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An estimate of WASH across healthcare facilities in India

Posted on February 23, 2021 by admin1  357

In News: Researchers from the Center for Disease Dynamics, Economics and Policy (CDDEP), Maryland, US, have estimated the cost of ensuring WASH.

Key Findings

  • It estimates that improving and maintaining WASH across the public healthcare facilities in India for a year would cost $354 million (Rs 2567,00,00,000 approximately) in capital costs and $289 million (Rs 2095,00,00,000 approximately) in recurrent expenses.
  • The study further finds that the most costly interventions were providing clean water, linen reprocessing and sanitation while the least expensive was hand hygiene, medical device reprocessing and environmental surface cleaning.
  • This study was a part of a larger project to determine the cost-effectiveness of WASH interventions to reduce healthcare-associated infections among mother and neonates across the Indian healthcare system.

Other reports

  • A 2019 joint global baseline report by WHO and UNICEF had pointed out that globally, one in four healthcare facilities lacked basic water servicing and one in five had no sanitation service and 42% had no hygiene facilities at point of care.
  • A WHO document on WASH in healthcare facilities points out that 8,27,000 people in low- and middle-income countries die as a result of inadequate water, sanitation and hygiene each year. Also, the death of 2,97,000 children under five years can be prevented each year if better WASH could be provided.
  • On a positive note, a 2012 WHO report had calculated that for every dollar invested in sanitation, there was $5.50 to be gained in lower health costs, more productivity and fewer premature deaths.

Relevance of the study

  • The India study by CDDEP comes as a welcome first-level estimate as ensuring the availability and sustainable management of water and sanitation to all which is one of the 2030 sustainable development goals of the WHO.
  • It offers policymakers an opportunity to address multiple overlapping problems through interventions on WASH in healthcare facilities.
  • This study forms the starting point for larger costing estimates, it also highlights the need for a concerted effort from local bodies, State and Central governments to sustainably address quality and inequality issues in WASH provision.

About WASH

  • The term “WASH in health care facilities” refers to the provision of water, sanitation, health care waste management, hygiene and environmental cleaning infrastructure, and services across all parts of a facility.
  • “Health care facilities” encompass all formally recognized facilities that provide health care, including primary (health posts and clinics), secondary, and tertiary (district or national hospitals), public and private (including faith-run), and temporary structures designed for emergency contexts (e.g., cholera treatment centres). They may be located in urban or rural areas.
  • Across all regions, WASH services in health care facilities fall short of WHO and national standards.
    • The availability of WASH services, especially in maternity and primary care settings where they are often absent, supports core universal health care aspects of quality, equity, and dignity for all people.
  • Basic WASH services in health care facilities are fundamental to providing quality care and for ensuring that primary health commitments, as detailed in the Astana Declaration, are achieved.

Concerns

  • Inadequate Water Sanitation and Hygiene (WASH) services in India’s health facilities, contribute to the high neonatal mortality rate, which is currently 24 deaths per 1000 live births.
  • This is primarily due to weak infection prevention and control in health facilities. Hospitals with poor WASH facilities are also found to have higher rates of maternal mortality.
  • Due to the lack of access to water and sanitation, women are further discouraged from institutional delivery or they delay health-seeking advice.
  • Inadequacies in proving WASH and also lack of infection prevention and control can lead to healthcare-associated infections.
    • Some of the pathogens to look out for are Acinetobacter baumannii, Enterococcus faecalis, Escherichia coli, Salmonella typhi, Streptococcus pneumonia and many more. “
    • These pathogens are commonly implicated as causative agents of healthcare-associated infections because of their ability to develop resistance to antibiotics.
    • Common healthcare-associated infections include central-line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections and ventilator-associated pneumonia.

Steps taken

  • KAYA KALP scheme –
    • In 2015, the Ministry of Health and Family Welfare (MoHFW) with support from UNICEF instituted the KAYAKALP scheme to recognise and reward the excellence of health facilities in promoting cleanliness, thereby improving the quality of health care services. 
  • Role of UNICEF –
    • UNICEF works closely with the Government of India on increasing WASH in health care facilities and its approach is evidence-based.
    • Their work includes gap assessment, demonstration of workable models on the ground and assistance in planning, management and monitoring to scale up successful institutional WASH models.

Source :TH

 
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