Water, sanitation, and hygiene services in health care facilities in the Autonomous Province of Vojvodina, Serbia

Abstract

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15–38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Challenges in water, sanitation, and hygiene within the 2030 agenda for sustainable development in the Republic of Serbia

“…It comprised a representative sample of urban and rural healthcare facilities across all levels of healthcare (primary, secondary, and tertiary) [23]. The survey showed that hand hygiene stations were often missing in common areas, patient rooms, and outside toilets, posing a risk for the spread of infectious diseases among patients, healthcare staff and visitors [23,24].…”

“…The observed finding call for urgent action to provide hygiene services in healthcare facilities primarily in primary healthcare centers in rural areas across the country [23,24]. The proposed measures are not limited to providing water, soap, and hand sanitizers; moreover, facilities should provide posters at points of care, in toilets, waiting rooms, and common areas to promote good hand washing and hand hygiene practices among staff and patients [23,24]. We also advise all health professionals to undergo regular structured training regarding WASH-related standards and procedures so that they can implement them in their everyday practice [23,24].…”

“…The proposed measures are not limited to providing water, soap, and hand sanitizers; moreover, facilities should provide posters at points of care, in toilets, waiting rooms, and common areas to promote good hand washing and hand hygiene practices among staff and patients [23,24]. We also advise all health professionals to undergo regular structured training regarding WASH-related standards and procedures so that they can implement them in their everyday practice [23,24].…”

“…On the other hand, healthcare facilities face additional challenges in providing WASH services [23,24]. First, facilities can improve their basic water services by implementing water safety plans, i.e., specific written procedures and protocols for preventing and controlling risky situations regarding water supply on the premises.…”

“…[25]. Second, healthcare facilities will have to make great technical and financial investments to provide basic sanitation for patients, staff, and persons with disabilities [23,24]. Third, facilities may find the provision of sanitation services according to WASH criteria financially, technically, and logistically demanding.…”