Examining factors driving inequities in water, sanitation, hygiene, and waste management services in healthcare facilities in Ghana: An analysis of routine national data

Abstract

In Ghana, little is known about the drivers of inequities of basic water, sanitation, and hygiene (WASH) services in healthcare facilities (HCFs). We aim to examine the status and factors driving access to basic WASH services in Ghana. This survey involved an analysis of routine health service data submitted to the District Information Management System 2 (DHIMS 2). Complete data were available for 1,646 HCFs across Ghana for analysis. Coverage of basic Water, Sanitation and hygiene services was 69, 58, and 64%, respectively. About 50% had a WASH-IPC action plan, and 67% had a WASH-IPC manager who is responsible for the day-to-day WASH management. Regional inequities in access to basic WASH services exist, with the newly established regions and those in Northern Ghana being disadvantaged. Significant drivers of basic WASH services were the location of HCF, the level of service delivery, and availability of a trained facility-based assistant WASH manager. WASH services in Ghanaian HCFs have improved, but it is still not up to the standards set by the Sustainable Development Goals for WASH. Universal access to basic WASH services can be attained by mounting targeted WASH interventions and appointing WASH-IPC managers at all levels of the health system. HIGHLIGHTS Little is known about the status and drivers of inequities in the provision of basic WASH services in Ghana.; More than half of the HCFs in Ghana have access to basic WASH services.; Health system factors and the geographic location of the facilities are related to basic WASH services.; Urgent targeted WASH actions are required at all levels to bridge the inequity gaps in the provision of WASH services towards UHC attainment.;

Keywords

• ghana
• healthcare-associated infections
• healthcare facilities
• infection control
• sanitation and hygiene
• water