Evaluation of water, sanitation and hygiene status of COVID-19 healthcare facilities in Ghana using the WASH FIT approach

Abstract

Access to improved water, sanitation and hygiene (WASH) is essential for the delivery of high-quality care in healthcare facilities and the prevention of hospital-acquired infections such as the transmission of the SARS-CoV-2. In addition, unimpeded access to WASH facilities in coronavirus disease 2019 (COVID-19) treatment centres (TCs) is central in facilitating compliance with infection prevention and control protocols. However, data for the WASH status of COVID-19 TCs in Ghana are limited. We evaluated the WASH status of seven COVID-19 TCs in Ghana using the WHO/UNICEF water and sanitation for health facility improvement tool (WASH FIT). The water domain had the highest number of indicators meeting standards with an average percentage score of 90.5% (range: 66.7–100%) across the seven TCs, followed by management (66.9%) and hygiene (58.7%). The TCs performed poorly in the sanitation and healthcare waste domain, with an average percentage score of 44.6% (range: 22.2–75%). These findings highlight the challenges being faced by COVID-19 TCs in implementing WASH services. Specific WASH interventions are urgently required to strengthen WASH services in the COVID-19 TCs. This should precede the prioritisation of resources to WASH infrastructure in the treatment facilities coupled with actions that involve all stakeholders.

COVID-19 Pandemic and Water, Sanitation, and Hygiene: Impacts, Challenges, and Mitigation Strategies

“…17,19,20 In communities, schools, HCF, and other public spaces, the presence of adequate WASH services and facilities is rare. 19,21,22…”

“…It poses also additional challenges to HCF due to waste management, because facilities produce more waste than usual. 21,22…”

“…According to Ashinyo et al, 21 strong WASH service infrastructure in the treatment center of COVID-19 is important to effectively management of COVID-19 cases. There are gaps in the management of the treatment center on WASH.…”

“…COVID-19 poses a significant impact on sustainability and continuity of WASH services. 21,23 The global pandemic COVID-19 causes socioeconomic and health service impacts. 1 Developing countries with humanitarian crises and vulnerable It poses also additional challenges to HCF due to waste management, because facilities produce more waste than usual.…”

Elucidating the role of environmental management of forests, air quality, solid waste and wastewater on the dissemination of SARS-CoV-2

“…Inadequate and unequal resource accessibility of COVID-19 practices within Water, Sanitation and Hygiene (WASH) interventions have been found (Arduino et al, 2020; Maal-Bared et al, 2020 ; Mushi and Shao, 2020 ; Zvobgo and Do, 2020 ; Adams et al, 2021 ). For example, healthcare facilities in countries such as Ghana, Kenya and Zimbabwe have unmet requirements for clean drinking water, water supplies, incineration and hand hygiene technology, responsible waste disposal, well-lit and clean environments, unshared toilets, pit latrines, swift response levels, management plans and health worker safety for long term optimum safety during the COVID-19 pandemic ( Maina et al, 2020 ; Ashinyo et al 2021 ; Hirai et al, 2021 ). The Indonesian government reduced costs of clean water to encourage higher levels of hygiene practises (Parikh et al, 2020).…”