The lack of water at healthcare services is putting about 1.8 billion people at a heightened risk of Covid-19 and other diseases, the World Health Organization and UNICEF warned in a joint communication.

“Working in a healthcare facility without water, sanitation and hygiene is akin to sending nurses and doctors to work without personal protective equipment (PPE)” points out Tedros Adhanom Ghebreyesus, WHO Director-General, adding that there were major gaps to overcome, particularly in least developed countries.

The joint Global Progress Report on WASH (water, sanitation and hygiene) in healthcare facilities comes even as Covid-19 exposes vulnerabilities within health systems, including inadequate infection prevention and control.

Despite this, water is not prioritised, the report said, pointing out that “Globally, 1 in 4 healthcare facilities has no water services, 1 in 3 does not have access to hand hygiene where care is provided, 1 in 10 has no sanitation services, and 1 in 3 does not segregate waste safely.”

Pointing out that healthcare facilities without water put healthcare workers and patients at risk, UNICEF Executive Director Henrietta Fore said: “This was certainly true before the Covid-19 pandemic, but this year has made these disparities impossible to ignore.”

Data published by WHO in October indicates that Covid-19 infections among healthcare workers are far greater than those in the general population: “Healthcare workers represent less than 3 per cent of the population, but account for 14 per cent of global Covid-19 cases reported to WHO. Ensuring healthcare workers have the basic WASH necessities to keep themselves, their patients, their families and children safe — is imperative,” the note said.

Worst in LDCs

The worst situation is seen in the 47 Least Developed Countries (LDCs), “where 1 in 2 healthcare facilities does not have basic drinking water, 1 in 4 healthcare facilities has no hand hygiene facilities at points of care; and 3 in 5 lack basic sanitation services.”

But this can be fixed, the two multilateral agencies said. The report’s preliminary estimates indicate that it would cost roughly $1 per capita to enable all 47 LDCs to establish basic water service in health facilities. On average, $0.20 per capita is needed each year to operate and maintain services.

Immediate, incremental investments in WASH have big returns in terms of the spin-off gains from improved hygiene and reduced infections, among others, the report said, adding that it tantamounted to a return of $1.5 for every dollar invested.

The report makes four recommendations: “Implement costed national roadmaps with appropriate financing; monitor and regularly review progress in improving WASH services, practices and the enabling environment; develop capacities of health workforce to sustain WASH services and promote and practice good hygiene; integrate WASH into regular health sector planning, budgeting, and programming, including Covid-19 response and recovery efforts to deliver quality services.” Upto this year, over 130 partners have committed resources, of which 34 have made dedicated financial commitments totalling $125 million.

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