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Cited by 77Child Nutrition and Water AccessInfection Control in HealthcareHealth Policy Implementation Science

Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013–2018: Results of health facility surveys and implications for COVID-19 transmission

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Kanyangarara, Mufaro, Allen, Savannah, Jiwani, Safia S, Fuente, David·2021·BMC Health Services Research
DOI 10.1186/s12913-021-06515-zPMC PMC8231746
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Abstract

Background: The COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services. Result: Overall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households. Conclusions: Availability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.

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  • Kanyangarara et al. (2021) revealed that there are multiple positive effects on pupils when WASH is well articulated in basic schools by providing safe drinking water, building good sanitary facilities and establishing appropriate hygiene habits.

    “The research conducted by Kanyangarara et al. (2021) revealed that there are multiple positive effects on pupils when WASH is well articulated in basic schools by providing safe drinking water, building good sanitary facilities and establishing appropriate hygiene habits.”

    From The level of implementation of water, sanitation, and hygiene (WASH) practices among the public basic schools in Ghana (2024) · cites this paper as Kanyangarara et al. (2021)

    The Introduction says improved WASH access benefits child health and girls’ education. But the study assesses WASH services in health facilities, not basic schools, and does not report effects of school WASH provision on pupils. (LLM, conf=0.87)

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  • Implementation of the CFHSI has strengthened and sustained existing efforts of WASH in schools by creating overall awareness of the importance of WASH in schools, stimulating a positive environment to advocate for improved WASH in schools and changing social norms, making unhealthy and unhygienic schools unacceptable.

    “According to Kanyangarara et al. (2021), the Implementation of the CFHSI has strengthened and sustained the existing efforts of WASH in schools by creating overall awareness of the importance of WASH in schools, stimulating a positive environment to advocate for improved WASH in schools and more importantly changing social norms, making unhealthy and unhygienic schools unacceptable.”

    From The level of implementation of water, sanitation, and hygiene (WASH) practices among the public basic schools in Ghana (2024) · cites this paper as Kanyangarara et al. (2021)

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References 33 · Cited by 77

Research works printed but not linked: 27

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Authors
Kanyangarara, M., Allen, S., Jiwani, S. S., & Fuente, D.
Affiliations
  • University of South Carolina (US)
  • Johns Hopkins University (US)
Corresponding author
Kanyangarara, Mufaro
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2021-06-25
Volume
21
Issue
1
Pages
601-601
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-021-06515-z
PMC
PMC8231746
OpenAlex
W3174908726
Cited by
77
References
33
Citations by year
2026: 9 · 2025: 18 · 2024: 21 · 2023: 17 · 2022: 11 · 2021: 1
FWCI
7.97
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of South Carolina COVID-19 Research Initiative (N/A)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
water, sanitation and hygiene, healthcare facilities, SARS-CoV-2 transmission, infection control, standard precautions, urban-rural differences, improved water sources, hand hygiene, sub-Saharan Africa, health facility survey
MeSH terms
COVID-19, SARS-CoV-2, Health Facilities, Humans, Hygiene, Sanitation, Water, Water Supply, Africa South of the Sahara, Pandemics

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