By: Franklin ASARE-DONKOH
A research study commissioned by WaterAid Ghana, ‘the Sustainable Water, Sanitation and Hygiene (WASH) in Health Care Facilities (HCFs) is a project which was undertaken in Asutifi North District in the Ahafo region and Wassa East District in the Western region, has revealed that a large number of health care facilities lack basic WASH facilities.
According to the research report, a whopping 27.8% of HCFs in Asutifi North had no sanitation service, while 53.6% of HCFs in Wassa East lacked basic sanitation service.
This was revealed at the 98th National Level Learning Alliance Platform (NLLAP), held at the Coconut Groove Regency Hotel in Accra.
In the Wassa East district, there are 28 HCFs, comprising 23 public HCFs, 2 mission/faith-Based HCFs, and 3 private HCFs, while in the Asutifi North district, there are 22 HCFs, consisting of 15 public HCFs, 1 mission/faith-Based HCF, and 6 private HCFs.
The study reveals that most facilities have flush or pour-flush toilets across the two districts. However, the choice of latrine technologies limited patients’ access to toilet use due to the following: Irregular water supply in HCFs, Poor use of toilet facilities because latrine technology is unfamiliar to the patients, Poor maintenance of the toilets, especially cleaning, repair, and maintenance In most cases, the cleaning was done by the health workers.
Water services in HCFs
According to the study, there is a high proportion of healthcare facilities with basic water service in the Asutifi North District. The high proportion of healthcare facilities with basic water service in the Asutifi North District was attributed to the ANAM initiative.
The partners of the ANAM initiative, such as World Vision International and Safe Water Network, have contributed immensely to urban and peri-urban water supply, rural water supply, and most health care facilities in the district. The World Vision through their “Nsupa model”.
Through the Nsupa model, about 226 water points have been established (134 taps from 12 mechanised systems, 51 drilled boreholes, and 41 rehabilitated wells). Seven (7) HCFs were supported with improved WASH facilities. §Safe Water Network applied its safe water enterprise model to provide services in towns (2 locally operated water stations. Consumers pay for these water services, supporting their sustainability.
It explained that the proportion of HCFs with basic water could have been higher, considering the huge investments made; however, issues of operations and maintenance derailed some aspects of the progress made in terms of frequent breakdowns. Although HCFs are willing to fix the problem, due to the unavailability of plumbing technicians and pump mechanics in their operational area, they had no option but to wait until the providers fixed the problem. Additionally, the MOU signed with Access Development, a limited liability company in Ghana established by the international NGO Water4, has been of great help in expanding water coverage (NUMA-purified water) in communities through an agreement for a ‘pay-as-you-fetch’ system.
With all these initiatives to boost access to water services, the study reveals that about 3.6% and 5.6% of HCFs in the Wassa East and Asufiti North Districts, respectively, still had no water service.
Environmental Cleaning Services in Health Care Facilities
The study also revealed that environmental cleaning services in healthcare facilities were very low (25.0%). Most of the HCFs in both districts had issues maintaining proper sanitary conditions and had no personnel responsible for cleaning.
As the world is advocating for inclusion of all manner of people in the provision and use of WASH and the provisions in Ghana’s Disability Act (Persons with Disability Act, 2006) enjoin institutions or individuals that provide public services to put in place the necessary facilities that make the service available and accessible to a person with a disability, the scenario in two districts is the opposite, as only 10.5% of facilities in the Asutifi North and 8.0% in the Wassa East Districts had toilet facilities accessible to people with reduced mobility or other impairments.
The scope of the data gathering was limited to public, mission, and private healthcare facilities in the Asutifi North and Wassa East districts of the Ahafo and Western Regions, respectively.
The study’s purpose was to assess the WASH services in health care facilities in the Wassa East and Asutifi North Districts in the Ahafo and Western Regions, respectively, for evidence-based advocacy. It was also to gather evidence from previous modeling of WASH service delivery in HCFs in similar contexts and develop content to support advocacy in the Asutifi North and Wassa East Districts and at the regional and national levels.
Sustainable Water, Sanitation, and Hygiene in Health Care Facilities (WASH in HCFs) is a project according to WaterAid Ghana that is designed to strengthen WASH and health systems, accelerating the coverage of reliable access to safer water and affordable, inclusive, and sustainable WASH services within HCFs in Ghana.
A key objective of the project is to develop the evidence base around WASH in HCFs to inform policy and practice and to advocate for the prioritisation of WASH access in HCFs.
The scope of the data gathering was limited to public, mission, and private healthcare facilities in the Asutifi North and Wassa East districts of the Ahafo and Western Regions, respectively. The two-fold focus of the study is to gather WASH in HCF data for social accountability work and support life cycle costing analysis (LCCA), as well as gather evidence from previous modelling of WASH service delivery in HCFs in similar contexts and produce contents to support advocacy.
Background
WaterAid Ghana, in collaboration with the Conrad N. Hilton Foundation (CNHF) is implementing the Sustainable Water, Sanitation and Hygiene in Healthcare Facilities (WASH in HCFs) advocacy project to strengthen WASH and health systems, accelerating the coverage of reliable access to safe water and affordable, inclusive, and sustainable WASH services within HCFs in Ghana. Several studies have been undertaken with a focus on the Wassa East and Asutifi North districts since the inception of the project to guide implementation.
WaterAid and Partners led the discussion at the 98 edition of the NLLAP with the objective of sharing some of the findings to inform the discussion on strengthening systems for WASH in healthcare facilities, highlighting the evidence base around safe water and WASH in HCFs to inform policies, and enhancing civil and social accountability for WASH in HCFs.