A quarter of all health care facilities have no basic water services.

We aim to change that.

Learn more about WHO and UNICEF’s comprehensive report of global progress on improving WASH in health care facilities.

The report identifies major global gaps in WASH services


One third of health care facilities do not have what is needed to clean hands where care is provided.


One in four health care facilities have no water services.


10% of health care facilities have no sanitation services.

1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets.

Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.

Report 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 the health workforce to sustain WASH services and promote and practice good hygiene.
  • Integrate WASH into regular health sector planning, budgeting and programming to deliver quality services, including COVID-19 response and recovery efforts.

The pandemic is a reminder of the intimate and delicate relationship between people and the planet. Any efforts to make our world safer are doomed to fail unless they address the critical interface between people and pathogens, and the existential threat of climate change, that is making our Earth less habitable.

WHO Director-General Dr Tedros Adhanom Ghebreyesus. 
Address To The 73Rd World Health Assembly (18Th May 2020).

Eight Practical Steps to Achieve Universal Access to Quality Care

1. Conduct Situation Analysis And Assessment

Conduct situational analysis of enabling environment for WASH in health care facilities (specifically health and WASH policies, governance structures, institutional arrangements, funding streams and stakeholders). Assess WASH coverage and compliance.

2. Set Targets And Define Roadmap

Set detailed targets (with a national costed roadmap) to address gaps, and estimate costs (capital investments, rehabilitation and recurrent costs). A joint WASH and health taskforce or technical working group is an effective mechanism to help set these targets and develop a roadmap.

3. Establish National Standards And Accountability Mechanisms

Develop standards (a set of requirements that dictate the infrastructure and resources necessary to provide sustainable WASH services) and implement using accountability mechanisms (regulation, accreditation, licensing, community scorecards, feedback mechanisms).

4. Improve Infrastructure And Maintenance

Select, install, operate, maintain and improve WASH infrastructure, (including through use of WASH FIT) to ensure sufficient, functioning WASH services are available.

5. Monitor And Review Data

Track the status or progress of WASH interventions by monitoring and reviewing indicators on a regular basis, including through national health monitoring information systems.

6. Develop Health Workforce

Invest in a well-trained and well-supported health workforce to enable health systems to perform well and to respond appropriately to challenges.

7. Engage Communities

Give community members and organizations agency in decision-making and management of services to ensure that health care facilities provide the level of care that citizens deserve and expect.

8. Conduct Operational Research And Share Learning

Generate evidence to understand the problem and what to do about it and scale-up proven improvement approaches.

Water, sanitation and hygiene is a fundamental human right. There is no place where such services are more important, than in health care facilities, especially during the COVID-19 pandemic which is ravaging our communities. I call on all countries and national authorities to act now and invest in universal WASH in health care facilities.

Madam Fabiola Yáñez, First Lady of Argentina

Follow our Twitter feed for updates

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@wateraid: Too many healthcare facilities around the world don't have clean water, decent toilets or hygiene facilities. Explore our new virtual exhibition - Wards without Water - to see the realities of this for patients and staff: https://t.co/J7luFkYjlM #Hygiene4Health https://t.co/zLbZhyryEh
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"Bringing #WASH services to all health facilities & hospitals in the world’s 46 least developed countries would cost about $9.6 billion over a decade". https://t.co/TvK95qou87 "The time is now". We agree!
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This ➡️@devex @MaEllenSirleaf @HelenClarkNZ "Ensuring everyone in the poorest countries has somewhere to wash their hands with soap & water at home would cost around $11 billion per year until 2030: equivalent to amount spent in Amazon’s Prime Day shopping event in June"
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@SanLearningHub: 📢Just published - new Frontiers of Sanitation on environmental cleanliness for child development! 👉https://t.co/HdnHEfDjD3 ⏰@al_macintyre & Clare Strachan @NossalInstitute will be discussing findings tomorrow at 9am UK time. Sign up to attend here 👉https://t.co/HK9Lniavsv https://t.co/uHd7etPnhL
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@amrutabyatnal @devex & @nkwanjacob perfectly describe why there can be no #quality health care 🏥 without 💦 🚽 & 🧼 #WASH https://t.co/N8Fgk2rO9y
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@DrMariaNeira: Opinion: Time to come clean on hand-washing investment | Devex https://t.co/AJv9pHU2uv
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@EuWateraid: Today is #WorldToiletDay 1. The global #sanitation workforce protects all of us from many infectious diseases. WASH services are critical to maintaining public #health But without sanitation #workers, these services would break down. https://t.co/3zkSEVlkQ3
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@_waterforwomen: On #WorldToiletDay, Water for Women Gender & Social Inclusion Specialist Joanna Mott reflects on the theme of "Valuing Toilets," and the question, "What's the value of a toilet?" https://t.co/faQrp3wcRU @dfat #sanitation #WASH #SDG5 #SDG6 #GESI #GEDSI #MHH https://t.co/uTnSSkMEPr
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@WaterAidEA: "Nurses are the backbone of effective health systems. Investing in nurses and midwives are among the fair ways for the well being of the population." - Fauste Uwingabire #RGHS2021 #Hygiene4Health https://t.co/JERRxlR17a
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