As one of our three program pillars, Water, Sanitation and Hygiene (WASH) at healthcare facilities is a priority focus for Freshwater Project International in Malawi.

Despite the fundamental need of Water, Sanitation and Hygiene (WASH) for quality health service delivery, recent studies have shown that access at healthcare facilities in developing countries is alarmingly insufficient.

A 2015 WHO/UNICEF global report reveals that 38% of health care facilities in low to middle income countries have no source of water, and almost one fifth of facilities did not have improved sanitation. This compromises the ability to provide basic, routine services, such as child delivery and inhibits prevention and control of infections and spread of disease for patients and their families, health workers and surrounding communities.  

All major initiatives to improve global health should include the provision of basic WASH services at healthcare facilities. Clean and safe healthcare facilities can increase demand for and trust in services, reinforce the role of healthcare services and staff in setting societal hygiene norms, increase the motivation and retention of health workers, and result in cost savings from infections averted and more efficient service delivery. 


  • 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)