Water Currents: WASH and Health Care Facilities

Water Currents is produced biweekly by USAID’s E3 Water Office. Each issue contains recent news and articles on water sector issues, partner and donor updates, latest sector research, and a special focus on one topic. Please provide your feedback and suggestions by contacting the waterteam@usaid.gov.

The focus topic for this issue is WASH and health care facilities and contains information on upcoming events; recent publications from USAID, the World Health Organization (WHO), and others; as well as links to key websites. The reports discuss hand hygiene, antimicrobial resistance, access to WASH services, and the treatment and disposal of medical waste. “In the News” features publications and resources from the recent Sanitation and Water for All High Level Meetings in Washington, DC.​


Water Currents - In Focus


May 3, 2017 Webinar: WASH Counts in Healthcare FacilitiesGlobal Handwashing Partnership, April 2017. Experts from USAID’s Maternal & Child Survival Program, WHO, and other organizations will share information on how to improve water, sanitation, and hygiene (WASH) in health care settings.

May 5, 2017: Making Progress: WASH in Healthcare Facilities Virtual EventWaterAid; WHO, April 2017. This virtual event will look at how improving quality of care for mothers and newborns can be enhanced through integrating WASH within health care facilities. Experts from WHO and the Soapbox Collaborative will discuss both the practical interventions and policy changes required to deliver effective infection prevention and control and tackle the rise of antimicrobial resistance.

May 5, 2017: Save Lives: Clean Your Hands—Fight Antibiotic Resistance—It's in Your HandsWHO, April 2017. May 5 is WHO’s annual call to action for health workers. This year the website features information and educational materials on combatting antibiotic resistance.

Recent Publications

Water, Sanitation, and Hygiene at the Health Center: The Health System’s Unaccounted for ResponsibilityUSAID, February 2017. This two-page brief outlines the challenges facing WASH in maternal and perinatal health, and proposes actions to address them via improved WASH in health facilities, greater leadership for ministries of health, increased coordination with other sectors, and better accountability.

Water and Sanitation for Health Facility Improvement Tool (WASH FIT) Guide: A Practical Guide for Improving Quality of Care through Water, Sanitation and Hygiene in Health Care FacilitiesWHO, 2017. This guide describes a risk-based, continuous improvement framework and associated tools for undertaking WASH improvements as part of wider quality improvements in health care facilities. The guide also comes with a set of training materials.

Intervening with Healthcare Workers’ Hand Hygiene Compliance, Knowledge, and Perception in a Limited-Resource Hospital in Indonesia: A Randomized Controlled Trial StudyAntimicrobial Resistance and Infection Control, March 2017. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among health care workers in a tertiary care hospital in Indonesia.

Healthcare Waste Generation Worldwide and Its Dependence on Socio-Economic and Environmental FactorsSustainability, February 2017. This paper examines the dependence of the health care waste generation rate on several socio-economic and environmental parameters from 42 countries.

Happy World Health Day, or 'What We Learned at the GLE.' WaterAid, April 2017. To mark World Health Day, WaterAid staff prepared a blog summarizing six key takeaways from the recent Global Learning Event on WASH in health care facilities.

The Role of Water, Sanitation and Hygiene (WASH) in Healthcare Settings to Reduce Transmission of Antimicrobial ResistanceAMR Control, July 2016. In this article, USAID’s Rochelle Rainey and Merri Weinger discuss how antimicrobial resistance is a multi-sectoral problem that requires a comprehensive strategy, including WASH improvements, to prevent emergence and transmission.

Assessment of Water, Sanitation, and Hygiene Facilities in Primary Health Care (PHC) Centres in Bauchi, Benue, Ekiti, Enugu, Jigawa and Plateau States, NigeriaWaterAid, October 2016. WaterAid Nigeria’s study provides evidence on the state of 242 WASH facilities in primary health care centers. The study also makes recommendations to improve WASH in these settings. A briefing note is also available.

Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth EnvironmentPLoS One, August 2016. Access to water and sanitation during childbirth is poor across low and middle-income countries. Even when women travel to health facilities for childbirth, they are not guaranteed access to basic WASH services. These indicators should be measured routinely to inform improvements.

