Four in five health centres in Nigeria STILL operating without soap or water two years after global promise

19 May 2021
Nurse washing her hands
WaterAid/Dennis Lupenga

19 May 2021, Abuja, Nigeria – WaterAid Nigeria is calling for the country’s Minister of Health, Honourable Dr Osagie Ehanire, to prioritise basic hygiene for health care facilities as part of the COVID-19 pandemic recovery plan. The demand comes as health ministers from around the world prepare to attend the World Health Assembly, against a backdrop of international struggles to bring the virus under control.

Two years ago the World Health Assembly’s 194 members unanimously agreed to ensure universal access to water, sanitation, and hygiene in all hospitals and other health facilities – since then the pandemic has highlighted just how vital these basic services are in controlling infection. Dr Tedros Adhanom Ghebreyesus, WHO Director-General, has described soap and water as akin to personal protective equipment and absolutely fundamental for stopping the spread of COVID-19.

However, in Nigeria, about 17% of health care centres lack do not have access to a water source, and four in five health care facilities (80%)[1] still lacks somewhere to wash hands with soap to protect patients and healthcare workers from catching and spreading deadly infections. In the world’s poorest countries, half of all hospitals and clinics have no clean water on site. 

When the World Health Assembly delegations last met in person, they passed a resolution to ensure that all health care facilities had water, sanitation, and hygiene. And yet, the data shows that across the world almost 2 billion people depend on health care facilities without basic water services, putting them at greater risk of catching COVID-19 and other deadly diseases. One in four health care facilities globally is still without clean water on-site, one in three still has nowhere to wash hands where patients are treated and one in ten still lacks decent toilets.

The resolution has not translated to realistic actions in Nigeria either. National data shows that 26% of health care facilities do not have access to toilets on-site and only 4% of health care facilities in Nigeria have access to combined water, sanitation, and hygiene services.[2]

Last December, the WHO estimated that to bring clean water, handwashing facilities and decent toilets to the health care centres in the poorest countries would cost just $3.6billion – which equates to around an hour and a half’s worth of what the whole world spent in a year on the Covid-19 response.

Furthermore, research[3] has shown that money spent on water, sanitation and hygiene within healthcare is a ‘best buy’ for any country, producing a fifty per cent return on investment. It helps to:

  • slow the spread of antimicrobial resistance - so-called Superbugs; 
  • prevent the spread of hospital infections;
  • and reduce maternal and newborn deaths.

Sustainable access to water, sanitation and hygiene is a cost-effective measure that guarantees the fight against COVID-19 and future pandemics. This realises lasting health outcomes in Nigeria, enabling people to reach their full potential.

“Two years ago, at the World Health Assembly, global leaders resolved to prioritise water, sanitation and hygiene in all health care facilities. Now is the time for them to make good on those promises.

“Millions of people are at risk of contracting diseases because they use or work in a health care facility which lacks basic water services. In the twenty first century this simply shouldn’t be and needn’t be the case. The cost of investing to ensure every health centre and hospital in the poorest countries has a reliable water supply, working toilets and good hygiene may seem high but the benefits of such an investment far outweigh the cost.

“Trying to create a robust pandemic preparedness and response plan without ensuring that every health care centre has clean water and the ability to keep its patients, frontline health workers and premises clean is like building a fortress with a gaping hole where the door should be. Unless leaders wake up to this, more lives will be needlessly lost.”


For more information, please contact:

WaterAid Nigeria: Oluseyi Abdulmalik, Communications and Media Manager on [email protected] or +234 8034312391

Notes to Editors:


WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 28 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 27 million people with clean water and 27 million people with decent toilets. For more information, visit; follow @WaterAidNigeria, @WaterAid or @WaterAidPress on Twitter, or visit us on Facebook at

  • 785 million people in the world – one in ten – do not have clean water close to home.[5]
  • 2 billion people in the world – almost one in four – do not have a decent toilet of their own.[6]
  • Around 310,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's around 800 children a day, or one child every two minutes.[7]
  • Every £1 invested in water and toilets returns an average of £4 in increased productivity.[8]
  • Just £15 can provide one person with clean water.[9]

In Nigeria[10]:

  • Only 9% of the population have access to basic water, sanitation and hygiene services.
  • 60 million people (30% of the population) lack access to clean water.
  • 112 million people (56% of the population) lack decent toilets.
  • 46 million people (23% of the population) practice open defecation.
  • 167 million people (84% of the population) lack basic handwashing facilities.
  • Only 3% of schools have access to basic water, sanitation and hygiene services.
  • Only 4% of healthcare facilities have access to basic water, sanitation and hygiene services.
  • Only 2% of parks and markets have access to basic water, sanitation and hygiene services.

[1] 2019 WASH National Outcome Routine Mapping (WASH NORM)

[2] 2019 WASH National Outcome Routine Mapping (WASH NORM)