A World Health Organization-UNICEF global study of health care facilities finds half lack basic hygiene services, putting around 3.85 billion people at risk of infection and death.

The study is based on data from 40 countries representing 35% of the world’s population. It presents an alarming picture of health facilities that lack water and soap for handwashing, have dirty toilets, and are unable to manage health care waste.

It says the lack of safe water, sanitation, and basic hygiene services, known as WASH, in health care facilities can lead to many preventable deaths. Rick Johnston is WHO lead WHO-UNICEF Joint Monitoring Program for WASH. He says sepsis, a major cause of mortality globally, could be prevented by improving WASH services in health care.

“It causes about 11 million avoidable deaths each year. And we know that in health care settings, sepsis mortality is linked to poor quality of care, including inadequate WASH… Still today, 670,000 neo-natal deaths occur due to sepsis. So, there is a huge burden that could be improved right there,” he said.

Data show the situation tends to be better in hospitals than in smaller health care facilities. The WHO reports the 46 least developed countries lag most behind in hygiene services, with only 32% of health care facilities providing WASH services.

Johnston says sub-Saharan Africa is the geographic region with the lowest coverage of basic services, about a third lower than globally.

“I mentioned hand hygiene services at 51% globally. It is only 38% in sub-Saharan Africa… Water services 78% globally, only 52% in sub-Saharan Africa… In sub-Saharan Africa, only 13% of health care facilities met the requirement for a basic health care service. So, lots of work to be done in sub-Saharan Africa,” he said.

The WHO estimates the cost of achieving universal basic WASH services in the 46 least developed countries at less than $10 billion between now and 2030. While that sounds like a lot, WHO officials say it comes to just under $1 per person per year. Officials say that is a fraction of what currently is being spent on health care services in those countries.

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