Water, sanitation and hygiene (WASH), while recognized as a necessity, requires acceptance by the healthcare team. As we work toward universal WASH, and as we work toward standards in attention health delivery process measures and outcome measures, we should work toward culturally appropriate design.
WASH monitoring reveals that 25% of health care facilities have no basic water services, 10% of health care facilities globally have no sanitation services and one in three do not have adequate facilities to clean hands at the point of care. One in three health care facilities do not segregate waste safely [1]. Advancing WASH in healthcare across the world is an urgent necessity, and global strategic plans are forming.
Care is affected for the 712 million people who have no access to water when they use health care facilities, yet we have not fully invested in understanding the effects. The reality of WASH inaccess also affects how current care is perceived and how current norms are ingrained.
To maximize our global efforts with adequate water, sanitation and hygiene in healthcare facilities across all countries, we should simultaneously strive to be welcomed into others’ space.
Understand where we are, as a world, with WASH and healthcare
*Fund the collection and comparison of: healthcare operations, delivery, equipment inventory and use, labor scope of practice, health outcomes and other considerations that inaccess to WASH has altered.
*Fund data analytics of outcomes alongside WASH progress. Understand the impact of WASH objectively.
Understand where countries are, as their own country, with WASH and healthcare
*Survey populations, government leaders and healthcare facilities with standard questionnaires. What do countries feel they need in WASH supplies? How do they feel access to WASH or inaccess to WASH affects health? What are the obstacles, barriers and strengths these countries have for WASH implementation? What do global strategies call for with WASH that countries may feel unnecessary or excessive? What are the major workarounds for facilities with WASH inaccess, and how have these workarounds hindered or supported patient safety? Survey these populations, and understand them.
*Analyze and report on country perspective. What are common workarounds, what are the reported outcomes and what are the objective outcomes? How can outcome data and epidemiology be strengthened, and how can this support be communicated and be welcomed?
*Survey countries to gain insight on cultural norms. What are norms that WASH has not yet disrupted, what norms is WASH currently disrupting, and what norms have WASH modified? What are norms that continue to be disrupted by inaccess to WASH?
*Dialogue and plan for logistics of WASH design, including labor, education, materials, ongoing maintenance, sustained finance and supportive infrastructure. Ask the countries what they need. Ask for these countries to partner in leadership of design, and designate liaisons to help see it through.
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