50% of world's healthcare facilities lack basic hygiene services: WHO

UNICEF

Half of the healthcare facilities across the world fail to provide patients with basic hygiene necessities like soap and water, and alcohol-based hand rubs, according to the latest report from the Joint Monitoring Programme (JMP) by WHO and UNICEF.

Of the 3.85 billion people who use these services, 688 million receive health care without any hygiene facilities, according to a press release from UNICEF on Tuesday.

“Hygiene facilities and practices in health care settings are non-negotiable,” said Dr Maria Neira, director of the WHO Department of Environment, Climate Change and Health. “Their improvement is essential to pandemic recovery, prevention, and preparedness. Hygiene in health care facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste.”

“I encourage member states to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation, and hygiene (WASH) services in health care facilities, and to monitor these efforts,” she added.

The “Progress on WASH in health care facilities 2000-2021: special focus on WASH and infection prevention and control” report has set a universal baseline to evaluate the overall access to hygiene facilities, including toilets in health centres for the first time. This data describes the critical elements of WASH services in hospitals in 40 countries, which take care of 35% of the global population.

Unfortunately, the report’s findings show a clear but alarming situation. Only 51% of health care services have hygiene and handwashing amenities at points of care, while 1 in 11 (9%) have neither.

For Bangladesh, that value is only 38%, with substantial differences between non-governmental (69%) and governmental facilities (32%). Clean water is significantly more readily available for people living in urban areas (90%) than those living in rural parts (67%) of the country.

Kelly Ann Taylor, UNICEF’s director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction (CEED), stated, “If healthcare providers don’t have access to a hygiene service, patients don’t have a healthcare facility. Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.”

The report suggests that interventions to increase access to proper handwashing and environmental cleaning are necessary because contaminated environments and hands are key contributors to pathogen transmission and the spread of antimicrobial resistance in healthcare facilities.

Coverage of WASH facilities is still uneven across different regions and income groupings.

Facilities in Sub-Saharan Africa are falling short of hygiene services. Even though 73% of health care facilities in the region have alcohol-based hand rubs or water and soap at points of care, only 37% have handwashing facilities at toilets. Of the hospitals in the region, 87% have hand hygiene facilities at points of care, compared to 68% of other healthcare facilities.

In the least developed countries, only 53% of health care facilities have access to a protected water source on their premises. In comparison, the global figure is 78%, with hospitals (88%) doing better than smaller health care facilities (77%), and the figure for eastern and south-eastern Asia is 90%. Globally, around 3% of health care facilities in urban areas and 11% in rural areas had no water service.

Among the data provided, 1 in 10 health care facilities had no sanitation service. The proportion of health care facilities with no sanitation services ranged from 3% in Latin America, the Caribbean, and in eastern and south-eastern Asia to 22% in sub-Saharan Africa. In the least developed countries, just 21% had essential sanitation services in health care facilities.

The data further reveals that many healthcare facilities lack basic environmental cleaning, safe segregation, and disposal of healthcare waste.

The report is being launched at World Water Week, in Stockholm, Sweden. The annual conference runs from Aug 23 to Sept 1, exploring new ways to tackle humanity’s most significant challenges: from food security and health to agriculture, technology, biodiversity, and climate.