"Half of health care facilities globally lack basic hygiene services", says WHO, UNICEF

3 min read
A woman washes her hands at a healthcare centre in Cambodia
Image: WaterAid/Remissa Mak

A report recently published by the World Health Organisation (WHO) and UNICEF has found that only half of all health facilities worldwide have basic handwashing services.

The report, titled “Progress on WASH in health care facilities 2000–2021: special focus on WASH and infection prevention and control”, found that around 3.85 billion people are forced to use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all.

Adequate water, sanitation and hygiene (WASH) in health care facilities is critical to high quality and safe patient care, and can include the provision of water, sanitation, healthcare waste management, hygiene, and cleaning tools and services across all parts of a health care facility.

This is particularly significant for services during labour, delivery, and postnatal care when the health of mothers and newborns can be severely impacted by poor WASH services. Additionally, the report notes that contaminated hands and environments play a significant role in the spread of disease at health care facilities. Increasing access to handwashing with soap and water, along with environmental cleaning, are essential for infection prevention and control, particularly during disease outbreaks such as COVID-19.

It is shocking that accessing basic hand-washing facilities in 2021 still depends on where you live!” says Bernice Sarpong, Technical Lead in Health for WaterAid Australia.

Washing your hands with soap and clean water is an essential first-line defence to stop germs from being passed onto people, including those most vulnerable in our communities, such as mothers, newborns, the elderly and those who are already sick. Political action and investment in hand hygiene are fundamental to building healthy, resilient communities and face any future health security threat such as a global pandemic.”

The report demonstrates that we are still seeing huge gaps in basic water, sanitation and hygiene services in health care facilities in least developed countries.

At WaterAid, we have been working closely with health care professionals and hygiene educators in Cambodia, Papua New Guinea and Timor-Leste, as well as with our partners and the health sector as a whole, to ensure clean water, toilets and hygiene are integrated into health care facilities everywhere, to ensure everyone can enjoy high-quality health services.

Below are just a few examples of our work in this space.


In Cambodia we have been working in partnership with the London School of Hygiene and Tropical Medicine (LSHTM) and the Ministry of Health - National Institute of Public Health (NIPH) on two projects aimed reducing health care associated infections, including the spread of COVID-19 and tackling antimicrobial resistance, and strengthening existing national policies and guidelines in line with global standards.

The first is the Changing Hygiene Around Maternal Priorities (CHAMP) Plus research project, which aims to improve the hygiene behaviours of midwives, mothers, fathers, caregivers and visitors that influence maternal and neonatal infection during labour, delivery and post—natal care in health care facilities.

The second is the Clean Frontline research project, which targets cleaners who are critical frontline workers responsible for cleaning HCFs and improving infection prevention and control.

Timor Leste

In partnership with the Ministry of Health and other key stakeholders in Timor-Leste, we are implementing a Municipal-led sustainable WASH in healthcare facilities and communities project. The project focuses on improving access to WASH in HCFs and communities in two selected rural locations to demonstrate how using an integrated approach can be modelled to accelerate government plans for reaching municipal-wide hygienic status.     

Papua New Guinea

PNG has ambitious targets of achieving 100% of medical centres (hospitals, health centres, and aid posts) across the country having access to safe, convenient, and sustainable water supply and sanitation facilities by 2030. In partnership with the National Department of Health and the National WaSH Programme Management Unit (PMU), we are conducting a situational analysis and assessment of WASH in HCFs in PNG. This is one of the eight practical steps developed by WHO and UNICEF to achieving sustainable universal access to quality care.