much as possible in order to practise current WASH and infection prevention and control procedures (IPC). Modules on WASH services and IPC should be included in pre-service training and on-going professional development. Authorities should closely interact with communities, especially in backward areas.
(iv) Authorities need to work closely with people in rural areas to promote demand for WASH services.
(v) Data on key WASH indicators should be routinely maintained to help accelerate progress by promoting continued action and accountability. Once the links between policies and outcomes are documented, it will also spur innovation. Therefore, WHO is working with member states and key partners to develop a data dashboard to bring together and track indicators on health facilities, such as WASH services at primary care level. Securing safe health services is an objective that must be boldly pursued.
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