How WaterAid is improving access to water, sanitation and hygiene within the health sector
Access to safe water, sanitation and hygiene (WASH) in healthcare facilities is fundamental to ensuring quality healthcare. Yet in many counties, inadequate WASH services continue to pose severe risks to patients, healthcare workers and communities.
A Roadmap for Change
In Papua New Guinea (PNG), access to WASH in healthcare facilities remains a major challenge. With a rapidly growing population of 9.2 million people, PNG ranks among the countries with the least access to these essential services globally. The lack of adequate WASH facilities significantly impacts healthcare delivery, particularly in rural areas where disparities are stark.
Recognising the critical role of WASH in healthcare, the PNG government has outlined ambitious goals in its 2010–2030 plans, aiming to modernise healthcare facilities and upgrade healthcare centres into hospitals.
Given PNG’s high maternal and infant mortality rates, urgent investment and commitment are needed to ensure safe healthcare environments for all.
To address these challenges, WaterAid supported the National Department of Health to develop the WASH in Healthcare Facilities National Guidelines and Roadmap. These frameworks highlight the importance of WASH services in protecting health workers, patients and caregivers, while preventing unnecessary deaths due to infections and poor sanitation.
The Roadmap outlines key priorities to achieve the ambitious target of ensuring 100% of medical centres—hospitals, health centres and aid posts—have access to safe and sustainable WASH facilities by 2030.
However, with less than a decade remaining, increased investment from the PNG government and international donors is critical. The National Guidelines set clear standards and provide step-by-step guidance for achieving minimum WASH requirements, ultimately improving the quality of healthcare services for all Papua New Guineans.
Hand Hygiene: Protecting Mothers and Babies
Hand hygiene is particularly critical in maternal and newborn care. However, many healthcare facilities in low- and middle-income countries, including PNG and Cambodia, lack access to water sources, proper sanitation and even basic soap for handwashing.
WaterAid collaborated with the London School of Hygiene and Tropical Medicine and the National Institute of Public Health to research the impact of hygiene practices on maternal and neonatal health.
The project, funded by the Australian Government’s Water for Women Fund, aimed to improve hygiene behaviours among midwives and caregivers during labour, delivery and postnatal care.
The research took place in six referral hospitals in Cambodia’s Kampong Cham province and used qualitative interviews and direct observations to assess and improve hand hygiene practices.
Findings from the study reinforced that simple handwashing with soap and clean water can significantly reduce maternal and neonatal infections.
Combating Antimicrobial Resistance in the Pacific
Antimicrobial resistance (AMR) poses a significant threat to health, especially in low-resource settings like the Pacific Islands. Inadequate infection prevention and control (IPC) in healthcare facilities allows resistant infections to spread, making effective WASH services more crucial than ever.
The Pacific faces particular challenges due to weak antimicrobial regulation, limited laboratory surveillance and inadequate WASH resources. In response, WaterAid has been supporting the Australian Government’s Department of Foreign Affairs and Trade Centre for Health Security program to strengthen IPC in national hospitals across Fiji, PNG, the Solomon Islands and Samoa. This program provides tools and frameworks to help ministries of health accelerate WASH improvements in healthcare facilities.
An assessment of the National Referral Hospital in the Solomon Islands, found that while IPC teams were skilled and dedicated, a lack of resources hindered their ability to maintain effective infection control. Non-functional or inaccessible WASH infrastructure, inconsistent knowledge and supply chain disruptions for hygiene products further exacerbated the problem.
To combat AMR and improve infection control, WaterAid and its partners are working on the following urgent actions:
Stronger Governance and Monitoring: Establish active governance structures to oversee WASH improvements and ensure ongoing quality control in healthcare settings.
Updated IPC Protocols: In the wake of COVID-19, healthcare facilities must revise their standard operating procedures to reflect new epidemiological data, risks, and best practices.
Accountability for WASH Compliance: Implement clear accountability mechanisms to ensure healthcare professionals, caregivers, and facility managers adhere to best-practice hygiene and sanitation standards.
Achieving universal WASH access in healthcare facilities requires political will, financial investment and cross-sector collaboration. WaterAid remains committed to working alongside governments, donors and communities to ensure healthcare facilities have the water, sanitation and hygiene services they need to provide safe, dignified and effective care. Because every patient, every mother and every child deserve nothing less than a clean and safe healthcare environment.