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Extending the use of the World Health Organisations’  water sanitation and hygiene assessment tool for surveys in hospitals – from WASH-FIT to WASH-FAST


Autoři: Michuki Maina aff001;  Olga Tosas-Auguet aff003;  Jacob McKnight aff003;  Mathias Zosi aff001;  Grace Kimemia aff001;  Paul Mwaniki aff001;  Arabella Hayter aff004;  Margaret Montgomery aff004;  Constance Schultsz aff002;  Mike English aff001
Působiště autorů: Health Services Research Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya aff001;  Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands aff002;  Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom aff003;  Water Sanitation and Hygiene Department, World Health Organization, Geneva, Switzerland aff004;  Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226548

Souhrn

Background

Poor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations’ Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system.

Methods

We adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability.

Results

We present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals’ overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees.

Conclusion

We propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.

Klíčová slova:

Health care facilities – Outpatients – Inpatients – Data visualization – Sanitation – Hygiene – Budgets – Global health


Zdroje

1. United Nations General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development. New York: United Nations. 2015;(1).

2. Hans Jørn Kolmos. Health Care Associated Infections: Sources and Routes of Transmission. In: Infection Control–Updates Croatia2012 [cited 2017 2nd November ]. Available from: http://cdn.intechopen.com/pdfs-wm/28876.pdf.

3. Rainey R and Weinger M. The Role of Water, Sanitation and Hygiene (WASH) in Healthcare Settings to Reduce Transmission of Antimicrobial Resistance. 2016 [cited 2017 18th December]. Available from: http://resistancecontrol.info/infection-prevention-and-control/the-role-of-water-sanitation-and-hygiene-wash-in-healthcare-settings-to-reduce-transmission-of-antimicrobial-resistance/.

4. WHO/UNICEF. Water, Sanitation and Hygiene (WASH) in Health Care Facilities Global Action Plan [cited 2018 28th September]. Available from: http://www.who.int/water_sanitation_health/healthcare_waste/wash-in-healthcare-facilities-action-plan.pdf.

5. Bouzid M, Cumming O, Hunter PR. What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries. BMJ Global Health. 2018;3(3). doi: 10.1136/bmjgh-2017-000648 29765776; PubMed Central PMCID: PMC5950627.

6. World Health Organization. WASH in health care facilities: Links with the network for improving quality of care for maternal newborn and child health 2017.

7. World Health Organization, UNICEF. Water, sanitation and hygiene in health care facilities: status in low and middle income countries and way forward. 2015.

8. World Health Organization, UNICEF. Water and Sanitation for Health Facility Improvement Tool (WASH FIT): a practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Geneva: 2017 9241511699.

9. Weber N, Patrick M, Hayter A, Martinsen AL, Gelting R. A conceptual evaluation framework for the water and sanitation for health facility improvement tool (WASH FIT). Journal of Water, Sanitation and Hygiene for Development. 2019. doi: 10.2166/washdev.2019.090

10. John A, Jamie B, Yves C. Essential environmental health standards in health care. Geneva: World Health Organization. 2008.

11. World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level: World Health Organization; 2016.

12. Barasa EW, Manyara AM, Molyneux S, Tsofa B. Recentralization within decentralization: County hospital autonomy under devolution in Kenya. PLOS ONE. 2017;12(8):e0182440. doi: 10.1371/journal.pone.0182440 28771558

13. Maina M, McKnight J, Tosas-Auguet O, Zosi M, Kimemia G, Mwaniki P, et al. Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya 2019:Forthcoming.

14. Tuti T, Bitok M, Malla L, Paton C, Muinga N, Gathara D, et al. Improving documentation of clinical care within a clinical information network: an essential initial step in efforts to understand and improve care in Kenyan hospitals. BMJ Global Health. 2016;1(1). doi: 10.1136/bmjgh-2016-000028 27398232

15. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2013.

16. McCracken G. The Long Interview.: Sage; 1988.

17. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health. 2018;6(11):e1196–e252. doi: 10.1016/S2214-109X(18)30386-3 30196093

18. de Francisco Shapovalova N, Meguid T, Campbell J. Health-care workers as agents of sustainable development. The Lancet Global Health. 2015;3(5):e249–e50. doi: 10.1016/S2214-109X(15)70104-X 25770922

19. Nevo B. Face Validity Revisited. Journal of Educational Measurement. 1985;22(4):287–93.

20. Smits H, Supachutikul A, Mate KS. Hospital accreditation: lessons from low- and middle-income countries. Globalization and Health. 2014;10(1):65. doi: 10.1186/s12992-014-0065-9 25185526

21. National Health Insurance Fund. Assessment checklist for accrediation of Health Facilities (NHIF ACT 1998). Nairobi: NHIF; 2016.


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2019 Číslo 12
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