[Answered] “Adequate water, sanitation and hygiene (WASH) amenities, including waste management and environmental cleaning services, are critical to safe functioning of health facilities.” Comment. Discuss what should be done to improve health facilities?

Healthcare facilities include primary, secondary, tertiary healthcare. A healthcare facility poor in WASH services i.e Water, Sanitation, and Hygiene lead to threat of infections and prevention of disease is severely compromised. Adequate water, sanitation and hygiene (WASH) amenities, including waste management and environmental cleaning services, are critical to their safe functioning.

Why WASH (Water, Sanitation and Hygiene) is Important?

1. Reduce incidence of diseases: There is clear evidence that shows that hygienic behaviour, in particular hand-washing with soap can significantly reduce the incidence of diseases like diarrhoea, which is the second leading cause of death amongst children under five years old.
2. Prevent spreading of disease: Good hand-washing practices reduce the spread of many diseases. It prevent spreading of microbes causing diseases.
3. Risk to patients and health workers: Poor hygiene, sanitation put patients and health workers at risk of getting sick from avoidable infections. Poor WASH facilities lead to increased chances of infection at health facilities.
4. Antimicrobial Resistance: Lack of WASH facilities also results in unnecessary use of antibiotics, thereby spreading antimicrobial resistance. Poor Hygiene lead to microbes getting adapted. Flush of antibiotic in water lead to development of microbial resistance.

How to improve health facilities?

1. Develop National standards and accountability mechanisms: Health authorities should establish national standards and accountability mechanisms. Lack of quality data limits authorities’ understanding of the problem. A national road-map is needed to improve WASH services in healthcare facilities.
2. Behavioural Change and culture of cleanliness: Health authorities should work towards developing a culture of cleanliness and safety in all healthcare facilities. Swachh Bharat Scheme should give special focus on healthcare facilities. A behaviour change must be instilled among community towards WASH and it’s benefits.
3. Ensure timely data collection: Authorities should ensure that collection of data on key WASH indicators should be done on time. It will accelerate progress by promoting continued action and accountability.
4. Conduct situation analysis and assessment– An analysis to examine health and WASH policies, governance structures, and funding is needed. An assessment is necessary for updated figures on WASH coverage and compliance in health facilities. Together, these documents form the basis for prioritising policies and mobilising resources.
5. Improve and maintain infrastructure-Health facilities’ infrastructure should be improved to meet national standards. It should be accompanied by various policies inputs.
6. Develop health workforce– All workers engaged in the health system, from doctors, to nurses, midwives, and cleaners should have access to up-to-date information on WASH and infection prevention and control practices during pre-service training and as part of regular professional development.
7. Engage communities– Community members play an important role in using and providing feedback on health services. They must be included in the development of WASH policies and in the regular review of WASH coverage and implementation data.

• Conduct research and share learning– External review and research is important for testing and scaling-up approaches. It help in reflecting and revising programmes and various strategies.

As member states strive to achieve the ‘flagship priorities’ and work towards the SDG targets, outcome is crucial. Indeed, whatever the healthcare facility, whoever the provider, and wherever it is located, securing safe health services is an objective member states must boldly pursue.