This slides guides on how WASH can be managed at the institution.

1. WATER SANITATION AND HYGIENE
( W A S H )
BUSITEMA UNIVERSITY
MPH 7108
Mr. Orech Sam (EH, Adv.Dip M&L, MPH)
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2. Objective(s)
By the end of the lesson, students should be able to:
• Understand how WASH is managaged at HCF
• Explain how WASH is handled at schools
• Describe the management of WASH in peri-urban and urban settings
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3. (A). Water, Sanitation, and Hygiene (WASH) in
H e a l t h c a r e F a c i l i t i e s
To provide quality care, healthcare facilities need to have;
 A safe and accessible water supply
 Clean and safe sanitation facilities
 Hand hygiene facilities at points of care and at toilets
 Appropriate waste disposal systems
 Infrastructure that supports water, sanitation, hygiene (WASH).
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4. Why do we need the practice at HCF?
• Healthcare waste management practices helps prevent the spread of
diseases within the healthcare facility and to the surrounding
community.
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5. The scope of the problem
• Healthcare facilities in resource-limited settings lack essential WASH
and health care waste services.
Lack
access
to
piped
water
Lack
improved
sanitation
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6. Cont...
Lack
soap
for
handwashing
Lack adequate infectious waste disposal
Source: Cronk, R., & Bartram, J. (2018). Environmental conditions in health care facilities in low-and middle-income countries:
coverage and inequalities. International journal of hygiene and environmental health, 221(3), 409-422.
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7. • WASH infrastructure and services are essential to allow healthcare
workers to perform appropriate infection prevention and control (IPC)
practices.
• For example, both healthcare workers and patients need access to hand
hygiene supplies to reduce the risk of spreading infections through
unwashed hands.
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8. • Different levels of healthcare facilities also have different WASH needs.
• A facility that provides acute care, such as performing surgeries or treating
highly infectious patients, requires more advanced IPC practices
• Require special needs for treatment of contaminated feces and a high level of
water quality.
• Facilities that offer only primary care services still require good WASH
systems
• But may not need to meet these stricter requirements.
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9. Managament of WASH at HCF
1. Water supply
Sources & treatment
• A reliable and safe water source for the facility.
• Implement water treatment processes to ensure water quality meets
health standards.
 Storage and distribution
• Establish proper water storage facilities.
• Implement a distribution system to ensure water availability
throughout the facility.
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10. Monitoring
• Regularly monitor water quality through testing and analysis.
• Have contingency plans for water shortages or contamination events
Water supply for HCF
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11. Minimum water quantities required in health
care settings
HEALTH CARE SETTING MINIMUM WATER QUANTITY REQUIREMENT
Outpatients 5 litres/consultation
Inpatients 40–60 litres/patient/day
Inpatient therapeutic feeding centre 60 litres/patient/day
Cholera treatment centre 60 litres/patient/day
Severe acute respiratory diseases isolation centre 100 litres/patient/day
Operating theatre or maternity unit 100 litres/intervention
Viral haemorrhagic fever isolation centre 300–400 litres/patient/day
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12. 2. Sanitation management
Medical waste disposal
• Develop and implement protocols for the proper disposal of medical
waste.
• Ensure compliance with local regulations for medical waste
management
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13. Waste Classification Waste Seggregation
Colour coded bins for waste
seggregation
• 15% of HCF wastes is either
infectious, chemically hazardous or
radioactive.
• Must be managed appropriately to
prevent unsafe exposure to health care
workers, patients, visitors, waste
handlers and the public.
• Used needles and other sharp
materials are generally considered the
most hazardous category of HCW
• 85% - is not hazardous and can be
disposed of along with general solid
waste
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14. Toilet and sewage systems
• Provide clean and well-maintained toilets for patients, staff, and visitors.
• Also considered sex-separated, will allows women and men to use the toilet privately and
separately
• Implement sewage systems that prevent contamination and meet hygiene standards.
Infection control
• Develop and enforce infection control measures related to sanitation.
• Provide training to staff on proper sanitation practices to prevent the spread of infections
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15. Infection Control Cont...
IPC Practice at HCF Disinfection of surfaces
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16. Basic health care waste management services
ladder
 Basic services
• Waste is safely segregated into at least three bins, and sharps and
infectious waste are treated and disposed of safely.
• Limited service
• There is limited separation and/or treatment and disposal of sharps and
infectious waste, but not all requirements for basic service are met.
• There are no separate bins for sharps or infectious waste, and sharps
and/or infectious waste are not treated/disposed of.
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17. 3. Hygiene management
Hand hygiene
• Implement and enforce strict hand hygiene protocols for staff, patients,
and visitors.
• Provide handwashing stations with soap and water, or alcohol-based
hand sanitizers.
Hand hygiene practices
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18. Training and education
• Conduct regular training sessions on hygiene practices for staff.
• Educate patients and visitors on the importance of hygiene in
preventing infections.
