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1:2 patients leave the hospital with an infection they did not have upon arrival:
“In some developing countries up to one in every two patients (45.6%) left hospital with an infection they had not had on arrival.”
With no readily available source of clean water to clean the wards or hands, healthcare facilities can become harbors for dangerous bacteria with health workers unknowingly transmitting disease from one patient to the next. A review in 2011 of healthcare acquired infections showed that in some developing countries up to one in every two patients (45.6%) left hospital with an infection they had not had on arrival. In one study at a large African teaching hospital, handwashing was only attempted 12% of the time and done effectively in only 4% of opportunities, despite nine in ten of the wards having a sink with soap available. WASH and hygiene in healthcare facilities is fundamental to infection prevention and control.
“In some developing countries up to one in every two patients (45.6%) left hospital with an infection they had not had on arrival.”
With no readily available source of clean water to clean the wards or hands, healthcare facilities can become harbors for dangerous bacteria with health workers unknowingly transmitting disease from one patient to the next. A review in 2011 of healthcare acquired infections showed that in some developing countries up to one in every two patients (45.6%) left hospital with an infection they had not had on arrival. In one study at a large African teaching hospital, handwashing was only attempted 12% of the time and done effectively in only 4% of opportunities, despite nine in ten of the wards having a sink with soap available. WASH and hygiene in healthcare facilities is fundamental to infection prevention and control.
The lack of WASH in Health Care Facilities is devastating:
“The lack of WASH in HCFs contributes to millions of infection-related deaths each year. When these infections do not result in death, they can cause prolonged hospital stays, long-term disability, increased antibiotic resistance and economic burden on health-care systems.”
Additionally, both lack of access to adequate WASH and high risk of infection in HCFs themselves can adversely affect patients’ willingness to seek care at HCFs, which increases the risk of health complications and death. In healthcare facilities where water is not readily available, additional non-medical costs may be incurred by patients. For example, patients may be forced to bring their own drinking water and/or pay for water for washing or laundry. Similarly, these conditions negatively impact health-care staff attendance, morale, retention and safety.
“The lack of WASH in HCFs contributes to millions of infection-related deaths each year. When these infections do not result in death, they can cause prolonged hospital stays, long-term disability, increased antibiotic resistance and economic burden on health-care systems.”
Additionally, both lack of access to adequate WASH and high risk of infection in HCFs themselves can adversely affect patients’ willingness to seek care at HCFs, which increases the risk of health complications and death. In healthcare facilities where water is not readily available, additional non-medical costs may be incurred by patients. For example, patients may be forced to bring their own drinking water and/or pay for water for washing or laundry. Similarly, these conditions negatively impact health-care staff attendance, morale, retention and safety.
WASH and safe births:
“Encouraging women to give birth in healthcare facilities is one of the key strategies for reducing maternal mortality. Yet even in the very facilities that are set up to serve their communities with healthcare and welcome new life into the world, there is often no constant clean water supply, functioning toilets or handwashing facilities.” - WaterAid
As clearly set out in the World Health Organization’s (WHO) ‘Essential environmental health standards in healthcare’, these are the basic front line defenses in the battle against infection and a lack of those services calls into question whether such establishments can adequately serve as healthcare facilities. A 2015 WHO survey of healthcare facilities in 54 developing countries revealed that 38% lack a clean water supply, 19% do not provide improved sanitation, and 35% do not have soap for handwashing. In the Sub-Saharan African countries surveyed, that percentage rises to 42%. Those figures also do not reflect whether the water supply is constant. The WHO estimates that of those healthcare facilities that have some form of clean water supply, around half do not have a reliable supply.
“Encouraging women to give birth in healthcare facilities is one of the key strategies for reducing maternal mortality. Yet even in the very facilities that are set up to serve their communities with healthcare and welcome new life into the world, there is often no constant clean water supply, functioning toilets or handwashing facilities.” - WaterAid
As clearly set out in the World Health Organization’s (WHO) ‘Essential environmental health standards in healthcare’, these are the basic front line defenses in the battle against infection and a lack of those services calls into question whether such establishments can adequately serve as healthcare facilities. A 2015 WHO survey of healthcare facilities in 54 developing countries revealed that 38% lack a clean water supply, 19% do not provide improved sanitation, and 35% do not have soap for handwashing. In the Sub-Saharan African countries surveyed, that percentage rises to 42%. Those figures also do not reflect whether the water supply is constant. The WHO estimates that of those healthcare facilities that have some form of clean water supply, around half do not have a reliable supply.
