Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
References
[1]
WHO/UNICEF (2018) Core Questions and Indicators for Monitoring WASH in Health Care Facilities in the Sustainable Development Goals.
[2]
WHO (2018) Water and Sanitation for Health Facility Improvement Tool (WASH FIT). 92 p.
[3]
WHO/UNICEF (2018) Progress on Drinking Water, Sanitation and Hygiene (WASH).
[4]
Maina, M., Tosas-Auguet, O., McKnight, J., Zosi, M., Kimemia, G., Mwaniki, P., et al. (2019) Evaluating the Foundations That Help Avert Antimicrobial Resistance: Performance of Essential Water Sanitation and Hygiene Functions in Hospitals and Requirements for Action in Kenya. PLOS ONE, 14, e0228489. https://doi.org/10.1371/journal.pone.0222922
[5]
Bouzid, M., Cumming, O. and Hunter, P.R. (2018) What Is the Impact of Water Sanitation and Hygiene in Healthcare Facilities on Care Seeking Behaviour and Patient Satisfaction? A Systematic Review of the Evidence from Low-Income and Middle Income Countries. BMJ Global Health, 3, e000648. https://doi.org/10.1136/bmjgh-2017-000648
[6]
WHO (2019) Seventy Second WHA, Agenda Item 12.5. https://doi.org/10.18356/3e906a0d-en
[7]
WHO/UNICEF (2015) Water, Sanitation and Hygiene in Health Care Facilities. WHO/UNICEF, Geneva, 38.
[8]
McCord, R., Cronk, R., Tomaro, J., Reuland, F., Behnke, N., Mmodzi, T.J., et al. (2019) The Implementation of Environmental Health Policies in Health Care Facilities: The Case of Malawi. International Journal of Hygiene and Environmental Health, 222, 705-716. https://doi.org/10.1016/j.ijheh.2019.05.003
[9]
WHO/UNICEF (2019) Water, Sanitation and Hygiene in Health Care Facilities: Practical Steps to Achieve Universal Access. The Transition from Capitalism. 189-204.
[10]
Magdalene matthews ofori-Kuma UE (2019) WASH in Health Care Facilities, UNICEF Scoping Study in Eastern and Southern Africa. 1-68.
[11]
WHO/UNICEF (2019) WASH in HCF Global Baseline Report 2019.
[12]
(2015) MoHSW-Zanzibar, MoH-Tanzania Mainland O and N. Tanzania Service Provision Assessment Survey 2014-2015. MoHSW, MoH, NBS, OCGS, and ICF International, Dar es Salaam and Rockville.
[13]
MoHCDGEC (2017) The National Guidelines for Water, Sanitation and Hygiene in Health Care Facilities.
[14]
MoHCDGEC (2020) National Strategy for Accelerating Sanitation and Hygiene for All.
[15]
MOHCDGEC (2018) National Infection Prevention and Control Guidelines. 1-130.
[16]
MOHCDGEC (2017) National Policy Guidelines for Health Care Waste Management in Tanzania.
[17]
National Institute for Medical Research (2016) Water, Sanitation and Hygiene Situation in Health Care Facilities in Tanzania Mainland and Way forward National Institute for Medical Research. 80.
[18]
MoH. Health Facility Registry Portal.
[19]
Loehlin, J.C. (1990) Component Analysis versus Common Factor Analysis: A Case of Disputed Authorship. Multivariate Behavioral Research, 25, 29-31. https://doi.org/10.1207/s15327906mbr2501_2
[20]
Derso, A., Addis, T. and Mengistie, B. (2023) Healthcare Facility Water, Sanitation, and Hygiene Service Status and Barriers in Addis Ababa, Ethiopia. Journal of Water, Sanitation and Hygiene for Development, 13, 1001-1017. https://doi.org/10.2166/washdev.2023.217
[21]
Guo, A., Bowling, J.M., Bartram, J. and Kayser, G. (2017) Water, Sanitation, and Hygiene in Rural Health-Care Facilities: A Cross-Sectional Study in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. American Journal of Tropical Medicine and Hygiene, 97, 1033-1042. https://doi.org/10.4269/ajtmh.17-0208
[22]
Atimen, D., Addis, T., Mengistie, B., Keleb, A. and Ademas, A. (2022) Healthcare Facility Water, Sanitation and Hygiene Service Status and Barriers in Ethiopia: It’s Implication for COVID-19 Pandemic and Healthcare Acquired Infection Prevention.
[23]
Berihun, G., Adane, M., Walle, Z., Abebe, M., Alemnew, Y., Natnael, T., et al. (2022) Access to and Challenges in Water, Sanitation, and Hygiene in Healthcare Facilities during the Early Phase of the COVID-19 Pandemic in Ethiopia: A Mixed-Methods Evaluation. PLOS ONE, 17, e0268272.
[24]
Girmay, A.M., Kenea, M.A., Mengesha, S.D., Wagari, B., Weldetinsae, A., Alemu, Z.A., et al. (2023) Level of JMP Ladders for Water, Sanitation, and Hygiene (WASH) Services among Healthcare Facilities of Bishoftu Town, Ethiopia: An Implication of Healthcare-Associated Infection Prevention Status. Journal of Water, Sanitation and Hygiene for Development, 13, 415-423. https://doi.org/10.2166/washdev.2023.230