Basic
hand
hygiene
practice
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19. 4. Infrastructure and maintenance
 Facility design
• Design healthcare facilities with proper WASH infrastructure in mind.
• Ensure the layout allows for easy access to water and sanitation facilities.
 Regular maintenance
• Establish a routine maintenance schedule for plumbing, sewage systems, and
WASH infrastructure.
• Promptly address any issues related to water and sanitation systems
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20. 5. Compliance and regulations
 Local regulation
• Stay informed about and comply with local and national regulations regarding
WASH in healthcare facilities.
• Collaborate with relevant health authorities to ensure compliance.
 Standards and guidelines
• Adhere to international standards and guidelines for healthcare-associated
WASH, such as those provided by the World Health Organization (WHO).
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21. 6. Emergency preparedness
Contigency planning
• Develop contingency plans for emergencies like water shortages,
floods, or other disasters.
• Ensure that staff are trained and aware of emergency protocols related
to WASH.
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22. 7. Monitoring and Evaluation
 Quality Assurance
• Establish a system for ongoing monitoring and evaluation of WASH services.
• Conduct regular audits to assess compliance and identify areas for
improvement.
Feedback mechanism
• Mechanisms for receiving feedback from staff, patients, and visitors
regarding WASH services.
• Use feedback to make necessary adjustments and improvements.
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23. 8. Commuity engagement
Communication
• Communicate with the local community about the facility's commitment to
WASH.
• Engage with the community to address concerns and gather input
Partnership
• Collaborate with local organizations, government agencies, and NGOs
working on WASH initiatives.
• Participate in community-wide WASH campaigns and education programs.
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24. (B). WASH AT SCHOOLS
Why WASH at Schools is important?
Every child around the world deserves an opportunity to learn in a safe
and healthy/clean environment.
Reduce student absence
Visible increase in student’s enrollment and reduction in drop-out rates.
Improve (increase) nutritional status or (decrease malnutrition rate)
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25. Students perform better
Invests in life-long positive skills
Reduce soil-transmitted helminthic infection, diarrheal diseases
and acute respiratory infection
Reduce child mortality and develop healthy and productive
generation.
Address issues of gender and socio-economic equity
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26. WASH in School boosts attendance and
achievement
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27. Hand washing situation in 34,867 primary
schools
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28. Strategic objective 1: By 2030, achieve the
provision of safe and adequate improved school
water supply for all
• Increase proportion of primary schools using drinking water from
improved water sources available at the school from the baseline
38.4% to 80%
• Increase proportion of secondary schools using drinking water from
improved water sources available at the school from the baseline 63%
to 100%
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29. Cont...
• Increase proportion of schools that conduct bacteriological water
quality test from the baseline to 50%
• Decrease proportion of non functionality rate of water supply
system in primary schools from the baseline 19% to 5%
• Decrease proportion of non functionality rate of water supply
system in secondary schools from the baseline 10% to 0%
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30. Strategic objective 2: By 2030, achieve access to
adequate and equitable improved school sanitation for
all which are safe, child, disability and gender sensitive
• Increase proportion of primary schools with access to improved
latrines from 38.6% to 80%.
• Increase proportion of secondary schools with access to improved
latrines from 54.3% to 100%.
• Increase proportion of open defecation free schools from the baseline
18% to 82%
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31. Cont...
• Increase proportion of schools with proper waste management
service (solid and hazardous, etc.) from the baseline to 80%
• Increase proportion of schools with proper liquid waste management
service from the baseline to 80%
• Increase proportion of schools latrines emptied and properly
disposed from the baseline to 50%.
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32. Strategic objective 3: By 2020, achieve access to
hygiene services and promote basic hygiene
behavior/practice.
• Increase proportion of schools with hand washing facilities with
soap and water available from the baseline 20.8% to 80%
• Increase proportion of schools with menstrual hygiene management
facilities with soap and water from the baseline to 100%
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33. Cont...
• Increase proportion of students practicing hand washing with
soap/substitute at all critical times from the baseline to 85%.
• Increase the proportion of adolescent students practicing proper
menstrual hygiene management from the baseline to 100%.
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34. Strategic Objective 4: By 2030, create enabling
environment for school WASH program
• Establish school WASH structure from federal to school level.
• Develop school WASH implementation guidelines, design and
construction and training manuals
• Human resource development and capacity building
• Strengthen monitoring and evaluation, learning and research
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35. (C). WASH AT PERI-URBAN AND URBAN
SETTINGS
• Managing Water, Sanitation, and Hygiene (WASH) in peri-urban and
urban settings involves addressing the unique challenges and
complexities associated with densely populated areas.
• An overview of how WASH is typically managed in peri-urban and
urban settings are as described below.
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36. Water supply management
Infrastructure planning
• Design and implement robust water supply infrastructure to meet the
demands of urban populations.
