This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels ...of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data collection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in ...all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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Technical Note on Antimicrobial Resistance
This document reflects UNICEF’s response to the growing global threat of AMR to child survival, growth and development. It identifies UNICEF’s AMR-specific and AMR-sensitive actions in reducing infections, promoting access to and optimal use of antimic...robials, and increasing AMR awareness and understanding. Of particular relevance to this group, UNICEF country offices are directed to provide technical support for development and implementation of national AMR action plans, linking them as appropriate to maternal, newborn and child health programmes and ensuring these are prioritized in both surveillance and policy changes. The guidance note on AMR is intended to inform UNICEF’s AMR-related internal initiatives, programming and activities, as well as external engagements with governments and other stakeholders.
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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 facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that l...ack 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.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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En el presente informe se señalan las principales deficiencias que padecen los servicios WASH nivel mundial: un tercio de los establecimientos de salud no disponen de los elementos necesarios para limpiarse las manos en los lugares donde se presta atención; uno de cada cuatro establecimientos care...ce de servicios básicos de agua, y uno de cada diez no cuenta con servicios de saneamiento. Esto significa que 1800 millones de personas son usuarias de unos establecimientos que carecen de servicios básicos de agua, y que 800 millones de personas acuden a centros que no disponen de aseos. Este problema es aún mayor en los 47 países menos adelantados del mundo, donde la mitad de los establecimientos de salud carecen de servicios básicos de agua. Por otro lado, la magnitud del problema sigue siendo una incógnita, ya que continúa habiendo importantes deficiencias de datos, sobre todo en materia de limpieza del entorno.
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Further Analysis of the 2014 Cambodia Demographic and Health Survey | DHS Further Analysis Reports No. 105
WHO’s Ambition and Action in Nutrition 2016-2025 is anchored in the six global targets for improving maternal, infant and young child nutrition and the global diet-related NCD targets.
In support of the 2030 Agenda for Sustainable Development, particularly SDG2 and SDG3, and in concert w...ith the 2016-2025 UN Decade of Action on Nutrition, WHO’s Ambition and Action in Nutrition 2016-2025 aims for “A world free from all forms of malnutrition where all people achieve health and well-being”. It defines the unique value of WHO for advancing nutrition: the provision of leadership, guidance and monitoring and proposes a theory of change. Finally, following a set of guiding principles, it proposes priority actions for WHO, the delivery model and a clear allocation of roles across the Organization.
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Recommended actions and international and national level
Presentation on WASH in Malawi
The Ghanaian Cabinet approved the antimicrobial resistance (AMR)Policy and Implementation plan(hereafter referred to as the national action plan or NAP)in December 2017, whilst the country case study was in progress. This has set in motion the implementation phase for Ghana, which is a long awaited... event since the drafting of the Policy started in 2011. This case study, whilst limited in its ability to interact with all stakeholders, has identified entrypoints within the operational divisions of Ghana Health Services,as potential areas where the AMR policy platform may seek to embed AMR activities. Much work has already been done within Ghana to identify the key entrypoints within the various ministries and government agencieswhere AMR can be incorporated. These stakeholders already form part of the AMR Policy Platform which is the governance structure for AMR and have been participating actively in the development of the AMR Policy and NAP activities formulation.
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