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Health care-associated infections (HAIs) affect patients and health systems every day, causing immense suffering, driving higher health-care costs and hampering efforts to achieve high-quality care
...
for all. HAIs are often difficult to treat, are the major driver of antimicrobial resistance (AMR) and cause premature deaths and disability. The COVID-19 pandemic, as well as outbreaks of Ebola, Marburg and mpox are the most dramatic demonstrations of how pathogens can spread rapidly and be amplified in health care settings. But HAIs are a daily threat in every hospital and clinic, not only during epidemics and pandemics. Lack of water, sanitation and hygiene (WASH) in health care settings not only affects the application of infection prevention and control (IPC) best practices but also equity and dignity among both those providing and receiving care.
more
Those who clean are the first line of defense against health care-associated infections (HAIs), and support efforts to reduce antimicrobial resistance (AMR).
Strengthening the training of this important group can contribute to resolving many of t
...
oday’s public health challenges. This is important given that cleaning both surfaces and hands is vital to control the transmission of a number of HAIs.
This two-part training package targets those who clean heath care facilities.
The Trainer’s Guide takes the user through how to prepare, deliver and sustain an effective training for those who clean. The Modules and Resources provides instructions, definitions, photographs, posters and specific illustrations of recommended practices
The package can be used by those who deliver environmental cleaning training programmes and/or those with a background in IPC including ministries of health, nongovernmental organizations, academic institutions, experts working in Quality of care, IPC and environmental cleaning/ Water, sanitation and Hygiene (WASH) and Health facility IPC focal points and onsite cleaning supervisors
more
Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation
...
and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already deprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
more
Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
...
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-associated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
more
The road map 2030 was developed by WHO through an extensive global consultation, with indicators set for measuring progress against targets and milestones. This compendium of indicators provides a comprehensive
...
and standardized listing of recommended indicators, including the 70 core indicators presented in the M&E framework. These indicators will also support reporting on strategies described in other road map companion documents to guide action against neglected tropical diseases include the sustainability framework, the global strategy on water, sanitation and hygiene, the One Health approach and the strategic framework for integrated control and elimination of skin-related neglected tropical diseases.
The purpose of this compendium is to guide monitoring and evaluation of programmes and thereby to improve their quality and effectiveness in alignment with the road map goals. It provides a standardized listing of the most widely used indicators relevant to countries, with uniformity in defining indicators to allow comparisons over time and among different programmes. Detailed metadata are provided for each of these indicators to facilitate validity, internal consistency, standardized measurement, estimation methods and comparability of data across countries.
more
Cholera is a diarrhoeal disease that is usually contracted when drinking water contaminated with Vibrio cholerae bacteria. The fight against this disease requires a multidisciplinary approach that combines a water, hygiene
...
and sanitation (WaSH) response with a monitoring system, improved water supply and quality, sanitation and hygiene, and a health response with the treatment of the disease itself.
more
Updated 8 June 2021. The document has two sections:
A. The first section covers fundamental principles which are crucial to a successful, holistic intervention.
B. The second covers relevant standards and guidance in the handbook’s Water Supply,
...
Sanitation and Hygiene Promotion (WASH) and Health chapters.
more
The Lancet Global Health Volume 9, ISSUE 3, e361-e365, March 01, 2021
The public health community has tried for decades to show, through evidence-based research, that safe water, sanitation, and
...
hygiene (WASH) and clean cooking fuels that reduce household air pollution are essential to safeguard health and save lives in low-income and middle-income countries. In the past 40 decades, there have been many innovations in the development of low-cost and efficacious technologies for WASH and household air pollution, but many of these technologies have been associated with disappointing health outcomes, often because low-income households have either not adopted, or inconsistently adopted, these technologies.
more
Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security
...
and safety, environmental effects on ecosystems and biodiversity, and socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
more
Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbate
...
d by limited access to, and availability and affordability of, antimicrobials required to treat infections caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
more
The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in
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health care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further reveals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.
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The Cholera Outbreak Guidelines: Preparedness, Prevention, and Control provide a practical field guide for responding to cholera outbreaks. Developed by Oxfam GB, the guidelines combine lessons from past cholera interventions
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and best practices for effective outbreak management. The document outlines key strategies, including preparedness planning, rapid response to outbreaks, water and sanitation improvements, hygiene education, and coordination among stakeholders. It covers both non-endemic and endemic cholera outbreaks, offering step-by-step guidance on surveillance, intervention, and monitoring. The aim is to ensure community-based, gender-sensitive, and rapid public health responses to control cholera and minimize mortality.
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The World Health Organization (WHO)6, the Civil Society Action Committee and the Lancet Migration global collaboration are amongst many organisations that have advised governments against returning irregular migrants during the Coronavirus d
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isease 2019 (COVID-19) pandemic. The expulsion of irregular migrants to under-prepared countries puts migrants and communities at risk, and is against the principles of solidarity and public health that should inspire action during these challenging times. It also puts at risk the staff who implement these policies. Detention, overcrowded conditions and lack of hygiene all render irregular migrants more vulnerable to the impact of COVID-19. Irregular laborers, agricultura land food workers, cleaners and caregivers are all essential in the response to the pandemic, there fore the temporary or longer term regularisation of migrants to facilitate their access to health, social services and employment should be considered as a humane, practical and self-interested alternative to forcible return.
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he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian resp
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onses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH services. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
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Over 3000 resources to use with your projects, training, and community education in different languages
A resource for improving menstraul hygiene around the world.
Comprehensive guidance with examples of good practice, information for colleagues and pupils in class
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and tips on how to break the taboo
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The objectives of the scheme is to promote cleanliness, hygiene and infection control practices in public health care facilities, to incentivize and
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recognize such public healthcare facilities that show exemplary performance in adhering to standard protocols of cleanliness and infection control, to inculcate a culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation, to create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes.
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The document outlines the 2017 cholera outbreak in Zambia, mainly in Lusaka, due to poor sanitation and unsafe water. By December, 493 cases were reported, with risks increasing due to the rainy sea
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son. The Zambia Red Cross Society (ZRCS), in collaboration with the Ministry of Health, WHO, and UNICEF, responded by setting up treatment centers, supplying clean water and chlorine, and conducting hygiene education. 1,500 volunteers were mobilized to support 70,000 people directly. The IFRC allocated CHF 222,351 to control the outbreak, but challenges like limited funding and poor infrastructure remained.
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The Haiti & Dominican Republic Cholera Operation Plan of Action outlines the Red Cross's strategy to combat cholera on the island of Hispaniola following the 2010 outbreak in Haiti. As part of a 10-year national strategy, the plan includes an initial two-year emergency response (2014-2016) with a bu
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dget of 9.9 million Swiss francs. The approach focuses on three key areas: improving water and sanitation by repairing and expanding water systems and constructing sanitation facilities, prevention and hygiene promotion through community education and hygiene training, and preparedness and response by strengthening disease monitoring, training Red Cross volunteers, and prepositioning medical supplies. This initiative, led by the Haitian and Dominican Red Cross in collaboration with international partners and local governments, aims to reduce cholera infections and improve public health on the island.
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Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In ad
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dition, Maldives is a front runner in infectious disease prevention through successful water, sanitation, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
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