Research by the Center for Disease Dynamics, Economics and Policy (CDDEP) recently brought to light the estimated costs associated with ensuring Water, Sanitation, and Hygiene (WASH), and implementing related infection prevention and control measures in Indian healthcare facilities over one year. The study aimed to assist in more informed health policy decision-making using the gathered data.
Understanding WASH
WASH is an abbreviation representing the interconnected areas of Water, Sanitation, and Hygiene. It’s a key component of the World Health Organization (WHO) WASH Strategy, prepared in reaction to Member State Resolution (WHA 64.4) and the 2030 Agenda for Sustainable Development (SDG 3: Good Health and Well Being, SDG 6: Clean Water And Sanitation).
The Need for the Study
An existing deficiency in Healthcare and Sanitation Facilities drove the need for this study. A 2019 report by WHO and UNICEF highlighted that worldwide, one in four healthcare facilities lacked basic water services. Additionally, 42% had no hygiene facilities at the point of care.
Economic Importance of Sanitation
The economic value of sanitation was underlined in a 2012 WHO report, which demonstrated that there were USD 5.50 returns for every dollar invested in sanitation, owing to lower health costs, increased productivity, and fewer premature deaths.
The Consequences of Negligence
A WHO document reported that inadequate implementation of the WASH strategy in low- and middle-income countries results in approximately 827,000 yearly deaths. Better WASH implementation could prevent the death of 297,000 children under five each year.
Objective and Findings of the Study
The study’s goal was to determine the cost-effectiveness of WASH interventions to reduce healthcare-associated infections among mother and neonates across the Indian healthcare system. It was estimated that enhancing WASH in public healthcare facilities in India and these improvements’ sustenance for a year would cost about Rs. 2567 crores.
Cost-Efficient and Expensive Interventions
The most expensive interventions were found to be providing clean water, linen reprocessing, and sanitation. In contrast, hand hygiene, medical device reprocessing, and environmental surface cleaning were the least expensive interventions.
Healthcare-Associated Infections
Deficiencies in WASH provision and lack of infection prevention and control can lead to healthcare-associated infections. The pathogens behind these infections include Acinetobacter Baumannii, Enterococcus Faecalis, Escherichia Coli, Salmonella Typhi, and Streptococcus Pneumoniae. Common healthcare-associated infections are Catheter-associated urinary tract infections, Central-line-associated bloodstream infections, Surgical site infections, and Ventilator-associated pneumonia.
Implication of the Study
The findings indicate the feasibility and affordability of addressing WASH gaps across the Indian healthcare system compared to other national health campaigns. The study also underscores the need for a collective effort from local bodies, and state and central governments to address quality and inequality issues sustainably in WASH provision.
Improvement in Healthcare Policy Framing
The unique intersection between WASH, infection prevention, control, and antimicrobial resistance provides policy makers an opportunity to tackle multiple overlapping problems through interventions on WASH in healthcare facilities.
