3 out of 10 health care facilities in the Philippines lack access to clean toilets

4 April 2019, MANILA – Three in ten health facilities in the Philippines lack access to clean toilets, according to a new report by the World Health Organization (WHO) and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP). 23% of the health care facilities have unclean toilets while 4% have no toilets at all.

The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health care facilities. While the report highlights some significant information gaps, the available data shows that one in four health care facilities around the world lack basic water services, impacting over 2 billion people. The report further reveals that many health centres lack sanitation service, basic facilities for hand hygiene and safe segregation and disposal of health care waste.

These services are crucial to preventing infections, reducing the spread of antimicrobial resistance and providing quality care, particularly for safe childbirth.

“Health care facilities won’t be able to provide quality care to people if there is no safe water, toilet or handwashing facility,” said WHO Representative in the Philippines Dr Gundo Weiler. “The recent water shortage in Metro Manila highlighted the need for long-term solutions to water, sanitation and hygiene in health care facilities. The Philippines must ensure that safe WASH facilities are available and accessible to ensure health for all Filipinos.”

The recent water shortage in Metro Manila affected five major hospitals, such as, Rizal Medical Center in Pasig City; National Center for Mental Health in Mandaluyong City; and National Kidney and Transplant Institute, Philippine Children’s Medical Center and Quirino Memorial Medical Center, all in Quezon City. Major hospitals were forced to reduce the admission of patients to some specialty wards, like the operating room and emergency room, to prevent disease outbreaks. The lack of water prompted the Secretary of Health Francisco Duque III to talk to a water concessionaire to prioritize the supply of water to the five hospitals and limit the number of watchers into one per patient. The Department of Health has identified accessibility to WASH in all health care facilities as a priority.

According to UNICEF, 7,000 newborn babies died every day globally in 2017, mostly from preventable and treatable conditions including infections like sepsis. As part of its Every Child Alive Campaign, UNICEF is calling for governments and authorities to make sure every mother and baby have access to affordable, quality care. 

“When a child is born in a birthing facility or hospital without sufficient access to water, sanitation, and hygiene, both the child and the mother are at risk of infection. Health care workers should be able to practice handwashing with soap and use sterile medical equipment. The healthcare facility should have access to safe water for drinking, handwashing with soap, and to provide access to clean toilets.” said UNICEF Ad Interim Country Representative Julia Rees.

In an accompanying report, Water, sanitation, and hygiene in health care facilities: Practical steps to achieve universal access for quality care, WHO and UNICEF researchers note that more than 1 million deaths each year are associated with unclean births. Infections account for 26% of neonatal deaths and 11% of maternal mortality.

The WHO and UNICEF Practical Steps report provides details on eight actions governments can take to improve the WASH services in health care facilities including establishing national plans and targets, improving infrastructure and maintenance and engaging communities. These actions and resulting improvements in WASH services can yield dramatic returns on investment in the form of improved maternal and newborn health, preventing antimicrobial resistance, stopping disease outbreaks and improving quality of care.

In the Philippines, WHO is supporting the government in establishing WASH standards for health care facilities, strengthening the capacity of health workforce on WASH assessment and planning for health care facilities, updating the health care waste management manual, and developing a monitoring system on WASH in Health Care Facilities. UNICEF is working with the Department of Health to operationalize the National Sustainable Sanitation Plan through the development of programming guidelines, tools and monitoring systems. UNICEF is also working in selected Provinces to  model programming interventions that support rural communities to improve their access to WASH services.