Health centers are a life-line for rural Malawians. When a health center lacks access to clean water, it is nearly impossible for medical professionals to provide hygienic, safe care to their patients.


Of primary concern are health services available to expectant mothers. When expectant mothers arrive at health centres prior to delivery, they frequently have to wait outside, without convenient access to clean water.


Water Supply and Distribution Rehabilitation

If medical staff do not have immediate access to clean water, much time is wasted, and services are often delayed. Postnatal care is just as difficult under these unhygienic conditions, leading to to high rates of infection among new mothers and infants. These conditions contribute to the country’s high ratios of maternal and neonatal mortality.

Most health centers in Malawi were constructed with a functioning and consistent water distribution system. However, over the years, many of those systems have fallen into disrepair. The galvanized pipe systems originally installed have often corroded and blocked, leaving the health center without access to clean running water, in some cases for many years. Or leakages in storage or distribution systems cause inconsistent water supply or contamination. In some cases, pumps are broken and need to be replaced. Other facilities are new, but have no water supply and distribution system in place.

Partnered with Engineers Without Borders-USA (EWB), Freshwater Project International (FPI) offers a comprehensive water system assessment and technical upgrade.

During this process we provide an in-depth technical assessment of the the well, pump, storage and distribution system. The water supply rehabilitation program implemented by FPI replaces the old galvanized water distribution system with reliable and easy to repair HDPE pipes. We install control valves at each connection in order to offer accessible maintenance solutions while maintaining a functioning system overall. We replace any broken fixtures and leave the facility with the appropriate tools and technical training needed to ensure ongoing infrastructure functionality of the water system.


The potential impact is tremendous! An improved water system at the facility providing the vital and life-saving clean water required at any health center for regular functionality will undoubtedly save lives. In addition, the nurses and doctors will be able to focus on their work rather than being bogged down or delayed by non-functioning water systems. They will be able to see more patients and provide a greater level of care. The training of local experts offers long-term sustainability and reliability of the infrastructure installed.


  • Higher quality of care

  • Less healthcare-related infections

  • Greater uptake of health services

  • Improvements in healthcare staff morale

  • Improved maternal, child and neonatal health

Essential Components of WASH at HEALTH CENTERS

Essential environmental health standards for health care in low-resource settings are described in the World Health Organization's Essential Environmental Health Standards in Health Care (WHO, 2008).

  • Availability of an on-site safe, sufficient and reliable water source

  • Adequate numbers of improved, accessible and gender segregated sanitation facilities for patients, staff, and visitors

  • Staff, visitor and patient practice of safe hygiene practices (e.g. handwashing)

  • Hygiene promotion to patients and caregivers

  • Safe management and disposal of health care waste


Lack of access to clean water at birth exposes infants and mothers to infections and water-born diseases. This leads to the tragedies of infant and maternal mortality, orphaning, low-birth weight, stunted growth, and several other acute and chronic, life-altering illnesses. FPI places priority on providing fresh water and sanitation to birthing centers and maternal waiting shelters in Malawi, Africa.


  • Improved protection against infection and disease for both mothers and infants

  • Improved health of the mother and infant and increased ability to breastfeed safely

  • Reduced maternal mortality and orphaning

  • Reduced infant mortality and early childhood mortality


(1) UNICEF/WHO 2015 Report: Water, Sanitation and Hygiene in Health Care Facilities: Status in Low- and Middle-income Countries and Way Forward. 

(2) World Health Organization's Essential Environmental Health Standards in Health Care (2008)