A quarter of all health care facilities have no basic water services.

We aim to change that.

Learn more about WHO and UNICEF’s comprehensive report of global progress on improving WASH in health care facilities.

The report identifies major global gaps in WASH services


One third of health care facilities do not have what is needed to clean hands where care is provided.


One in four health care facilities have no water services.


10% of health care facilities have no sanitation services.

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.

Report Recommendations

  • 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.

The pandemic is a reminder of the intimate and delicate relationship between people and the planet. Any efforts to make our world safer are doomed to fail unless they address the critical interface between people and pathogens, and the existential threat of climate change, that is making our Earth less habitable.

WHO Director-General Dr Tedros Adhanom Ghebreyesus. 
Address To The 73Rd World Health Assembly (18Th May 2020).

Eight Practical Steps to Achieve Universal Access to Quality Care

1. Conduct Situation Analysis And Assessment

Conduct situational analysis of enabling environment for WASH in health care facilities (specifically health and WASH policies, governance structures, institutional arrangements, funding streams and stakeholders). Assess WASH coverage and compliance.

2. Set Targets And Define Roadmap

Set detailed targets (with a national costed roadmap) to address gaps, and estimate costs (capital investments, rehabilitation and recurrent costs). A joint WASH and health taskforce or technical working group is an effective mechanism to help set these targets and develop a roadmap.

3. Establish National Standards And Accountability Mechanisms

Develop standards (a set of requirements that dictate the infrastructure and resources necessary to provide sustainable WASH services) and implement using accountability mechanisms (regulation, accreditation, licensing, community scorecards, feedback mechanisms).

4. Improve Infrastructure And Maintenance

Select, install, operate, maintain and improve WASH infrastructure, (including through use of WASH FIT) to ensure sufficient, functioning WASH services are available.

5. Monitor And Review Data

Track the status or progress of WASH interventions by monitoring and reviewing indicators on a regular basis, including through national health monitoring information systems.

6. Develop Health Workforce

Invest in a well-trained and well-supported health workforce to enable health systems to perform well and to respond appropriately to challenges.

7. Engage Communities

Give community members and organizations agency in decision-making and management of services to ensure that health care facilities provide the level of care that citizens deserve and expect.

8. Conduct Operational Research And Share Learning

Generate evidence to understand the problem and what to do about it and scale-up proven improvement approaches.

Water, sanitation and hygiene is a fundamental human right. There is no place where such services are more important, than in health care facilities, especially during the COVID-19 pandemic which is ravaging our communities. I call on all countries and national authorities to act now and invest in universal WASH in health care facilities.

Madam Fabiola Yáñez, First Lady of Argentina

Follow our Twitter feed for updates

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@HandwashingSoap: Calling all #GlobalHandwashingDay celebrants! Report back on your advocacy efforts here: https://t.co/eD0QtOq7VQ https://t.co/P8UAA6v9oF
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@claireekt: @WHO @UNICEF collaborative established last year works alongside partners to support & learn more about country roadmaps. A new webpage hosted by @HandwashingSoap provides a brief outline https://t.co/R2xnoyTH0x #handhygiene
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@claireekt: There’s a small feature on #handhygiene in #healthcare in this new report. And thanks to @melkbingham @julesstorr @Shams_Syed & others, a summary of some great partnership work in Timor Leste https://t.co/UrSkZ82Mmr
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@claireekt: #handhygiene prevents the spread of infectious diseases inc bacterial, diarrhoeal & respiratory. Yet millions of people still do not have access to facilities- can you imagine! https://t.co/LMVJuz83zc
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@claireekt: NEW - State of the world's #handhygiene report https://t.co/4H8V5ejw9o
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@WaterAidWAfrica: Women are required to leave their babies in search of water. Investments in WASH services will provide the desired convenience for patients at the hospital to practice #handhygiene and stay safe. #WaterAidWestAfrica #GlobalHandwashingDay https://t.co/MveenxlL1Z
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@WorldBankWater: When water and sanitation services are well managed and good hygiene practices are applied, many infectious diseases that cause millions of deaths each year are prevented. #GlobalHandwashingDay #OurFutureAtHand #SafeHands #WaterSolutions #HandHygieneForAll https://t.co/fAwvl1ExxY
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@wateraid: #GlobalHandwashingDay is a chance to seize political will seen during #COVID19 and fund #HandHygiene for all. Find out more: https://t.co/sECDVA2STc https://t.co/fDmrgGHgFb
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@sanwatforall: Governments across the world have shown amazing leadership in emphasizing the importance of hand hygiene.🧼💧 This #GlobalHandwashingDay, we @unicefrosa are taking over @sanwatforall with @unicefwater to celebrate the success of the #HandHygiene4All initiative. #OurFutureAtHand https://t.co/4T6M5STzPG
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