Bring you own” birthing kit:
“In some cases, women giving birth must buy their own ‘clean birth kit’, which includes a plastic sheet and gloves to compensate for the lack of adequate hygiene provision in maternity units.”
Beyond the risk of infection that such conditions can cause, lack of clean water, toilets and good hygiene may have other consequences for healthcare users. For example, women in labor may be asked to bring in their own jerry cans of water for drinking and washing during the birth. Such water may be fetched from unsafe sources such as rivers or ponds. This not only puts mothers and their babies at grave risk of contracting a potentially fatal infection, but the lack of hygienic conditions can put women off attending healthcare facilities, thereby undermining efforts to increase the proportion of births assisted by skilled attendants. In some cases, women giving birth must buy their own ‘clean birth kit’ which includes a plastic sheet and gloves to compensate for the lack of adequate hygiene provision in maternity units. These costs must be considered as part of overall efforts to reduce the cost of accessing healthcare services.”
“In some cases, women giving birth must buy their own ‘clean birth kit’, which includes a plastic sheet and gloves to compensate for the lack of adequate hygiene provision in maternity units.”
Beyond the risk of infection that such conditions can cause, lack of clean water, toilets and good hygiene may have other consequences for healthcare users. For example, women in labor may be asked to bring in their own jerry cans of water for drinking and washing during the birth. Such water may be fetched from unsafe sources such as rivers or ponds. This not only puts mothers and their babies at grave risk of contracting a potentially fatal infection, but the lack of hygienic conditions can put women off attending healthcare facilities, thereby undermining efforts to increase the proportion of births assisted by skilled attendants. In some cases, women giving birth must buy their own ‘clean birth kit’ which includes a plastic sheet and gloves to compensate for the lack of adequate hygiene provision in maternity units. These costs must be considered as part of overall efforts to reduce the cost of accessing healthcare services.”
Newborns and sepsis:
“8% of maternal mortality is caused by sepsis. A failure to make sure that a woman has a clean place to give birth, that a midwife, birth attendant or doctor has clean hands when helping her deliver, and that the blade which separates the child from his mother by cutting the umbilical cord is clean puts a baby at risk. The absence of sufficient infection prevention and control measures in healthcare facilities should be of particular concern to those attempting to redress the slow progress to reduce maternal mortality globally.”
The bacteria that cause neonatal sepsis are acquired shortly before, during, and after delivery. They can be obtained directly from mother's blood, skin, or birth canal before or during delivery, or from the environment during and after delivery. Clean delivery practices and handwashing during delivery, and handwashing by healthcare providers after delivery are necessary for reducing the risk of sepsis. Infections can also be easily transmitted if dirty implements are used to cut the umbilical cord, and by contaminated surfaces such as beds and other objects. A failure to make sure that a woman has a clean place to give birth, that a midwife, birth attendant or doctor has clean hands when helping her deliver, and that the blade which separates the child from his mother by cutting the umbilical cord is clean, puts a baby at risk of contracting sepsis.
“8% of maternal mortality is caused by sepsis. A failure to make sure that a woman has a clean place to give birth, that a midwife, birth attendant or doctor has clean hands when helping her deliver, and that the blade which separates the child from his mother by cutting the umbilical cord is clean puts a baby at risk. The absence of sufficient infection prevention and control measures in healthcare facilities should be of particular concern to those attempting to redress the slow progress to reduce maternal mortality globally.”
The bacteria that cause neonatal sepsis are acquired shortly before, during, and after delivery. They can be obtained directly from mother's blood, skin, or birth canal before or during delivery, or from the environment during and after delivery. Clean delivery practices and handwashing during delivery, and handwashing by healthcare providers after delivery are necessary for reducing the risk of sepsis. Infections can also be easily transmitted if dirty implements are used to cut the umbilical cord, and by contaminated surfaces such as beds and other objects. A failure to make sure that a woman has a clean place to give birth, that a midwife, birth attendant or doctor has clean hands when helping her deliver, and that the blade which separates the child from his mother by cutting the umbilical cord is clean, puts a baby at risk of contracting sepsis.
- Tanzania: 44% of healthcare facilities where women give birth have adequate water and sanitation facilities, but only a quarter of delivery rooms in those same health centers have water and toilets. Even if every woman in Tanzania chose to give birth in a health center, less than two thirds of those births (59%) would be in centers that could provide the mother and baby with a safe environment.
