In 2015, for the first time, WHO and UNICEF assessed the status of WASH in health care facilities in low- and middle-income countries1. With a significant proportion of facilities without any services at all, WHO, UNICEF and partners committed at a global meeting2 to address the situation, with the aim of achieving universal access in all facilities, in all settings, by 2030. Water, Sanitation and Hygiene (WASH) in Health Care Facilities Global Action Plan

Multiple benefits of adequate WASH in health care facilities A GLOBAL ACTION PLAN, Reduced health care acquired infections with five change objectives, Reduced anti-microbial resistance was developed in March 2015. Improved occupational health and safety In the first phase of this work, Health and four task teams (comprised of Facilities better prepared Safety Improved outbreak prevention health and WASH specialists) to continue to provide Climate Disease and control (e.g. cholera, Ebola) are working to address five WASH in disasters, change including climate climate and disaster prevention and Improved diarrheal disease change objectives and produce related events resilience treatment prevention and control tangible deliverables. The Task Teams are: Advocacy WASH and Policy; Monitoring; Improved satisfaction More efficient Healthcare Staff Evidence and Research; and services costs morale and and ability to provide Standards and Facility-based Disease/deaths performance safe care Improvements. averted

Community People Health staff model good WASH centered care Increased uptake of services, behavior; improved hygiene e.g. facility births, vaccinations practices at home

Change Objectives WASH in health care facilities is prioritized as a necessary input to achieving all global and national health goals, especially those linked to CO 1 Universal Health Coverage. Key decision makers and thought leaders champion WASH in health care facilities. CO 2 All countries have national standards and policies on WASH in health care facilities and dedicated budgets to improving and maintaining services. CO 3 Global and national monitoring efforts include harmonized core and extended indicators to measure WASH in health care facilities. The existing evidence base is reviewed and strengthened to catalyze advocacy messages and improve implementation of WASH in health CO 4 care facilities. Health care facility staff, management and patients advocate for and champion improved WASH services. Risk-based facility plans are CO 5 implemented and support continuous WASH improvements, training and practices of health care staff.

1 WHO/UNICEF, 2015, Water, sanitation, and hygiene in health care facilities: status in low and middle-income countries and way forward. Report. http://www.who.int/water_sanitation_health/publications/ wash-health-carefacilities/en/ 2 WHO/UNICEF, 2015. Water, sanitation and hygiene in health care facilities: urgent needs and actions. Meeting Report. http://www.who.int/water_sanitation_health/en/

WASHinHEALTH CARE FACILITIES for better health care services Global Action Plan Task Teams and Activities

STANDARDS AND FACILITY ADVOCACY AND POLICY MONITORING EVIDENCE AND RESEARCH IMPROVEMENTS

Change Objective 1 Change Objective 2 Change Objective 3 Change Objective 4 Change Objective 5

Aim: To advocate for global and national Aim: To develop, test and revise Aim: To draw on and extend Aim: To develop a suite of action to improve WASH in health care core and expanded indicators the evidence base to support field-tested tools, training and facilities and support leaders dedicated to track WASH in health care increased investments, quality reference materials for a variety to this effort. facilities. improvements and advocacy of facilities and settings. efforts.

Activities Activities Activities Activities Document national case studies including Core and expanded indicators Develop priority operational Support regular training and processes and change mechanisms for incorporated into all relevant research agenda and seek competency assessments for all improving WASH in health care facilities. WASH and health monitoring opportunities to address the health facility staff including and accountability mechanisms. evidence gaps. cleaners and health care workers.

Partners: Canada Global Affairs, UK Department for International Development (DFID), Emory University, Global Health Council, Hilton Foundation, Indian Institute of Public Health (IIPH), Infection Control African Network (ICAN), IRC WASH, Japan International Cooperation Agency (JICA), London School of Hygiene and Tropical Medicine (LSHTM), Médicins Sans Frontières (MSF), SoapBox Collaborative, Swiss Federal Institute of Aquatic Science and Technology (EAWAG), Terre des Hommes, United Nations Children Fund (UNICEF), University of East Anglia, USAID, WASH Advocates, WaterAid, Water Institute-University of North Carolina (UNC), Water Supply and Sanitation Collaborative Council (WSSCC), World Bank, World Health Organization (WHO), World Vision.

Government representatives from: Cambodia, Chad, Ethiopia, India, Liberia, Mali, Sierra Leone, Zambia and Zanzibar.

Health priorities represented: Health systems, Infection prevention and control (IPC), Maternal and newborn health (MNCH), Outbreaks and emergencies, quality Universal Health Coverage (UHC).

Advocacy Global Advocacy Water and Compendium infographic on UHC, Plan drafted of appropriate MCH and joint Sanitation technologies compiled action produced Health Facility Improvement Tool (WASH FIT) finalised First set of risk assessment/ Research meeting Joint event with facility to review evidence quality UHC at the Core and improvement and develop 69th World Health expanded tools tested research plan Assembly indicators tested

AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2015 2016 2030 AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Universal access to WASH in health care Core Briefing facilities by Task Core and Global Meeting to Teams monitoring note on expanded 2030 indicators evidence assess progress and plan initiated indicators next steps drafted finalised finalised Review existing data on key health Launch website outcomes linked with www.washinhcf.org WASH in HCF

On-going: Health and WASH On-going: experts advocating for WASH Implementation in health care facilities adaption of facility tools for different settings.

Get involved and contribute to an important global movement Visit www.washinhcf.org