In 2015, for the first time, WHO and UNICEF assessed the status of WASH in
health care facilities in low- and middle-income countries1. With a significant
proportion of facilities without any services at all, WHO, UNICEF and
partners committed at a global meeting2 to address the situation, with the
aim of achieving universal access in all facilities, in all settings.
Water, Sanitation and Hygiene
(WASH) in Health Care Facilities
Global Action Plan
A GLOBAL ACTION PLAN,
with five change objectives,
has been developed. In the
first phase of this work, four
task teams (comprised of
health and WASH specialists)
are working to address the
change objectives and product
tangible deliverables. Task
teams include: Advocacy,
Action and Leadership;
Monitoring; Evidence and
Operational Research; and
Policies, Standards and
Facility-based Improvements.
Multiple benefits of adequate WASH in health care facilities
Reduced health care acquired infections
Reduced anti-microbial resistance
Improved occupational health and safety
Facilities better
prepared to continue
to provide WASH in
disasters; climate
related events
More efficient
services
Disease/deaths
averted
Health and
Safety
Climate
change
and disaster
resilience
Healthcare
costs
Health staff model good
behavior; improved hygiene
practices at home
Disease
prevention and
treatment
WA S H
Community
WASH
People
centered care
Outbreak prevention and
control (e.g. cholera, Ebola)
Diarrheal disease prevention
and control
Staff
morale and
performance
Improved satisfaction
and ability to provide
safe care
Increased uptake of services;
e.g. facility births, vaccinations
Change Objectives
WASH in health care facilities is prioritized as a necessary input to achieving all global and national health goals especially as those linked to
Universal Health Coverage. Key decision makers and thought leaders champion WASH in health care facilities.
All countries have national standards and policies on WASH in health care facilities and dedicated budgets to improving and maintaining services.
Global and national monitoring efforts include harmonizing core and extended indicators to measure WASH in health care facilities.
The existing evidence base is reviewed and strengthened to catalyze advocacy messages and improve implementation of WASH in health
care facilities.
Health care facility staff, management and patients advocate for and champion improved WASH services. Risk-based facility plans are
implemented and support continuous WASH improvements, training and practices of health care staff.
CO 1
CO 2
CO 3
CO 4
CO 5
1 WHO/UNICEF, 2015, Water, sanitation, and hygiene in health care facilities: status in low and middle-income countries and way forward. Report. http://www.who.int/water_sanitation_health/publications/
wash-health-carefacilities/en/
2 WHO/UNICEF, 2015. Water, sanitation and hygiene in health care facilities: urgent needs and actions. Meeting Report. http://www.who.int/water_sanitation_health/en/
WASH HEALTH CARE FACILITIES
in
for better health care services
Gl ob al Ac t ion P l a n Ta s k Te a m s a n d Ac t i v i t i e s
ADVOCACY LEADERSHIP AND
ACTION
Change
Objective 1
EVIDENCE AND OPERATIONAL
RESEARCH
MONITORING
Change
Objective 2
Change Objective 3
POLICY, STANDARDS AND
FACILITY IMPROVEMENTS
Change Objective 4
Change Objective 5
Aim: To advocate for global
and national action to improve
WASH in health care facilities
and support the leaders
dedicated to this effort.
Aim: To develop, test and
revise core and extended
indicators to track WASH in
health care facilities.
Aim: To draw on and extend
the evidence base to support
increased investments,
quality improvements and
advocacy efforts.
Aim: To develop a suite of
field-tested tools, training
and reference materials for
a variety of facilities and
settings.
Activities
Document national case studies
including processes and change
mechanisms for improving WASH
in health care facilities.
Activities
Core and extended indicators
incorporated into all
relevant WASH and health
monitoring and accountability
mechanisms.
Activities
Develop priority operational
research agenda and seek
opportunities to address the
evidence gaps.
Activities
Support regular training and
competency assessments for
all health care facility staff
including cleaners and health
care workers.
Participating organisations: DFID, Emory University, Global Health Council, Infection Control Network Africa, London School of Hygiene
and Tropical Medicine, Ministry of Health representatives from Ethiopia, Sierra Leone and Zambia, SoapBox Collaborative, UNICEF,
University of East Anglia, USAID, WASH Advocates, WaterAid, Water Institute-University of North Carolina, Water Supply and Sanitation
Collaborative Council, WHO, World Bank.
Health priorities represented: Health systems, Infection prevention and control, Maternal and newborn health, Outbreaks and
emergencies and quality Universal Health Coverage.
Core & expanded
indicators
implemented in
national assessments
Advocacy infographic
on UHC, MCH and joint
action
First set of risk
assessment/facility
improvement tools
tested and shared
Global Advocacy Plan
drafted
AUG
SEP
OCT
NOV
DEC
Compendium
of appropriate
technologies compiled
JAN
FEB
MAR
2015
AUG
SEP
OCT
Task Teams initiated
Joint event with
quality UHC at the
69th World Health
Research meeting to
review evidence and
develop research plan
APR
MA
JUN
JUL
MA
JUN
JUL
2030
2016
NOV
DEC
Core monitoring
indicators finalised
Launch website www.
washinhcf.org
JAN
FEB
Briefing note on
evidence finalised
MAR
APR
All facilities
have WASH
services
2016
Global Meeting to
assess progress and
plan next steps
Review existing
data on key health
outcomes linked with
WASH in HCF
On-going:
Implementation and
adaption of facility tools
for different settings.
G e t i nvo l ve d and cont rib ute to an impo r tant glo bal movement: washinhc f@who.int