WASH in health care facilities
Clean water, sanitation and hygiene in health care facilities saves lives.
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Inadequate Water Sanitation and Hygiene (WASH) services in India’s health facilities, contributes to the high neonatal mortality rate, which is currently 24 deaths per 1000 live births. This is primarily due to weak infection prevention and control in health facilities. Hospitals with poor WASH facilities are also found to have higher rates of maternal mortality. Due to the lack of access to water and sanitation, women are further discouraged from institutional delivery or they delay health-seeking advice.
In India, only 19.2 per cent of labour rooms and 3.2 per cent of post-natal care wards have functional toilets. Sepsis, which is mostly spread in health facilities, contributes to 16.4 per cent of the overall neonatal mortality and 11 per cent of maternal deaths. However, risks do not end there when they are brought home to a community that lacks toilets.
The other key challenges include a lack of WASH-trained human resources, a lack of adequate planning and financing for implementation of WASH in health care facilities and insufficient monitoring and evaluation.
Inadequate WASH in health care facilities has an economic burden because of the increased healthcare / medical costs and decreased wages due to missing work to take care of sick family members.
The 2011 Global Antibiotic Resistance Partnership report concluded that a large proportion of hospital-acquired-infections in India are preventable with increased infection control, including stepping up hygiene practices such as frequent hand washing.
Ensuring clean and hygienic hospitals
Good WASH facilities in health care institutions serve to prevent infections and spread of disease, protect staff and patients, and uphold the dignity of vulnerable populations, including pregnant women and new borns. An inclusive focus on WASH in health care facilities is a unique opportunity to encourage safe water management, toilet use and handwashing with soap among mothers and their young children.
UNICEF works closely with the Government of India on increasing WASH in health care facilities and our approach is evidence based. Our work includes gap assessment, demonstration of workable models on the ground and assistance in planning, management and monitoring to scale up successful institutional WASH models.
In 2015, the Ministry of Health and Family Welfare (MoHFW) with support from UNICEF instituted the KAYAKALP scheme to recognise and reward the excellence of health facilities in promoting cleanliness, thereby improving the quality of health care services. KAYAKALP is a scheme for rewarding best-performing health facilities at all levels based on an external assessment by a team constituted by the health department in each state.
UNICEF supports the capacity building of state, district and block-level stakeholders to share knowledge and information on the need to focus on WASH in healthcare facilities. This includes guidance on how to conduct a needs assessment followed by the development of facility improvement plans and supportive supervision of programme implementation. Our efforts are also directed towards supporting the improvement of WASH infrastructure and practices in health care facilities in state training institutions.
UNICEF supports continued monitoring of WASH infrastructure and practices in healthcare facilities to ensure sustainability.
We also support the process of assessments of the conditions of the WASH facilities in healthcare facilities, which are carried out with the involvement of state and district level staff of the health department.