WHO and UNICEF say half of global healthcare facilities lack basic sanitation service

Half of the world's healthcare facilities lack basic sanitation services, including lack of water and soap or alcohol-based hand sanitizer in health care settings and in toilets, according to a report prepared by the latest joint monitoring programme between WHO and UNICEF. About 3.85 billion people use these medical institutions and face a greater risk of infection, and 688 million of them have no sanitation and cleaning service facilities in the medical places.

Dr Maria Neira, Director of WHO's Department of Environment, Climate Change and Health, said, "Sanitation facilities and practices in healthcare facilities are essential. Improved sanitation facilities and practices are critical for pandemic prevention and preparedness and recovery efforts. Good hygiene in healthcare facilities cannot be ensured without increased investment in basic measures, including the provision of clean water, clean toilets and the safe management of medical waste. I encourage Member States to step up their efforts to implement the 2019 World Health Assembly commitments to strengthen water, sanitation and hygiene services in health-care settings and monitor this.”

Numerous countries reported on critical water sanitation in their hospitals and other health points. The latest report, "Progress in WASH in Healthcare Settings, 2000-2021: A Special Focus on WASH and Infection Prevention and Control," establishes for the first time a global baseline for sanitation services, assessing sanitation facilities in health-care settings and toilets situation. Currently, 40 countries (35% of the world's population) have provided sanitation data, compared with 21 in 2020 and 14 in 2019.

New global estimates shed light on the health situation within healthcare facilities of particular concern. 68% of facilities have sanitation facilities in treatment and care settings, and 65% of facilities have water and soap handwashing facilities in toilets, but only 51% of facilities have sanitation facilities that meet basic health service standards in all of these locations. In addition, 1 in 11 healthcare facilities globally (9%) have no sanitation facilities at all.

Kelly Ann Naylor, Director of UNICEF's Water Sanitation Programme and Climate, Environment, Energy and Disaster Risk Reduction, said, "If health workers do not have access to sanitation services, patients have no safe place to seek care. There is no safe water and basic sanitation. and sanitation services hospitals and clinics can be death traps for mothers, newborns and children. About 670,000 newborns die each year from sepsis. This is absurd. These deaths could have been avoided, so this situation is Totally unacceptable".

The report notes that in healthcare settings, contaminated hands and the environment greatly contribute to the spread of pathogens and the spread of antimicrobial resistance. Implementing measures to enable more people to wash their hands with water and soap and to keep the environment clean are cornerstones of infection prevention and control programmes, which are essential for good health care, especially for safe childbirth.

Water sanitation coverage remains uneven across regions and income groups:

Sanitation facilities in sub-Saharan Africa are lagging behind. Three-quarters (73%) of facilities in the region have alcohol-based hand sanitizer or water and soap at the point of treatment, but only one-third (37%) provide water and soap handwashing facilities in toilets. The majority (87%) of hospitals have hand hygiene facilities at the point of care, compared to only 68% in other facilities.
In LDCs, only 53 per cent of healthcare facilities have direct access to water from protected water sources. The global figure is 78%, with hospitals (88%) doing better than smaller medical institutions (77%). 90% in East and Southeast Asia. Globally, about 3% of urban and 11% of rural health facilities do not have water supply.
In countries for which data are available, 1 in 10 healthcare facilities globally have no sanitation facilities. 3% of health facilities in Latin America and the Caribbean and East and South-East Asia have no sanitation facilities, and 22% in sub-Saharan Africa. In LDCs, only one in five (21%) health facilities have basic sanitation facilities.
The data further shows that many healthcare facilities lack basic environmental cleaning services and that medical waste is not safely segregated and disposed of.