Scaling Up Water, Sanitation, and Hygiene (WASH) Services in Health-Care Facilities: A Regional Initiative Aligned with Sustainable Development Goals

Introduction

WHO/Europe is convening a meeting of experts to enhance water, sanitation, and hygiene (WASH) services in health-care facilities. This initiative aims to build safer, more equitable, and resilient health systems while improving the quality of care. The event is organized under the Protocol on Water and Health in partnership with the Ministry of Interior and the National Center for Public Health and Pharmacy of Hungary.

Importance of WASH Services in Health-Care Facilities

WASH services, including waste management and environmental cleaning, are critical to achieving universal health coverage and delivering quality patient care. Key benefits include:

• Enhancement of health-care delivery
• Upholding patient dignity
• Boosting staff morale and improving working conditions
• Strengthening infection prevention and control
• Supporting emergency preparedness
• Reducing antimicrobial resistance risks
• Lowering health-care costs

These outcomes directly contribute to Sustainable Development Goal (SDG) 3: Good Health and Well-being, and SDG 6: Clean Water and Sanitation.

Leveraging Momentum for National and Regional Action

The meeting aims to:

1. Create a platform for sharing experiences among countries in the WHO European Region.
2. Promote leadership and consolidate actions to improve quality of care and climate resilience of health systems through enhanced WASH services.
3. Reaffirm and increase momentum for national actions on WASH.
4. Showcase best practices and identify enablers and challenges within the Region.
5. Support scaling up and integration of WASH provisions into health programming, including primary health care and climate resilience efforts.

The outcomes will inform the development of an actionable framework for the Region, translating global and regional commitments into evidence-based, tangible steps for Member States and partners. This aligns with SDG 13: Climate Action and SDG 17: Partnerships for the Goals.

Political Mandate and Global Prioritization

WASH services in health-care facilities have gained significant global policy attention, evidenced by:

• World Health Assembly resolution (2019)
• United Nations General Assembly resolution (2023)

These resolutions emphasize accelerated action, cross-sectoral collaboration, and integration of sustainable WASH provisions into national health planning.

Within the WHO European Region, Member States have committed to:

• Prioritizing universal access to essential services
• Ensuring quality care by improving WASH in health-care facilities

This commitment is highlighted in the Declaration of the Seventh Ministerial Conference on Environment and Health (Budapest, 2023) and established as a regional priority under the Protocol on Water and Health.

WASH is increasingly recognized as a critical measure for infection prevention, control, and combating antimicrobial resistance, as reflected in recent action plans and roadmaps. However, progress remains inconsistent across the Region, with significant data gaps limiting comprehensive understanding of national and regional strengths and challenges.

These efforts support SDG 3: Good Health and Well-being, SDG 6: Clean Water and Sanitation, and SDG 10: Reduced Inequalities.

Role of the Protocol on Water and Health

The Protocol on Water and Health is a legal, multilateral instrument jointly supported by WHO/Europe and the United Nations Economic Commission for Europe. Hungary currently holds the chairmanship. The Protocol has been instrumental in:

• Prioritizing WASH services in health-care facilities at the regional level
• Driving progress towards global and regional targets related to WASH

This initiative contributes to achieving SDG 6: Clean Water and Sanitation, SDG 3: Good Health and Well-being, and SDG 16: Peace, Justice, and Strong Institutions through strengthened governance and cooperation.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on improving water, sanitation, and hygiene (WASH) services in health-care facilities, which directly relates to ensuring healthy lives and promoting well-being for all ages.
   • It emphasizes infection prevention and control, quality of care, and reducing antimicrobial resistance, all key components of SDG 3.
2. SDG 6: Clean Water and Sanitation
   • The core subject of the article is scaling up WASH services, which is central to SDG 6’s goal of ensuring availability and sustainable management of water and sanitation for all.
   • It highlights the importance of safe water, sanitation, hygiene, waste management, and environmental cleaning in health-care settings.
3. SDG 13: Climate Action
   • The article mentions building climate resilience of health systems through improved WASH services, linking to SDG 13’s focus on combating climate change and its impacts.
4. SDG 17: Partnerships for the Goals
   • The article describes collaboration among WHO/Europe, national governments, and partners, reflecting SDG 17’s emphasis on strengthening global partnerships to achieve the goals.

2. Specific Targets Under Those SDGs Identified

1. SDG 3 Targets
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services.
   • Target 3.d: Strengthen the capacity of all countries for early warning, risk reduction, and management of health risks, including infection prevention and control.
   • Target 3.3: End epidemics of communicable diseases and combat antimicrobial resistance.
2. SDG 6 Targets
   • Target 6.1: Achieve universal and equitable access to safe and affordable drinking water.
   • Target 6.2: Achieve access to adequate and equitable sanitation and hygiene for all, with special attention to vulnerable populations and health-care facilities.
   • Target 6.a: Expand international cooperation and capacity-building support to developing countries in water and sanitation-related activities.
3. SDG 13 Targets
   • Target 13.1: Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries, including health systems.
4. SDG 17 Targets
   • Target 17.16: Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships.
   • Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships.

3. Indicators Mentioned or Implied to Measure Progress

1. Indicators Related to WASH in Health-care Facilities
   • Proportion of health-care facilities with basic water supply, sanitation, and hygiene services.
   • Availability and quality of waste management and environmental cleaning in health-care settings.
   • Data on infection prevention and control measures implemented in health-care facilities.
2. Indicators on Antimicrobial Resistance
   • Rates of antimicrobial resistance in health-care settings as a measure of effectiveness of infection control linked to WASH improvements.
3. Indicators on Climate Resilience
   • Measures of health system resilience to climate-related hazards, including integration of WASH services in climate adaptation plans.
4. Data Gaps Highlighted
   • The article notes significant data gaps in the Region, implying the need for improved monitoring systems and indicators to assess progress comprehensively.

4. Table of SDGs, Targets, and Indicators

Source: who.int