WASH FIT: Approach and application to date Technical Session 3 Global Learning Event on WASH in health care facilities 28 30 March 2017 1 Kathmandu, Nepal WASH in HCF: GLE 28-30 March 2017, Kathmandu Arabella Hayter haytera@who.int
Water and Sanitation for Health Facility Improvement Tool A risk-based management tool for improving WASH services in HCF To make facilities Clean and safe Well-managed Able to provide quality, peoplecentred care Adapted from Water Safety Plan approach Developed 2015, launched this week! 2
What type of facilities is WASH FIT for? Mainly primary, and in some instances secondary, care facilities Resource-constrained settings E.g. health centers, health posts, or small district hospitals which provide outpatient services, family planning, antenatal care, child and mother clinics and maternity/child delivery services. However, WASH FIT is a framework and the methodology can be adapted for use in other types of facility 3
What are the benefits of implementing WASH FIT? Improves the day-to-day management and operation of a facility Encourages a team-based approach Engages community members Helps identify where risks exist and what improvements are needed Provides a framework to develop, monitor and continuously implement an improvement plan 4
Methodology Continuous process, not a one-off 5
Treatment, supply, storage, water quality testing, showers, energy. Hand hygiene, environmental cleaning and disinfection Latrines (e.g. maintenance, MHM, disability access) storm water management, Health care waste management (all stages) Facility management, leadership, staffing, problem reporting 6
7 Snapshot Evaluation form
Based on WHO Standards & in line with SDG indicators Water quantity & quality Hand hygiene Excreta and wastewater disposal Health care waste disposal Cleaning and disinfection Control of vector borne diseases Information and hygiene promotion (NB: standards available in English, French & Spanish, Being translated into Russian) http://www.who.int/water_sanitation_he alth/hygiene/settings/ehs_hc/en/ 8
So WASH FIT includes all of the global SDG indicators but it isn t for monitoring?
WASH FIT is not a monitoring tool it is for taking action! 10 WASH in HCF: GLE 28-30 March 2017, Kathmandu
Goals & purpose For facilities to use internally to prioritize and maintain WASH improvements, focusing on actions To be used as part of broader quality improvements in health care facilities To cover the whole facility and help make improvements systematically Encompasses infrastructural changes, maintenance and repair as well as behavioural changes, such as hand hygiene behaviour Focuses on small, low cost improvements when resources are scare 11
Identify the main hazards for each domain E.g.: Only handwashing station in consultation room Bin with sharps exposed, consultation room Blocked latrine, maternity ward 12 WASH in HCF: GLE 28-30 March 2017, Kathmandu
Consider level of risk and prioritise improvements 13
Use answers to prioritize actions Prioritize activities that are higher risk and are easier to address Move on to Higher risk /difficult to address and Lower risk/easier to address 14
Examples of WASH FIT improvements 15 Planting plants by HCF entrance The exterior of the facility is well-fenced, kept generally clean (free from solid waste, stagnant water, no animal and human faeces in or around the facility premises, etc. WASH in HCF: GLE 28-30 March 2017, Kathmandu Clear signs demonstrating gender separation of latrines Toilets or improved latrines clearly separated for staff and patients and visitors Photos: Chad 2016, WHO Hand washing poster drawn by head of HCF Hand hygiene promotion materials clearly visible and understandable at key places
Use of WASH FIT to date Chad (July 2015 - ): Health care workers trained from 13 HCF in cholera hotspot areas, plans to increase to 24 additional HCF Mali, (Nov 2015 - ): Two national trainings conducted, part of 3-yr project with WHO, WaterAid & CDC; WASH FIT rolled out in one district (11 HCF) Liberia, (Nov 2015 - ): Series of national training of trainers conducted as part of Ebola recovery work; cascading training has been challenging. West African Regional WASH FIT workshop, June 2016: Chad, Mali, Liberia + DRC, Ghana, Guinea, Senegal, Sierra Leone Madagascar (Dec 2016): National training Laos: (Jan 2017): National training with participants from Cambodia Trainings and WASH FIT activities planned in Ethiopia, Kenya, Malawi, Tajikistan 16 WASH in HCF: GLE 28-30 March 2017, Kathmandu
Lessons learned Facilities often lack a budget to make improvements WASH & quality must be taken up by governments Training must come with a plan for roll out and implementation and regular follow up Need better monitoring and analysis of progress and challenges at the facility level 17 WASH in HCF: GLE 28-30 March 2017, Kathmandu
What materials and support are available? WASH FIT guide (English, French, Laos; Arabic, Russian, Spanish coming soon) (www.washinhcf.org/tools) Associated training modules and guidelines for running WASH FIT training (www.washinhcf.org/training) NB: training should be adapted to a given country/region/ facility context Coming soon: WASH FIT Mobile.. 18 WASH in HCF: GLE 28-30 March 2017, Kathmandu
Thank you! 19 WASH in HCF: GLE 28-30 March 2017, Kathmandu