Water and Sanitation for Health Facility Improvement Tool (WASH FIT): A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities
World leaders recently declared that universal health coverage (UHC) and access to high quality, integrated “people centred” health services, are essential to health for all and to human security. Yet, efforts to accelerate UHC and quality of care will be undermined because fundamental infrastructure and hygiene in health facilities are not in place. A WHO/UNICEF 2015 global review reported that nearly 40% of facilities lack water supplies, 19% are without sanitation and 35% do not have any hand hygiene materials. Indeed, UHC may be an empty promise without adequate attention to quality, and quality initiatives will fail without adequate attention to water, sanitation and hygiene (WASH). The lack of WASH services compromises the ability to provide safe and quality care, places both health care providers and those seeking care at substantial risk of infection-related morbidities and mortality, and poses a significant economic and social burden. Pregnant women, who are increasingly giving birth in health care facilities, and their newborns, are especially vulnerable to the consequences of poor WASH services. Among hospital-born babies in developing countries, health care associated infections are responsible for between 4% and 56% of all causes of death in the neonatal period, 75% of which occur in South-East Asia and sub Saharan Africa.