Development of a Framework to Improve the Provision of Water, Sanitation, and Hygiene in Healthcare Facilities of Mwandi District in Western Province

Abstract

Healthcare facilities (HCFs) require safe water, sanitation, hygiene, environmental cleaning, and waste management (WASH) in the provision of quality services to promote, restore, maintain, and improve health. However, the unavailability of studies on the challenges and opportunities of WASH services in HCFs of Mwandi District has limited the potential for improved health care and quality of life. Without proper elucidation, this has the potency to dissuade women from using HCFs for childbirth and healthcare, potentially increasing maternal mortality rates. To examine the challenges and opportunities in accessing safe WASH services in HCFs in Mwandi District, more of Qualitative techniques were utilized to gather data from 8 HCFs in Mwandi District. This involved initial observations employing the WASH Status Checklist, followed by focus group discussions with expectant mothers and 23 key informant interviews. Thematic analysis was used to analyse the data.  The results showed that only half of the investigated facilities provided basic water services, hampered by water salinity issues. Even though most facilities had improved sanitation facilities, they, however, do not meet the basic sanitation standards. This was primarily due to issues such as corroded pipes, insufficient accessible toilets for people with disabilities, and the absence of menstrual hygiene facilities. Many facilities lacked gender-segregated staff facilities. Most of the facilities had functional hand hygiene facilities but also did not meet the basic standards due to a lack of soap for hand washing. A significant number encounter inefficiencies in cleaning protocols, and the majority face poor infrastructure conditions. The findings further revealed that these challenges stem from inadequate prioritization and funding for Water, Sanitation, and Hygiene (WASH) initiatives. The existing knowledge often concentrates on individual components, the findings stress the necessity for an integrated approach that collectively addresses water supply, sanitation, hygiene, and waste management. This holistic perspective can significantly contribute to the development of more effective guidelines and policies, offering a nuanced understanding of the interconnected nature of WASH components. Furthermore, the research sheds light on the pivotal role of localized political will, specifically highlighting the influence of Health Centre Advisory Committees (HAHC) in shaping governance at the community level, especially concerning WASH projects. The study offers a comprehensive overview of challenges and sustainability opportunities related to WASH services, crucial for their effective functioning. It emphasizes the necessity for heightened awareness and increased budget allocation for the sustainable maintenance of WASH services