The Issue

Latest WHO/UNICEF data show that there are major global gaps in water, sanitation and hygiene (WASH) services in health care facilities: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services.

This means that 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.

Coronavirus disease (COVID-19) is exposing key vulnerabilities in health systems, such as inadequate infection prevention and control. WASH services in health care facilities, so often taken for granted, are needed more than ever to protect vulnerable health workers and patients.


of health care facilities
have basic water services


of health care facilities
have hand hygiene services at points of care


of health care facilities
have basic sanitation


of health care facilities
have basic health care
waste management services


countries have basic
water data (increase
from 38 in 2019)


countries have hand hygiene data at points of care (increase from 55 in 2019)


countries have basic
sanitation data (increase
from 18 in 2019)


countries have basic health care waste management data
(increase from 48 in 2019)

What ways do we know work for countries to improve WASH?

Countries should undertake efforts at the sub-national and national level to implement the eight practical steps, and in particular:

  • 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.

Metrics for success

Situational Analyses

By 2021, all countries have completed situational analyses


By 2021, all countries have standards

Integration with Health

By 2023, all countries have included WASH in health plans, budgets, and implementation efforts

Health Budgets

By 2023, all countries
have included WASH in health budgets

At least 80% of facilities have basic WASH services
Universal access to basic WASH services