Assessment of water, sanitation and hygiene in HCFs: which tool to follow?

Abstract

Water, sanitation and hygiene (WASH) is important to improve and maintain the quality of health care services. Improving and managing WASH services require strong and consistent monitoring mechanisms to measure progress and direct efforts where needs are greatest. Although several tools are available to assess WASH in health care facilities (HCFs), there is always a dilemma among the program managers to select an appropriate tool for the assessment of WASH. Thus, it was aimed to perform a descriptive review of all available WASH assessment tools and assist in reaching a consensus for an optimal tool to assess WASH in HCFs. For this descriptive review, PubMed, ScopeMed and Google Scholar were used to search all available tools for the assessment of WASH. All the tools available online since 1991 till July 2018 were included in the review. Globally, nine different WASH assessment tools were retrieved. The majority of them have their self-limitations on the basis of 11 selected indicators and were examined in all the retrieved tools. There are variability and overlapping components within the specific tools. Very few survey instruments including human resource (HR), supply, budget, patient/staff satisfaction and documentation for appropriateness of WASH were found to be neglected. The majority of instruments were based on the subjective assessment of WASH validating with microbiological surveillance and photo documentation. The descriptive review suggests that various tools are available for the assessment of WASH but none of them seem to be complete with all indicators and to have consensus for the elements. Therefore, there is a need to develop a robust and comprehensive tool for the assessment of WASH in HCFs.

What it takes to save lives: An assessment of water, sanitation, and hygiene facilities in temporary COVID-19 isolation and treatment centers of Southern Ethiopia: A mixed-methods evaluation

“…In our current COVID-19 climate, speed and efficiency are key design drivers-but the safety of patients and staff is also of paramount importance. Clean water, sanitation, and hygiene (WASH) programs are one of the ways to ensure such safety, and an investment in water and sanitation systems, is one of the most cost-effective pandemic preparedness strategies, especially in resource-constrained settings [13]. In health care facilities (HCFs), WASH is characterized as infrastructure, services, and behaviors that encompass water supply and water quality, sanitation facilities (including bathing or shower areas), soap and hand wash water availability, and certain elements of waste management in health care (e.g.…”

“…In a 2019 global report of WASH in HCFs, one in four HCFs lacked basic water services, one in five did not have sanitation services, and one in six had no hygiene services [15]. In the local context, water coverage in such facilities is 32% and the sanitation coverage is 85% while the hygiene data are not available [13]. Quality WASH facilities act as barricades to the transmission of the COVID-19 virus in health care facilities [16].…”

Using the Water and Sanitation for Health Facility Improvement Tool (WASH FIT) in Zimbabwe: A Cross-Sectional Study of Water, Sanitation and Hygiene Services in 50 COVID-19 Isolation Facilities

“…The cut-off points remain flexible and may be modified depending on the aim and purpose of WASH FIT users. While WASH FIT may not be a comprehensive tool [ 25 ], the potential utility and application of WASH FIT have been well-documented [ 20 , 26 , 27 , 28 ]. Moreover, WASH FIT will be further updated to accommodate additional topics, such as climate, occupational health, and gender [ 29 ].…”

When It Is Not Measured, How Then Will It Be Planned for? WaSH a Critical Indicator for Universal Health Coverage in Kenya

“…In addition, there are existing monitoring tools which can be useful in monitoring WaSH in HCF indicators. Patel et al [ 49 ] review on WaSH in healthcare monitoring tool developed from 1991 to July 2018 recommended the need for more comprehensive and concrete WaSH in health care monitoring tools. A recent assessment by the USAID and Maternal Child Survival Program on the Kenyan Health Management Information Systems (HMIS) indicated that half of hospitals surveyed used an electronic medical record that was not linked to the District Health Information Software (DHIS2) in 2016 [ 50 ].…”