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.
Acknowledgments
We would like to acknowledge the Emory University and Soapbox for providing access to the necessary WASH tools. We would also like to thank the Centre for Environmental Health (CEH), India for supporting this review.
Research funding: This project was funded by the Center for Environmental Health, India.
Conflict of interest: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: The conducted research is not related to either human or animal use.
References
1. Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. Geneva: World Health Organization, 2008.Search in Google Scholar
2. WHO Library Cataloguing-in-Publication Data. Water, sanitation and hygiene in health care facilities: status in low and middle income countries and way forward. I. World Health Organization. II. UNICEF, 2015. ISBN 978 92 4 150847 6 (NLM classification: WX 167).Search in Google Scholar
3. WHO/UNICEF Report. Water, sanitation and hygiene in health care facilities: status in low-and middle-income countries and way forward, 2015.Search in Google Scholar
4. UNICEF, WHO, WaterAid. Water, sanitation and hygiene in health care facilities in Asia and the Pacific, a necessary stepto achieving universal health coverage and improving health outcomes, 2015. Available from: http://www.wateraid.org/what-we-do/our-approach/research-and-publications, Accessed on 3rd June, 2015.Search in Google Scholar
5. Water, Sanitation and Hygiene (WASH) in Health Care Facilities for Better Health Care: Global Action Plan, WHO & UNICEF, 2015.Search in Google Scholar
6. Meeting Report: Water, sanitation and hygiene in health care facilities – urgent needs and actions. In: Global Meeting, 17–18 March, 2015, Geneva, Switzerland.Search in Google Scholar
7. WHO/UNICEF/SHARE. Global strategy, burden of disease, and evidence and action priorities. Workshop Report, World Health Organization, 21–24 March, 2016, London.Search in Google Scholar
8. Service Provision Assessment (SPA) Surveys. Overview of Methodology, Key MNH Indicators and Service Readiness Indicators Paul Ametepi, MEASURE DHS – 01/14/2013.Search in Google Scholar
9. Service Availability and Readiness Assessment (SARA). An annual monitoring system for service delivery. Reference manual, World Health Organization, 2013.Search in Google Scholar
10. Water, sanitation and hygiene in health care facilities: status in low and middle income countries and way. I. World Health Organization. II. UNICEF forward – 2015. Website: http://www.sdindicators.org/.Search in Google Scholar
11. Water, Sanitation and Hygiene (WASH) in health-care facilities in emergencies. In: Adams J, Chartier Y, Harvey B, Maison D, editors. WHO, Geneva, 2012.Search in Google Scholar
12. Driving improvements in WASH in healthcare facilities in Cambodia: facility level assessments to national level change, 2015. https://www.mhtf.org/document/driving-improvements-in-wash-in-healthcare-facilities-in-cambodia-facility-level-assessments-to-national-level-change/.Search in Google Scholar
13. Sanitation Index: Indicators for monitoring cleanliness under Mahatma Gandhi Swachhta Mission, 2014. Urban Development and Urban housing Department, Government of Gujarat, India. Available from: http://www.mgsm-gujarat.in/uploads/Assets/sanitation-indexbook/mgsmindicators12312014105154497.pdf , Accessed on February 2017.Search in Google Scholar
14. Award to Public Health Facilities Kayakalp. National Health Mission. Ministry of Health and Family Welfare, Government of India. 2014. Available from: https://www.nhp.gov.in/sites/default/files/pdf/award_to_public_health_facilities_kayakalp.pdf, Accessed on May 2014.Search in Google Scholar
15. Assessment of Water, Sanitation and Hygiene services and practices at Functional Delivery Points of 8 High Priority Districts, Gujarat, 2014. Available from: http://iapsm.org/pdf/WASH%20State%20report.pdf, Accessed on January 2017.Search in Google Scholar
16. Anon., WASH & CLEAN – a situational analysis on hygiene on maternity wards in India and Bangladesh, 2014, 4 pp.Search in Google Scholar
17. WHO & UNICEF WASH FIT Digital: Water and Sanitation for Health Facility Improvement Tool, 2018. https://washfit.org/#/, Retrieved on November 5, 2018.Search in Google Scholar
18. EAWAG. The Facility Evaluation Tool for WASH in Institutions (FACET), 2018. Available from: https://www.eawag.ch/en/department/sandec/projects/sesp/facet/, Retrieved on November 5, 2018.Search in Google Scholar
19. WASHCon. WASHCon – Water, Sanitation and Hygiene in Healthcare Facilities, 2018. Available from: http://washconhcf.org/research-tools/washcon/, Retrieved on November 5, 2018.Search in Google Scholar
20. WASHCon. WASHCon & WASH FIT: Working in Concert, 2018. Available from: www.cgswash.org.Search in Google Scholar
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