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. 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 has been developed. In the Improved occupational health and safety first phase of this work, four Health and task teams (comprised of Facilities better Safety Outbreak prevention and health and WASH specialists) prepared to continue Climate Disease control (e.g. cholera, Ebola) are working to address the to provide WASH in change and disaster prevention and Diarrheal disease prevention change objectives and product disasters; climate treatment and control related events resilience tangible deliverables. Task teams include: Advocacy, Action and Leadership; WASH Improved satisfaction Monitoring; Evidence and More efficient Healthcare Staff services and ability to provide Operational Research; and costs morale and Disease/deaths performance safe care Policies, Standards and averted Facility-based Improvements. 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 as 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 harmonizing 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

ADVOCACY LEADERSHIP AND EVIDENCE AND OPERATIONAL POLICY, STANDARDS AND ACTION MONITORING RESEARCH FACILITY IMPROVEMENTS Change Change Objective 1 Objective 2 Change Objective 3 Change Objective 4 Change Objective 5 Aim: To advocate for global Aim: To develop, test and Aim: To draw on and extend Aim: To develop a suite of and national action to improve revise core and extended the evidence base to support field-tested tools, training WASH in health care facilities indicators to track WASH in increased investments, and reference materials for and support the leaders health care facilities. quality improvements and a variety of facilities and dedicated to this effort. advocacy efforts. settings. Activities Activities Activities Activities Document national case studies Core and extended indicators Develop priority operational Support regular training and including processes and change incorporated into all research agenda and seek competency assessments for mechanisms for improving WASH relevant WASH and health opportunities to address the all health care facility staff in health care facilities. monitoring and accountability evidence gaps. including cleaners and health mechanisms. care workers.

Participating organisations: DFID, Emory University, Global Health Council, Infection Control Network Africa, London School of Hygiene and Tropical Medicine, Ministry of Health representatives from Ethiopia, Sierra Leone and Zambia, SoapBox Collaborative, UNICEF, University of East Anglia, USAID, WASH Advocates, WaterAid, Water Institute-University of North Carolina, Water Supply and Sanitation Collaborative Council, WHO, World Bank.

Health priorities represented: Health systems, Infection prevention and control, Maternal and newborn health, Outbreaks and emergencies and quality Universal Health Coverage.

Core & expanded Compendium Advocacy infographic indicators of appropriate on UHC, MCH and joint implemented in technologies compiled action national assessments

First set of risk Research meeting to Joint event with Global Advocacy Plan assessment/facility review evidence and quality UHC at the drafted improvement tools develop research plan 69th World Health tested and shared

AUG SEP OCT NOV DEC JAN FEB MAR APR MA JUN JUL 2015 2016 2030 AUG SEP OCT NOV DEC JAN FEB MAR APR MA JUN JUL All facilities have WASH services 2016 Briefing note on Global Meeting to Task Teams initiated Core monitoring evidence finalised indicators finalised assess progress and plan next steps

Review existing Launch website www. data on key health washinhcf.org outcomes linked with WASH in HCF

On-going: Implementation and adaption of facility tools for different settings.

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