Water, Sanitation, and Hygiene Service Availability at Rural Health Care Facilities in Southwestern Uganda

Background: Improved Water, Sanitation and Hygiene (WASH) services in Health Care Facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of hospital acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improved staff morale. Despite these benefits, there is limited evidence on the status of WASH in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the status of WASH within HCFs in the GKMA in order to inform policy and WASH programming.Methods: A cross-sectional study was conducted in 60 HCFs. The status of WASH in the study facilities was assessed using a validated WASH Conditions (WASHCon) tool comprising of structured interviews, HCF observations and microbial water quality analysis. Data were analysed using Stata 14 software and R software. The relationships between WASH status and HCF characteristics were assessed using Fishers’ exact tests.Results: Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH status respectively. About 48.3% (28/58) had a limited water supply status, 84.5% (49/58) had limited sanitation status, 50.0% (29/58) had limited environmental cleanliness status, 56.9% (33/58) had limited hand hygiene status and 51.7% (30/58) had limited waste management status. Overall, there were significant differences in water supply status by ownership of the HCF and level of HCF. There was a significant statistical difference in WASH status between public and private not for profit facilities (p = 0.021). A significant difference was also observed in WASH status between hospitals and lower levels HCFs (p = 0.004). Conclusion: Majority of the HCFs in the GKMA had limited access to all WASH service domains i.e. water supply, sanitation, hand hygiene, environmental cleanliness and healthcare waste management. We recommend deliberate increased investments in WASH for healthcare services, especially for sanitation and hand hygiene provisions which were in the poorest state. Improvements in WASH conditions will not only minimize the risk of transmission of HAIs but also associated costs.

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Section: Introductionmentioning

confidence: 57%

Status of Water, Sanitation and Hygiene in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda.

Kayiwa

Mugambe

Mselle

et al. 2020

Preprint

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“…More PNFP HCFs had better WASH services compared to the public HCFs. It has been assumed that private facilities at the same level as public facilities generally have better service standards (4). Unlike public HCFs where services are free, PNFP HCFs in the study area provide healthcare services at a cost.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…There is limited data on WASH in HCFs in urban Uganda, however, a study conducted in south western Uganda indicated critical gaps in the provision of WASH in HCFs in rural facilities (4). Mulogo,Matte (4) reported that only 38% of the HCFs had toilets with hand washing facilities; with only 24% having soap and water (4). Similarly, Guo, Bowling (5) reported that less than 50% of rural HCFs in Uganda had access to improved water sources on premises, improved sanitation, and consistent access to water and soap for handwashing.…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, Guo, Bowling (5) reported that less than 50% of rural HCFs in Uganda had access to improved water sources on premises, improved sanitation, and consistent access to water and soap for handwashing. Whereas Mulogo, Matte (4) and Guo,Bowling (5) give useful insights into WASH in HCFs in rural settings, their ndings do not explicitly give a picture of availability of WASH services in a typically growing urban setting such as the Greater Kampala Metropolitan area (GKMA). Besides, the ndings are not comparable to the Joint Monitoring Programme (JMP) WASH service ladders (6).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Water, Sanitation and Hygiene Services in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda

Kayiwa

Mugambe

Mselle

et al. 2020

Preprint

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Background: Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improved staff morale. Despite these benefits, there is limited evidence on availability of WASH services in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the availability of WASH services within HCFs in the GKMA in order to inform policy and WASH programming.Methods: A cross-sectional study was conducted in 60 HCFs. Availability of WASH services in the study HCFs was assessed using a validated WASH Conditions (WASHCon) tool comprising of structured interviews, HCF observations and microbial water quality analysis. Data were analysed using Stata 14 software and R software. Results: Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH service respectively. About 48.3% (28/58) had limited water service, 84.5% (49/58) had limited sanitation service, 50.0% (29/58) had limited environmental cleanliness service, 56.9% (33/58) had limited hand hygiene service, and 51.7% (30/58) had limited waste management service. About 94.4% of public HCFs had limited WASH service compared to only 68.2% of private not for profit facilities. More health centre IIIs, 92.5% and health centre IVs (85.7%) had limited WASH service compared to hospitals (54.5%).Conclusions: Our findings indicate that provision of water, sanitation, hand hygiene, environmental cleanliness, and health care waste management services within HCFs are largely hindered by structural and performance limitations. In spite of these limitations, it is evident that environmental cleanliness and treatment of infectious waste can be attained with better oversight and dedicated personnel. Attaining universal WASH coverage in HCFs will require deliberate and strategic investments across the different domains.