What Are the Threats from Antimicrobial Resistance for Maternity Units in Low- and Middle-Income Countries? Global Health Action, September 2016. This article stresses the need to address the current lack of attention, evidence, and action on the threat of antimicrobial resistance to maternity units. The benefits of addressing this would be felt widely, but particularly by the women who become pregnant and the newborn babies potentially at risk—estimated, respectively, as 210 million and 140 million in 2015.

Hygiene on Maternity Units: Lessons from a Needs Assessment in Bangladesh and India.Global Health Action, December 2016. A needs assessment was conducted in seven maternity units in Gujarat, India, and eight in Dhaka Division, Bangladesh, in 2014. The study developed and applied a suite of tools—a “walkthrough checklist” to establish the state of hygiene as measured by visual cleanliness and the presence of potential pathogens.

Antimicrobial Resistance: A Threat to Neonate SurvivalThe Lancet, October 2016. Facility-based births could help to reduce the risk of sepsis, but poor quality facilities are where the dangers of antimicrobial resistance are greatest.

Other Key Publications

Water, Sanitation and Hygiene in Health Care Facilities: Status in Low- and Middle-Income Countries and Way ForwardWHO, 2015. Drawing on data from 54 low- and middle-income countries, the findings in this first multi-country review of WASH services in health care facilities are sobering. The report concludes that 38 percent lack access to even rudimentary levels of water, 19 percent lack sanitation, and 35 percent do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly.

Healthcare Waste Fact SheetWHO, November 2015. This fact sheet discusses the types, the health risks, and the environmental impacts of medical waste.

WASH in Healthcare Facilities: WASH Policy Research DigestUNC Water Institute, October 2015. Issue two of the Research Digest includes a detailed review of WHO and UNICEF’s 2015 report on WASH in health care facilities and a synthesis of literature and solutions to address the impact of health care facilities on infection, mortality, and maternal and neonatal health.


WASH and Healthcare WebsitesWHO. Three different websites maintained by WHO — Health Care Facilities and WasteHealth-Care Waste, and WASH in Health Care Facilities—contain training modules, fact sheets, and other resources on WASH access in health care facilities, treatment and disposal of medical waste, and other issues.


Water Currents - In the News

UN Water GLAAS 2017: Financing Universal Water, Sanitation and Hygiene under the Sustainable Sanitation and Water for All (SWA) High Level Meetings, April 19 and 20, Washington, DC. Some of the reports and resources covered in the Finance Ministers’ Meeting, convened by The World Bank on behalf of the SWA partnership, and from the Sector Ministers’ Meeting, convened by UNICEF, include:

2017 High-Level Meetings Special EditionSWA, April 2017. This edition of the SWA newsletter contains photos, videos, and blog posts summarizing the recent meetings.

Financing WASH: How to Increase Funds for the Sector While Reducing Inequalities: Position Paper for the Sanitation and Water for All Finance Ministers’ MeetingIRC; Water.org, April 2017. This paper addresses three key issues that are receiving limited attention in the water and sanitation sector discussions on finance: lack of finance for strengthening the enabling environment, untapped use of micro and blended finance, and inequities in allocation of finance in the sector.

Final Review of Progress Made Towards the 2017 HLM CommitmentsSWA, March 2017. This report states that significant progress has been made on more than half of the commitments made by 43 developing countries and 12 donor partners. The United States committed to strengthening governments’ ability to monitor and report on access to water and sanitation. To support this, USAID finalized new indicators that align with the Sustainable Development Goals (SDGs) and that are tracked across its programming worldwide.

How Can the Financing Gap Be Filled? A Discussion PaperThe World BankUNICEF, March 2017. This paper, prepared to support the SWA Finance Ministers’ Meeting preparatory process, provides a framework for country-level discussion, setting out key considerations for countries as they undertake financial planning for efforts to meet the SDGs.

If you would like to feature your organization's materials or suggest other content for upcoming issues of Water Currents, please send them to Dan Campbell, Knowledge Creation/WASH Specialist, at dcampbell@waterckm.com.