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Module 1 Introduction to Water and Sanitation for Health Facility Improvement Tool “WASH FIT”

Module 1 Introduction to Water and Sanitation for Health Facility Improvement Tool “WASH FIT”. Overview. WASH in Health Care Facilities : global status and activities Importance of WASH in Health Care Facilities WASH FIT Description and contents Methodology Application.

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Module 1 Introduction to Water and Sanitation for Health Facility Improvement Tool “WASH FIT”

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  1. Module 1 Introduction to Water and Sanitation for Health Facility Improvement Tool “WASH FIT”

  2. Overview • WASH in Health Care Facilities : global status and activities • Importance of WASH in Health Care Facilities • WASH FIT • Description and contents • Methodology • Application

  3. Globally, access to WASH in health care facilities is limited • 38% globally do not have access to an improved water source at or near the facility. • When reliability and safety is considered, water coverage drops by half. • 35% lack soap for handwashing and 19% are without sanitation • Data from 2015 WHO/UNICEF Global Assessment of WASH in HCF

  4. Safe health care waste management is also lacking

  5. Catalyzing action through the Sustainable Development Goals

  6. 1. Advocacy Leadership and Action 2. Monitoring 3. Evidence and Operational Research 4. Policy, Standards and Facility Improvements Global Action Plan on WASH in health care facilities Vision By 2030, to ensure that every health care facility, in every setting, has safely managed, reliable water, sanitation and hygiene facilities and practices to meet staff and patient needs in order to provide quality, safe people-centered care. Task Teams

  7. Linkages with health • Quality Universal Health Coverage • Infection prevention and control • Maternal, newborn and child health • Antimicrobial resistance

  8. Quality Universal Health Coverage

  9. Infection Prevention and Control • WASH included in new WHO IPC Core Components and Surgical Site Infection Guidelines • Technical support on health care waste for Global Injection Safety Campaign • Joint IPC/WASH indicators and monitoring tools • Alignment of messages-i.e. Clean Care is Safer Care: 139 WHO Member States have pledged to reduce health care-associated infection

  10. Maternal, newborn and child health WASH core element of new Quality of Care Framework

  11. Antimicrobial resistance (AMR) • WASH prevents infections-reducing need for antibiotics • Better WASH prevents spread of AMR in the environment • One of 5 key objectives of WHO Global Action Plan • Improved awareness • Strengthened knowledge • Improve sanitation, hygiene and infection prevention • Optimize use of antimicrobial medicines • Increase investments in medicines, diagnostics, vaccines

  12. What is the biggest problem related to WASH in HCF in your country/region/district?

  13. In your opinion… What makes a health facility: • Clean and safe? • Well managed? • Respectful of rights and people-centered? • What is needed to improve the quality of care? • How can people be encouraged to seek care?

  14. What roles and responsibilities do each of these groups have for WASH in HCF? • National (central) level • Regional/Provincial level • District level • Facilities • Individuals • Staff • Care seekers, their families and friends

  15. Water and Sanitation for Health Facility Improvement Tool • WASH FIT is a management tool that holistically protects health and upholds dignity through the assessment and management of risks from insufficient or unsafe water supply, inadequate sanitation and poor hygiene practices. • To make facilities • Clean and safe • Well-managed • Respectful of rights and people-centered • Adapted from Water Safety Plan approach

  16. WASH FIT What it is What it is not A tool for national level monitoring of WASH in health care facilities A one-size fits all approach An exercise that can be completed in a day • A tool for facilities to useinternally to prioritize and maintain WASH improvements, focusing on actions • Encompasses infrastructural changes, maintenance and repair as well as behaviouralchanges, such as hand hygiene behaviour • To be used as part of broader quality improvements in health care facilities • Comprehensive and systematic

  17. WASH FIT vs. global monitoring • Indicators are aligned with global indicators for monitoring WASH in HCF in the SDGs • However, WASH FIT should not be confused with global or national monitoring WASH FIT emphasises ACTION, not just monitoring for the sake of it!

  18. What type of facilities is WASH FIT for? • Mainly primary, and in some instances secondary, care facilities • Resource-constrained settings • E.g. health centres, health posts, or small district hospitals which provide outpatient services, family planning, antenatal care, child and mother clinics and maternity/child delivery services. However, WASH FIT is a framework and the methodology can be adapted for use in any type of facility

  19. What are the benefits of implementing WASH FIT? • Improves the day-to-day management and operation of a facility, • Encourages a team-based approach • Engages community members • Helps identify improvement needs • Provides a framework to develop, monitor and continuously implement an improvement plan

  20. Methodology:

  21. WASH FIT Domains What are the key areas of environmental health domains which are the minimum requirements to make a facility safe?

  22. Based on WHO Standards • Water quantity • Water quality • Hand hygiene • Excreta and wastewater disposal • Health care waste disposal • Cleaning • Control of vector borne diseases • Information and hygiene promotion Available in English, French & Spanish, Being translated into Russian (2017) http://www.who.int/water_sanitation_health/hygiene/settings/ehs_hc/en/

  23. WASH FIT

  24. Snapshot: Facility Assessment

  25. Use of WASH FIT to date (Updated January 2017) • Chad (July 2015 - ): Health care workers trained from 13 HCF in cholera hotspot areas, plans to increase to 24 additional HCF • Mali, (Nov 2015 - ): Two national trainings conducted, part of 3-yr project with WHO, WaterAid & CDC; WASH FIT rolled out in one district (11 HCF) • Liberia, (Nov 2015 - ): Series of national training of trainers conducted as part of Ebola recovery work; cascading training has been challenging. • West African Regional WASH FIT workshop, (June 2016): Chad, Mali, Liberia + DRC, Ghana, Guinea, Senegal, Sierra Leone • Madagascar, (Dec 2016): National training of trainers, and integration with new national WASH in HCF standards • Laos (January 2017): Regional training, Savannakhet Province. One district hospital has been chosen to implement WASH FIT as a pilot.

  26. Questions?

  27. Selected references WHO (2016) Standards for improving quality of maternal and newborn care in health facilities http://www.who.int/maternal_child_adolescent/documents/improving-maternal-newborn-care-quality/en/# WHO (2016) Global guidelines on the prevention of surgical site infection http://www.who.int/gpsc/ssi-guidelines/en/ WHO Clean Care is Safer Care http://www.who.int/gpsc/5may/en/ Contact washinhcf@who.int for further information

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