Tajikistan is upgrading maternity wards and other healthcare facilities to ensure that they have adequate water, sanitation, and hygiene (WASH). The country has reviewed HCFs and identified gaps, which are now being addressed by improving infrastructure, increasing national capacity, and coordinating efforts to make WASH a standard in all health care services.

One in every four HCFs in the world lacks basic water services, putting patients and health workers at risk. One-third of HCFs do not have adequate hand-washing and sanitation facilities. The extent of the problem is hidden by data gaps.

Water, sanitation, and hygiene are essential in HCFs for infection prevention, antimicrobial resistance reduction, and providing safe health services to all. COVID-19 exposed the flaws in these provisions. WASH services are required in HCFs to protect patients and health workers.

On June 6–9, Dushanbe, Tajikistan, hosted the Second High-Level International Conference on the International Decade for Action on “Water for Sustainable Development,” 2018–2028. Countries agreed at the conference that safe, affordable water, adequate sanitation, and hygiene, particularly in HCFs, are critical for child, maternal, and patient health.

They also talked about how to improve pandemic prevention, preparedness, and response, including for the current COVID-19 pandemic, by spending on water supply, sanitation and hygiene facilities, wastewater management, and constantly encouraging good WASH practices.

“WASH services must be a priority, especially in health facilities,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. With public investment, accountable management, and governance, we will be able to ensure safe water, sanitation, and hygiene are a global reality. This no-compromise investment will save one million lives, advance human rights and gender equality, and generate significant economic returns.

The UN Group of Friends in Support of WASH in Health Care Facilities, established in 2021 by Hungary and the Philippines in collaboration with WHO, advocates for increased action and international collaboration to improve WASH in HCFs worldwide.

Tajik officials shared eight concrete steps for improving WASH services in HCFs. WHO and UNICEF advocate for the implementation of costed national roadmaps with adequate funding, the monitoring and review of progress in improving WASH services, practises, and the enabling environment, the development of the health workforce’s capacity to sustain WASH services and promoting good hygiene, and the integration of WASH into regular health sector planning, budgeting, and scheduling to provide valuable services, as well as COVID-19 reaction and revival efforts.

Tajikistan places a high value on WASH for health.

In 2018, the Tajikistan Ministry of Health and Social Protection of the Population, in collaboration with the WHO European Centre for Environment and Health, conducted a situational analysis of WASH in HCFs. In 2020, 350 HCFs were surveyed across the country about their potable water, hygiene, hand cleanliness, waste management, and environmental cleaning. The survey discovered service gaps in all WASH dimensions, particularly hand hygiene, environmental cleaning, and sanitation.

This work has aided authorities and partners in the planning and implementation of WASH improvements in HCFs. To strengthen WASH and infection control policies, practices, and monitoring, coordination groups have been formed. The National Health Strategy for 2030 now includes water, sanitation, and hygiene as targets, increasing their visibility, accountability, and (ideally) funding. WASH recommendations are being implemented in the renovation of maternity wards and other health facilities.

The Dushanbe Conference hopes to demonstrate that increasing the speed of WASH is necessary, pressing, and attainable with political will.

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