A recent report by non-governmental organization WaterAid sheds light on the health and financial impact of inadequate water, sanitation, and hygiene (WASH) in healthcare facilities. In seven sub-Saharan African countries, including Ethiopia, Ghana, Malawi, Mali, Nigeria, Uganda, and Zambia, the lack of proper WASH contributed to 2.6 billion healthcare-associated infections (HCAIs) and 277,160 excess deaths in 2022. At least 50% of these infections are believed to have been caused by antimicrobial-resistant (AMR) bacteria.
The economic costs of these infections range from 2.5% to 10.9% of the healthcare budgets in the seven countries, while lost wages and productivity due to infections accounted for 0.4% to 2.9% of the countries’ gross domestic product. The report notes that nearly 4 million people globally lack basic hygiene services at their healthcare facility and one in five lack basic water services at these facilities.
Poor WASH at healthcare facilities contributes significantly to a rate of HCAIs that is more than twice that of high-income countries (15.5% vs 7.6%). The major transmission pathway for HCAIs is the lack of cleanliness and hygiene measures provided during the delivery of healthcare. Beyond health impacts, poor WASH also affects quality care, patient satisfaction, dignity and respectful care, future healthcare-seeking behaviors, and healthcare worker morale and retention all of which ultimately impact health outcomes negatively.
WaterAid warns that if AMR rates rise further then this problem could become even more severe as it would lead to even more cases of HAI which would result in even higher medical costs associated with these conditions as well as loss of income for households affected by illness or death . They suggest that national governments should develop a dedicated budget line for WASH in healthcare facilities , donors , G7 countries , multilateral financing institutions should prioritize WASH when working with national governments in LMICs . By investing just less than US$1 per capita needed for providing basic WASH services at these facilities , they could save a lot from medical costs associated with HAI .
