Water, sanitation, and hygiene (WASH) are vital for safe healthcare, yet nearly half of Africa’s healthcare facilities lack basic WASH services, undermining efforts to reduce healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). Globally, 11% of healthcare facilities lack basic water, 10% lack sanitation, and one-third lack waste management systems. Africa faces worsened challenges due to fragmented funding, leadership gaps, unreliable electricity, and poor waste management. Poor WASH infrastructure compromises patient safety, maternal and newborn health, and infection prevention; hand hygiene alone can prevent up to 50% of avoidable HAIs.
Several evidence-based WASH tools developed to address these gaps, including WHO/UNICEF’s WASH FIT, the Joint Monitoring Programme (JMP), Water Safety Plans (WSP), Hygiene Improvement Framework (HIF), and Integrated Management of Childhood Illness (IMCI) WASH tools. WASH FIT provides a participatory, risk-based framework for continuous improvement but faces implementation challenges in low-resource settings due to limited funding, technical capacity, and governance.
Hybrid approaches combining tools like WASH FIT with JMP, WSP + HIF, IMCI + WASH HCF Toolkit are most effective. Success relies on strong leadership, community engagement, and data-driven prioritization. Integrating these tools into national policies, investing in capacity building, and fostering multisector collaboration are essential for sustainable WASH improvements.
Emerging digital platforms and training resources help, but face barriers like poor connectivity and high staff turnover. Recommendations include hybrid training models, embedding WASH FIT in national health strategies, and public-private partnerships. Tailored implementation, sustained funding, and systemic prioritization are critical to scaling WASH improvements and enhancing infection prevention across Africa