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Health care authorities urged to ensure access to safe sanitation

Healthcare workers and their clients are at risk of infection due to unsafe or inadequate water supply across all levels of healthcare, Ministry of Health Director General Dr. Patrick Amoth has said.

“For Kenya, only 64 per cent of the health facilities have adequate water. However, this is skewed with the assessment having revealed that water availability increases with the levels of care at 53, 63, 80 and 100 percent for Level 2, 3, 4 and 5 respectively,” he noted.

Dr Amoth was speaking at a Machakos hotel during the dissemination of the first edition of the 2022 Kenya Status Report on Infection Prevention and Control in Health Care Facilities, Basic Hygiene and Hand Washing Services.

This revelation comes at a time when the country is still dealing with Covid 19 pandemic, reporting cholera outbreak and on high alert due to the Ebola outbreak reported in Uganda since September 2022.

He noted that National Infection and Prevention Control (IPC) policy however recommends for the availability of water at all times in sufficient quantities adding that there are some low performing areas as compared to the WHO/UNICEF 2020 report which indicated that 75 percent of health facilities had basic water supply.

He said that through this assessment, it has however been established that although about 64 per cent of the health facilities had adequate water, water was unsafe in half of the facilities adding that 58 per cent did not have adequate hand washing stations.

“62 per cent did not have functioning hygiene stations at points of care, 45 per cent did not have dedicated decontamination area, and 21 per cent did not have reliable sterile material supply or sterilization equipment,” he said.

While reiterating that there ought to be safe sanitation for all patients, staff and caregivers, Dr Amoth appealed to health care authorities to ensure access to safe sanitation in their health facilities in an effort to control communicable diseases.

“This will help protect nearby communities from exposure to untreated wastewater, faecal sludge and air pollution. The problem of diseases from unsafe health-care settings is growing worse. Worldwide, there is an increasing provision of healthcare, which is becoming more complex,” said Dr. Amoth.

“Under such settings, healthcare authorities should fulfill their responsibility by ensuring that there are effective procedures in place to ensure safe management of faecal waste,” added Dr. Amoth.

He pointed out that hospital acquired infections contributed to avoidable mobility and mortality, unnecessary burden to the health-sector and additional constraints on household resources.

“It is worth to note that from the global report by World Health Organization and UNICEF (2019), that more than 90 per cent of healthcare workers do not adhere to recommended hand hygiene practices, and 20 percent of healthcare women get wound infection after caesarean section some leading to neonatal sepsis and deaths in new-borns,” said Dr. Amoth.

He however expressed his concern that in some circumstances, people may choose not to seek care because the nearest facilities are not functioning or treatment is uncertain due to shortage of water, electricity or supplies.

The Director General said that the situation is however dire at health facilities stating that the assessment laid bare some of the inequalities that not only exist amongst the counties, but also across levels of care.

“From the current status of basic hygiene and hand washing services as assessed for Kenya, most of the parameters measured are within the WHO/UNICEF findings under the 2019 global report,” said Dr. Amoth.

He pointed out that the report highlighted the need for addressing basic infection and control components so as to avert unnecessary disease burden arising from healthcare settings.

The DG further called on county governors and the first ladies to take key advocacy roles as County Goodwill Ambassadors to improve on the low coverage.

He recommended that basic hygiene and hand washing services be immediately integrated into the development processes such as the County Development Integrated Plans citing that for every dollar invested in these basic services, there is a 15 dollars return.

Dr. Amoth noted that to achieve the national and global target 80 per cent coverage by 2025 and 100 percent by 2030; it will require investing Sh78 per person.

“As part of the solutions, I am aware that WHO and UNICEF has committed to building capacity in the upcoming Water Sanitation Facility Improvement Toolkit training of trainers in the coming days,” said Amoth.

He said this would go a long way in getting the requisite capacities in all counties adding that more of these findings and recommendations are within the report that was being launched.

“From this report, I expect this team of senior managers from county and headquarters, and health partners to come up with a scale-up plan for further assessment in order to cover more counties and health facilities,” said Amoth.

“I also expect a roadmap towards completion of the Kenya Healthcare Facilities WASH Guidelines and Standards, including the possibility of having an IPC score for the star rating healthcare facilities. I expect improvements in these fundamental services in subsequent annual assessment reports,” added Dr. Amoth.

By Rachael Kilonzo

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