Inadequate sanitation in healthcare facilities:A comprehensive evaluation of toilets inmajor hospitals in Dhaka, Bangladesh
STORIES |
University of Technology Sydney
Lack of access to functional and hygienic toilets in healthcare facilities (HCFs) is a significant public health issue in low- and middle-income countries (LMICs), leading to the transmission of infectious diseases. Globally, there is a lack of studies characterizing toilet conditions and estimating user-to-toilet ratios in large urban hospitals in LMICs. We conducted a cross-sectional study in 10 government and two private hospitals to explore the availability, functionality, cleanliness, and user-to-toilet ratio in Dhaka, Bangladesh.
From August to December 2022, we (researchers for this study) undertook infrastructure assessments of toilets in selected hospitals. We observed all toilets and recorded attributes of intended users, including sex, disability status, patient status (in-patient/out-patient/caregiver) , and/or staff (doctor/nurse/cleaner/ mixed-gender/shared). Toilet functionality was defined according to criteria used by the WHO/UNICEF Joint Monitoring Programme in HCFs. Toilet cleanliness was assessed, considering visible feces on any surface, strong fecal odor, presence of flies, sputum, insects,
rodents, and solid waste.
Amongst 2875 toilets, 2459 (86%) were observed. 68% of government and 92% of private hospital toilets were functional. Only 33% of toilets in government hospitals and 56%… in private hospitals were clean. A high user-to-toilet ratio was observed in government hospitals’ outpatients’ service (214:1) compared to inpatients service (17:1). User-to-toilet ratio was also high in private hospitals’ outpatients service (94:1) compared to inpatients wards (19:1). Only 3% of toilets had bins for menstrual-pad disposal and <1% of toilets had facilities for disabled people.