Latest Joint Monitoring Programme report by the World Health Organisation and the United Nations Children Fund says half of healthcare facilities worldwide lack basic hygiene services with water and soap or alcohol-based sanitisers.

Around 3.85 billion people use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all, the report showed.

“Hygiene facilities and practices in healthcare settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention, and preparedness,” WHO Director, Department of Environment, Climate Change and Health, Dr Maria Neira, said.

She added, “Hygiene in healthcare facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste.

“I encourage Member States to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation and hygiene services in healthcare facilities, and to monitor these efforts.”

The latest report, ‘Progress on WASH in healthcare facilities 2000–2021: special focus on WASH and infection prevention and control’, has for the first time established this global baseline on hygiene services – which assessed access at points of care as well as toilets – as more countries than ever report on critical elements of WASH services in their hospitals and other health centres. 

For hygiene, data are now available for 40 countries, representing 35% of the world’s population, up from 21 countries in 2020 and 14 in 2019.

The newly established global estimate reveals a clearer and more alarming picture of the state of hygiene in health care facilities. Though 68% of healthcare facilities had hygiene facilities at points of care, and 65 percent had handwashing facilities with water and soap at toilets, only 51 percent had both and therefore met the criteria for basic hygiene services. Furthermore, 1 in 11 (9 percent) of health care facilities globally have neither.

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“If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF Director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction. “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670 000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.”

The report notes that contaminated hands and environments play a significant role in pathogen transmission in healthcare facilities and the spread of antimicrobial resistance. Interventions to increase access to handwashing with water and soap and environmental cleaning form the cornerstone of infection prevention and control programmes and are crucial to providing quality care, particularly for safe childbirth.

According to the report, facilities in sub-Saharan Africa are lagging on hygiene services. While three-quarters (73%) of healthcare facilities in the region overall have alcohol-based hand rub or water and soap at points of care, only one-third (37%) have handwashing facilities with water and soap at toilets.

The vast majority (87%) of hospitals have hand hygiene facilities at points of care, compared to 68% of other healthcare facilities.

“In the Least Developed Countries, only 53% of healthcare facilities have access on-premises to a protected water source. To compare, the global figure is 78% with hospitals (88%) doing better than smaller healthcare facilities (77%), and the figure for eastern and south-eastern Asia is 90%. Globally, around 3% of health care facilities in urban areas and 11% in rural areas had no water service.

“Of the countries with available data, 1 in 10 healthcare facilities globally had no sanitation service. The proportion of healthcare facilities with no sanitation services ranged from 3% in Latin America and the Caribbean and in eastern and south-eastern Asia to 22% in sub-Saharan Africa. In the Least Developed Countries, just 1 in 5 (21%) had basic sanitation services in health care facilities.

“The data further reveals that many healthcare facilities lack basic environmental cleaning and safe segregation and disposal of health care waste,” it noted.

The Nigeria Association of Resident Doctors (NARD), has said six out of 10 doctors in the country plan to leave the country for greener pastures.

The NARD President, Dr. Dare Ishaya, disclosed these in an interview that there are only 12,297 resident doctors in both the Federal and State tertiary health institutions in the country.

“As of the last time we issued the questionnaire, we found that out of 10 resident doctors, six of them are planning to leave or have the intention to leave.

“The statistics we had then was in December 2021. So, it’s either they are planning to leave or they have thought of leaving.

“As we speak, I am aware that a lot of my colleagues are working towards leaving the country, and there are a lot of factors responsible for that. The push factor is majorly the economy.

“Of course, you will agree with me that we are having inflation in the country and the rate at which our naira is being devalued is alarming. If you compare our pay with the pay where most of these health workers go, you will discover that what we earn here is not up to one-tenth of what they get practising there.

“As long as these factors exist, our members and other health workers will continue to seek greener pastures except if things are done to reverse them,” he added.

Ishaya stated that currently, there are only 9,297 resident doctors in the FTHI and there are between 2,000 and 3,000 resident doctors in the STHI.

The Nigerian Medical Association said the brain drain being witnessed in the country would worsen if the doctors leave the country.