Improving WASH services in health care facilities   

In June 2023, the updated WHO/ UNICEF Global report on WASH in health care facilities was launched  at a global event on safe and sustainable infrastructure in health care facilities, in Amman, Jordan. It reinforced the need for improving WASH in health care facilities to save lives and reduce costs, a mission the hands4health project is contributing to in Mali and Burkina Faso. The needs are stark: globally, more than 1 billion people visit health care facilities with inadequate or no WASH services; and only 68% of primary health care facilities in sub-Saharan Africa have hand hygiene facilities (WHO/UNICEF, 2023). The WHO/UNICEF event aimed at:

  • Launching a global plan for WASH in health care facilities (2023-2030); 
  • Exchanging effective approaches and scale up climate-resilient WASH; 
  • Equiping stakeholders with new knowledge and tools.

Our colleague, Aboubacar Ballo, Regional WASH-Africa Advisor at Terre des hommes (Tdh) and hands4health partner was present at the event, along with representatives of the Malian Ministry of Health and the Swiss Water & Sanitation Consortium, to present the WASH FIT approach implemented in Mali. WASH FIT (Water and Sanitation for Health Facility Improvement Tool) is a risk-based, quality improvement tool for health care facilities, recommended by the WHO. The approach in Mali has been hailed as a model for community engagement to prioritise and allocate investment for WASH in health care facilities. Below is a short summary of the presentation by Aboubacar Ballo:

  • In Mali, a WASH-IPC (Water, Sanitation and Hygiene and Infection Prevention and Control) Task Force led by the Ministry of Health has been in place since 2015.  
  • Since 2018, the WASH FIT approach has been contextualised and replicated in 330 health care facilities with the support of several NGOs, including hands4health partner Terre des hommes (Tdh).   
  • The WASH FIT approach reinforces trust and accountability of stakeholders and supports national advocacy for improving WASH in health care facilities, through the following steps: (i) Community and health care facilities staff present WASH FIT plans to local authorities and demand their right to WASH; (ii) Local leaders include WASH FIT priorities in the 5-year municipal development plan; and (iii) Health care facilities management committees and municipalities purchase hygiene consumables and fully fund new toilet blocks.  
  • This leads to improved WASH in health care facilities and additional employment opportunities for cleaning and maintenance of WASH facilities.  
  • Local advocacy documents and WASH FIT outcomes are presented at the national level to inform the new national WASH in health care facility strategy.  

Hands4health supports the WASH FIT approach in Mali and its replication in Burkina Faso. As part of the project, a joint retreat between the Tdh teams from Mali and Burkina Faso took place in 2022. This joint workshop enabled the Burkina Faso team to learn from Tdh Mali’s experience in using the WASH FIT approach in primary health care facilities.

For more information about the WASH FIT approach in Mali, please see the presentation from Aboubacar here (in English) and from the Malian Ministry of Health representative here (in French).