Lao People’s Democratic Republic: Building back better using a climate-smart approach
Practical steps addressed: 1-2-3-4-6
Invest in operation and maintenance to ensure WASH services are sustained; this includes budgets for repairs and training.
- Inexpensive but important climate-smart interventions (e.g. LED light bulbs, heat reflective paint) are needed as the threat of climate change becomes more severe.
- Supportive supervision will ensure improvements are sustained, staff remain motivated and that MoH officials continue to be informed about progress.
- Within the scope of the COVID response plan, MoH has succeeded, with support from WHO, in mobilising over US$ 1.8 million from government and donor sources to boost the national Safe, Clean and Green/Climate Resilient Hospital Initiative and improve WASH services in 54 health care facilities in six provinces. Implementation of the funds is on-going.
Context and triggers
• Safe water for drinking
• Safe water for health practice
• Safe waste separation
• Safe personal protective equipment
• Green environment
• Energy efficient lights (LED)
• Mercury-free thermometers
• Clean hands
• Clean handwashing stations and toilets
• Clean bathroom
• Clean rooms/hospital
• Water available 24/7
• Clean technology (autoclave)
• Computers, records protected from flood
Throughout its use, WASH FIT has been periodically reviewed and revised based on feedback. New technical modules on health care waste management, cleaning and disinfection, relevant standard operating procedures (SOPs) and posters have all been developed in response to COVID-19. Two versions of WASH FIT now exist, one for central, provincial and district hospitals and one for primary care centres. At the heart of both is the ambition to make facilities safer and more climate resilient.
Monitoring: building WASH indicators into DHIS-2
In 2018, WASH, health care waste and climate-resilience indicators for hospitals were integrated into an existing DHIS-2 platform. The update required engagement of two main departments, the Department of Hygiene and Health Promotion and the Department of Planning and International Cooperation, MoH. Baseline data will be collected by the MoH from all central, provincial and district hospitals between Q4 2020 and Q2 2021. Data collection from health centres is already underway, in collaboration with Plan International, SNV and other international nongovernmental organizations.
Ongoing challenges and gaps
- Climate change threats are increasing, further stretching facility resilience and resources.
- Coordination between the Ministry of Public Works and Transport (responsible for urban WASH) and Ministry of Health (responsible for rural WASH) and sub-national level capacity building (district and health centre levels) needs to be strengthened to enable implementation of the national roadmap and targets and increase domestic funding.
- Sustained technical support to sub-national health offices, district hospitals and health centres will be needed until tools and approaches are sufficiently institutionalized.