• Consider alternative water sources, such as rainwater harvesting or
treated wastewater for non-potable purposes
Equitable access
• Ensure equitable access to clean and safe water for all residents,
including those in informal settlements.
• Address water scarcity issues through efficient management and
conservation measures.
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37. Sanitation management
Sewage
• Develop and maintain comprehensive sewage systems to prevent
environmental contamination.
• Upgrade or extend sewage systems to cover informal settlements.
Public toilet
• Install and maintain public toilets in strategic locations to improve
sanitation in crowded areas.
• Consider community-managed toilet facilities to ensure sustainability.
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38. Hygiene promotion
Community engagement
• Engage with the community to raise awareness about the importance
of hygiene practices.
• Conduct educational campaigns on proper handwashing, waste
disposal, and overall sanitation.
School and Community programs
• Integrate WASH education into school curricula and community
programs.
• Collaborate with local organizations to implement hygiene promotion
initiatives.
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39. Infrastructure and Management
Urban Planning
• Incorporate WASH infrastructure into urban planning, considering
population growth and density.
• Develop and upgrade drainage systems to prevent waterlogging and
flooding
Waste Management
• Implement efficient waste management systems, including recycling
and composting
• Encourage community participation in waste reduction and
segregation
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40. Solid Waste and its Management
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41. Definition
It is defined as Waste (also known as rubbish, trash, refuse, garbage,
junk) is any unwanted or useless materials.
OR
Any materials unused and rejected asworthless or unwanted and a
useless or profitless activity using or expending or consuming
thoughtlessly or carelessly
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42. • Since the beginning, Human kind has been generating waste.
• It could be in the form of Bones, Other parts of animals they
slaughter and Wood
• With the progress of civilization the waste generated became
of a more complex nature.
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43. • At the end of 19th century (Industrial revolution) there was rise in the
world of consumers.
• The increase in population and urbanization was also largely
responsible for the increase in solid waste
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44. Types of Waste
• Solid Waste
• Liquid Waste
• Gaseous Wastes
• Animal by-products
• Biodegradable waste
• Biomedical waste
• Bulky waste
• Business waste
• Chemical waste
• Clinical waste
• Coffee wastewater
• Commercial waste
• Construction and demolition
waste (CD waste)
• Controlled wastes (asbestos,
tyres)
• Consumable waste
• Composite
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45. Effects of solid wastes
a) Health Hazard
• If solid wastes are not collected
and allowed to accumulate, they
may create unsanitary
conditions.
• This may lead to epidemic
outbreaks.
• Many diseases like cholera,
diarrhea, dysentery, plague,
jaundice, or gastro-intestinal
diseases may spread and cause
loss of human lives.
• In addition, improper handling of
the solid wastes is a health
hazard for the workers who come
in direct contact with the waste
b) Environmental Impact
• If the solid wastes are not treated
properly, decomposition and
putrefaction (decay) may take
place.
• The organic solid waste during
decomposition may generate
obnoxious (intolerable) odors.
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46. Waste management
• 4 Rs CONCEPT
• Four Rs (Refuse, Reuse, Recycle and Reduce) to be followed for waste
management.
CONTROL MEASURES
• The main purpose of solid waste management is to minimize the adverse
effects on the environment.
• The steps involved are Collection, Disposal oand Utilization of wastes
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47. CONTROL MEASURES Cont...
a. COLLECTION OF SOLID WASTES
• Collection of waste includes gathering the
waste, transporting it to a centralized
location, and then moving it to the site of
disposal.
• The collected waste is then separated into
Hazardous
• Non-hazardous materials.
b. DISPOSAL OF SOLID WASTES
• Before the final disposal of the solid
wastes, it is processed to recover the
usable resources and
• to improve the efficiency of the solid
waste disposal system.
• The main processing technologies
are
• compaction
• Incineration
• Manual separation.
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48. c. UTILIZATION OF WASTES
• The solid wastes can be properly utilized to gather the benefits such as
• Conservation of natural resources
• Economic development
• Generate many useful products
• Employment opportunities
• Control of air pollution
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49. SOLID WASTE MANAGEMENT
• Waste management is the collection, transport, processing, recycling
or disposal, and monitoring of waste materials.
• The term usually relates to materials produced by human activity, and
is generally undertaken to reduce their effect on health, the
environment or aesthetics.
• Management is also carried out to recover resources from it. Waste
management can involve solid, liquid, gaseous or radioactive
substances
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50. • Waste management practices differ for developed and developing
nations, for urban and rural areas, and for residential and industrial
producers.
• Management for non-hazardous waste residential and institutional
waste in metropolitan areas is usually the responsibility of local
governmentauthorities.
• Management for non-hazardous commercial and industrial waste is
usually the responsibility of the generator.
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51. Methods of disposal
• Incineration
• Recycling
• Sustainbility
• Biological processing
• Energy recovery
• Avoidance and Reduction method
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52. Thank You!!
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