Improving WASH in Health Care Facilities

In Ghana, one place apart from home to feel cared for is a Health Care Facility (HCF). Not only are the health personnel professional, but most importantly, the health care institution must have functional Water Access, Sanitation and Hygiene (WASH) facilities including toilet facilities, handwashing stations and clean drinking water stations. Unfortunately, the Ghana Joint Monitoring Programme (JMP) report in 2016 estimated that 30% of HCFs lack access to basic water services and 83% of health facilities do not have improved sanitation. This disturbing revelation motivated Global Communities to partner with an International NGO Water4 through its local implementing partner Access Development to improve the WASH status of 30 HCFs in the Wassa East District of the Western Region of Ghana.

Background
Global Communities in partnership with Water4 and its local implementing partner Access Development in the Wassa East in the Western Region, is working to promote Water, Sanitation and Hygiene (WASH) in HCFs for six months. In recent times, there has been a call for all stakeholders to support WASH programs in HCFs principally to curtail preventable infections and make the facilities more user-friendly for both staff and clients. After a baseline assessment of these institutions, the outcome was fused into a one-week training session for about 90 stakeholders including leadership of the Wassa East District Health Directorate, staff of the HCFs and community members. Posters and documented guidelines on improving WASH statuses in HCFs have been distributed to all the HCFs in the Wassa-East District.

Current Status of the Earmarked Health Care Facilities
Two months after the training, all 30 HCFs have made significant progress. They have either improved their sanitation facilities or constructed new ones, and improved their hygiene conditions and gained access to sustainable water sources for drinking and for cleaning. After the training sessions, some HCFs have been very motivated to do even better by improving their WASH status. Three of such institutions are: Plantation Socfinaf Ghana (PSG) Health Center, Sekyere Krobo Community Clinic and Atieku Health Center.

Plantation Socfinaf Ghana (PSG) Health Center
According to Godson Adu-Agyei, the Physician Assistant of PSG Health Center, “The training exposed a few loopholes in our WASH status and we are determined to be the best clinic in every aspect.” For example, though the health center is excellent in health care delivery, prior to the WASH training, it lacked essential sanitation.
Now, the health center that previously used one mop and a duster to clean all rooms in the ward have separate mops and dusters for different departments. “The consulting rooms, labs, injections rooms, emergency room and wards have separate mops and dusters. Cleaning is also done with the right detergents and the right proportion of water and hydrochloric acid,” says the cleaner, Bright Mensah. He added that there is now proper segregation of infectious from non-infectious waste, and that waste bins are lined and changed after proper disposal.

Additionally, provision for a toilet facility has been made for the Out Patient Department (OPD). One highlight of the facility is the creation of space in the female washroom for Menstrual Hygiene Management (MHM). Generally, the staff have a positive attitude to change and are eager to ensure their WASH is as excellent as their medical delivery.

Atieku Health Center
If ‘walk the talk’ were an institution, Atieku Health Center would be it. They have installed a handwashing facility each in the delivery, labor, recovery and laying in wards, consulting room and Ante-Natal Care (ANC) and laboratory.
According to Senior Midwifery Officer Francisca Ametefe, “Some of the wards previously used veronica buckets for handwashing but within a period of six months sinks have been installed. All these were made possible when we successfully lobbied for water connection to the health center. The nudge we had from the training moved us to fast-track the lobbying process.”

Also, washroom facilities that were previously unlabeled and unsegregated have been labeled and segregated according to gender for both staff and clients. These steps have proven that successful interventions do not require only direct provision of amenities; they also require the right training and a willing leadership.

Sekyere Krobo Community Clinic
Located in a small community of Sekyere Krobo, this community clinic has shown great commitment at improving their WASH status, especially by providing safe water to the client. They are among the first institution to acquire and label their drinking water station.

“To improve the hygienic us of the station they have implemented a policy requiring all clients to visit the facility with their personal drinking cup. This way they incur less cost purchasing disposable cups and prevent the spread of diseases through the use of common drinking cups. However, provision I made for emergency cases” says the nursing officer of the clinic, Eric Asare-Asino. This is the story of a small community clinic making giants steps to advance their WASH status.

Future of the Partnership and Intervention
Global Communities’ vision for this partnership is for all Ghanaians, regardless of the location of HCF staff and clients, to have sustainable access to dignified, safe and improved water supply and sanitation, and the knowledge, attitudes, and behaviors needed to properly and hygienically use these facilities to meet their basic needs and stay healthy. The partnership will also create an enabling environment that influences government and citizens alike to hold themselves and each other accountable for realizing sustainable change in HCFs.