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Assessment of the relationship between microbiological quality of groundwater sources and the status of the sources

Fadipe

Oladepo

Oguntola

et al. 2021

Environmental Quality Mgmt

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Groundwater contamination is now a global issue, and the sources of contamination differ from countries. The study reports the assessment of microbiological characteristics of different groundwater sources in Ilesa west local government area for potability status. Also, it examined the strength of the relationship between the microbiological results with the construction and sanitation characteristics of the sources to determine the cause of the pollution. The work involved an on-site survey of 69 drinking water sources extracted from a gridded map of the study area to gather information on water sources, treatment, construction, and sanitary status. Water sampling from each household was conducted during rainy and dry seasons for microbiological characteristics using the most probable number (MPN) of counting coliforms. Most of the water samples were heavily polluted and exceeded the WHO guidelines with MPN/100 mL ranging from 0 to > 1.1 × 10 3 . The Kendall's tau_b correlation revealed that the water source in form of hand-dug wells has the strongest correlation (r = 0.94) with the microbiological result. The hand-dug wells that were partially lined, and those not lined at all, correlate (r = 0.95 and r = 0.94), respectively, with the microbiological results. The microbiological loads of all the water sources are high, and the status of the casing has proved to be the major factor influencing the pollution in the hand-dug wells. There is a need to enforce the construction standards for household hand-dug wells, perform routine water quality assessment for boreholes, and authority should encourage the treatment of all water sources before drinking. K E Y W O R D Sboreholes, hand-dug wells, microbiological quality, MPN, spring, well characteristics Abbreviations: APHA, American Public Health Association; DWAGL, hand-dug wells with casing height of less than 0.1 m; DWAN, hand-dug wells with casing height of 0.1-0.3 m; DWANH, hand-dug wells with casing height above 0.3 m; DWC, hand-dug wells with coagulation treatment; DWCH, hand-dug wells with chlorination treatment; DWFH, hand-dug wells far from septic tank//pit latrines with a distance of more than 15 m; DWFM, hand-dug wells far from the septic tank/pit latrines with a distance of 8 m-15 m; DWFS, hand-dug wells far from the septic tank/pit latrines with a distance of less than 8 m; DWNT, hand-dug wells with no form of treatment; Eh, redox potential; GIS, geographic information system; GPS, global positioning system; LCNPM, hand-dug wells lined but have cracks and no pumping machine installed; LGA, Local Government Area; LNPF, hand-dug wells with lids not properly fitted; LPF, hand-dug wells with fitted lids; LRNPM, hand-dug wells Lined/ringed with no pumping machine installed; LRWPM, hand-dug wells lined/ringed with pumping machine installed; MPN, most probable number; NLRNPM, hand-dug wells not lined/ringed with no pumping machine installed; NLRWPM, hand-dug wells not lined /ringed with pumping machine installed; PAST, Paleontological statistics; PHAC, Public H...

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Water, Sanitation, and Hygiene Service Availability at Rural Health Care Facilities in Southwestern Uganda

Cited by 19 publications

References 9 publications

Status of Water, Sanitation and Hygiene in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda.

Status of Water, Sanitation and Hygiene in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda.

Assessment of Water, Sanitation and Hygiene Services in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda

Assessment of the relationship between microbiological quality of groundwater sources and the status of the sources

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