- Nigeria: Only 2 out of 5 maternity units in Southern Nigeria had soap or antiseptic in or near operating theatres or delivery rooms.
- India: With 167 maternal deaths per 1,00,000 live births and 28 newborn deaths per 1,000 live births, India has one of the highest rates of maternal and neonatal mortality in the world. 1 in 5 newborn deaths could be prevented by ensuring access to clean water and a clean birthing environment.
50 % of the health burden of malnutrition is attributable to WASH:
“Diarrhea is deadly. 1.5 million people die every year from diarrheal diseases (including cholera); 90% are children under 14, mostly in developing countries. 88% of diarrhea is attributed to unsafe water supply, inadequate sanitation and hygiene. As diarrhea causes undernutrition, it creates a vicious cycle by also reducing a child’s resistance to subsequent infections; repeated bouts of diarrhea can negatively impact children’s physical and cognitive development.”
The World Health Organization states that one of the three pillars of food security is “the appropriate use [of food] based on knowledge of basic nutrition and care, as well as adequate water and sanitation.” WASH can stop the cycle of undernutrition. Safe drinking water reduces the amount of fecal bacteria children ingest. Improved sanitation reduces exposure to fecal bacteria and provides a clean environment for children to live, learn, and play. Hygiene, especially handwashing, has been shown to reduce diarrheal disease by about 45%.
“Diarrhea is deadly. 1.5 million people die every year from diarrheal diseases (including cholera); 90% are children under 14, mostly in developing countries. 88% of diarrhea is attributed to unsafe water supply, inadequate sanitation and hygiene. As diarrhea causes undernutrition, it creates a vicious cycle by also reducing a child’s resistance to subsequent infections; repeated bouts of diarrhea can negatively impact children’s physical and cognitive development.”
The World Health Organization states that one of the three pillars of food security is “the appropriate use [of food] based on knowledge of basic nutrition and care, as well as adequate water and sanitation.” WASH can stop the cycle of undernutrition. Safe drinking water reduces the amount of fecal bacteria children ingest. Improved sanitation reduces exposure to fecal bacteria and provides a clean environment for children to live, learn, and play. Hygiene, especially handwashing, has been shown to reduce diarrheal disease by about 45%.
WASH and HIV/AIDS:
“HIV-positive people cannot be treated without clean water, in the hospital and at home. Anti-Retroviral drugs (ARVs) are essential to enable people living with HIV/AIDS to lead healthy and productive lives. Their consumption requires approximately 1.5 litres of safe water every day.”
WASH is essential for ensuring that people living with HIV/AIDS live healthy and productive lives. People living with HIV/AIDS are six times more likely than people without HIV to acquire a diarrheal disease. In addition, babies born to mothers living with HIV are three times more likely to have diarrhea. People living with HIV/AIDS need two and a half times the amount of water needed by people without HIV, as well as improved hygiene and sanitation to help prevent opportunistic infections. Furthermore, Anti-Retroviral drugs (ARVs) are essential to enable people living with HIV/AIDS to lead healthy and productive lives. Their consumption requires approximately 1.5 litres of safe water every day. The physical burden of fetching water is also a strain for people living with HIV/AIDS when they experience reduced energy levels, side effects from HIV medication and/or symptoms of opportunistic infections.
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“HIV-positive people cannot be treated without clean water, in the hospital and at home. Anti-Retroviral drugs (ARVs) are essential to enable people living with HIV/AIDS to lead healthy and productive lives. Their consumption requires approximately 1.5 litres of safe water every day.”
WASH is essential for ensuring that people living with HIV/AIDS live healthy and productive lives. People living with HIV/AIDS are six times more likely than people without HIV to acquire a diarrheal disease. In addition, babies born to mothers living with HIV are three times more likely to have diarrhea. People living with HIV/AIDS need two and a half times the amount of water needed by people without HIV, as well as improved hygiene and sanitation to help prevent opportunistic infections. Furthermore, Anti-Retroviral drugs (ARVs) are essential to enable people living with HIV/AIDS to lead healthy and productive lives. Their consumption requires approximately 1.5 litres of safe water every day. The physical burden of fetching water is also a strain for people living with HIV/AIDS when they experience reduced energy levels, side effects from HIV medication and/or symptoms of opportunistic infections.
For more information:
