WASH in health care facilities: initiatives, challenges and lessons from Nepal post emergencies

Almost one-fifth of health care facilities (HFCs) in Nepal do not have access to WASH services posing serious threat to patients and staff while jeopardising the dignity of vulnerable population seeking health services including pregnant women and the disable. Though Nepal has been able to reach many hard to reach areas with health services, ensuring infection prevention from health facilities is still a challenge. The 2015 Earthquake further devastated the situation. Under various initiatives in the last five years, significant efforts were undertaken to assess and improve the situation. Over 600 HCFs mostly in the earthquake affected districts were supported for improved WASH services while development of guidelines on WASH in HFCs is in progress. Incorporating indicators on WASH services in HFCs into the Health Management Information System and putting in place a viable mechanism for operation and maintenance of WASH facilities are few of the priority areas.