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The Global Handwashing Partnership

Hospital hygiene woefully inadequate, finds new WHO/UNICEF report

March 17, 2015

One of the most vulnerable times in life is the precious moments after birth. Each year an estimated 430,000 newborns die from sepsis and other severe infections, with the greatest risk facing those born in low-resource settings. We know that a lack of water, sanitation, and hygiene (WASH) can magnify this risk. Given that safety recommendations advocate for babies to be born in healthcare facilities, the first-ever World Health Organization (WHO) and UNICEF report on the state of Water, Sanitation, and Hygiene in Health Care Facilities around the world is essential and concerning reading.

We know that healthcare facilities must achieve basic standards of hygiene, but this report shed light on the disturbing fact that 35% of over 66,000 healthcare facilities in 54 countries did not have soap and water for handwashing.  Lack of basic hygiene threatens the health not only of newborns, but of all patients. Annually 15% of all patients develop at least one infection during their hospital stay. Patients are not indifferent to this risk:  concerns about poor WASH facilities can deter people from seeking healthcare when they are most in need.

Inadequate investment in hygiene in healthcare facilities is a health opportunity squandered. Hygiene is a relatively affordable, easy-to-implement preventive intervention that delivers big benefits, including saving lives, reducing hospital stays, and managing countries’ healthcare costs. Investment in hygiene in healthcare facilities is additionally augmented when patients and family members incorporate handwashing behaviors they learned at the healthcare facility into their daily routine at home.

Large-scale progress must be made on access to hygiene. However, for that to happen countries need to know where they currently stand. Measuring the current status of hygiene and using the targets, such as those proposed by the Joint Monitoring Programme, to measure progress can help elucidate the full scope of the hygiene crisis. According to the WHO/UNICEF report, there is less data available on hygiene facilities compared to water and sanitation and no data on functionality or use. Not surprisingly, fewer governments have targets for the availability of hygiene facilities compared to water and sanitation. This lack of accountability is associated with inadequate financing for even the most basic hygiene facilities..

There are opportunities to change the status of hygiene, both in healthcare facilities and other key extrahousehold locations, such as schools. Governments should incorporate hygiene into national policies and budgets. At the global level, hygiene must be included in the Sustainable Development Goals, not just as a goal, but also as an indicator. This will ensure that governments are held accountable for progress they have or have not made. Finally, in conversations about universal health coverage, water, sanitation, and hygiene must be addressed, given their essential role in health and wellness.

Can you imagine delivering a baby in a facility without a place for the birth attendant, nurse, or doctor to wash their hands? When hygiene is such a simple solution, no mother should have to face this reality. No parent should worry about their newborn’s health being put at risk due to a lack of soap and water. No patient should consider avoiding essential hospital care out of fear of infections on the hands of their healthcare providers. And no healthcare worker should worry that, despite their best intentions, they are causing their patients unnecessary harm due to inadequate hygiene facilities. While these scenarios are currently far too often a reality, they don’t need to be. Join us and advocate for hygiene today. Because when it comes down to it, this really is a matter of life and death.

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