Lack of toilets and safe water in health-care facilities

A recent WHO and UNICEF report, supported by our research, revealed an alarming lack of water, sanitation and hygiene (WASH) services in health care facilities in 54 countries, despite the importance of WASH in caring for patients and reducing infection. Since its release, researchers from The Water Institute at UNC co-authored an editorial calling for health sector leadership in setting standards, tracking service delivery, investing in human resources, and coordinating WASH, health, and development so that health facilities can become cleaner and safer for patients.

Bulletin of the World Health Organization

In March 2015, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) released a report on the status of water and sanitation in health-care facilities from 54 low- and middle-income countries. Data representing 66,000 health facilities show that water was not readily available in about 40%. Over a third of facilities lacked soap for hand washing and a fifth lacked toilets. In many countries, in facilities where water is available, there is no guarantee that it is safe for consumption.

This is a major embarrassment for the health sector: health facilities serve as foci for infection and patients seeking treatment fall ill and may die, for the lack of the most basic requirements for good hygiene – safe, reliable water supplies and adequate sanitation. Pregnant mothers rely on a birthing environment that, at a minimum, does not place them or their baby at risk. Infections cause nearly half of late neonatal deaths (430,000) – many of which are attributable to inadequate hygiene. The same conditions contribute to major disease outbreaks, such as cholera, as well as the spread of antimicrobial resistance – another major public health threat.

Lack of toilets and safe water in health-care facilities. J. Bartram, R. Cronk, M. Montgomery, B. Gordon, M. Neira, E. Kelley, Y. Velleman. 2015. Bulletin of the World Health Organization 93:210.