Progress on WASH in health care facilities 2000-2021: Special focus on WASH and infection prevention and control (IPC)

WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene (WASH)

August 30, 2022

The WHO/UNICEF Joint Monitoring Programme (JMP) produces internationally comparable estimates of progress on drinking water, sanitation and hygiene (WASH) and is responsible for monitoring the Sustainable Development Goal (SDG) targets related to WASH. This report presents national, regional and global estimates for WASH in health care facilities up to the year 2021, with a special focus on WASH and infection prevention and control (IPC). The report has established a new global baseline on hygiene services – which assessed access to hand hygiene facilities at points of care as well as toilets.

Key findings

  • Hygiene: Half of health care facilities (51 per cent) around the world lack basic hygiene services with water and soap or alcohol-based hand rub where patients receive care and at toilets in 2021, according to this report. Around 3.85 billion people rely on these facilities, including 688 million people who receive care at facilities with no hygiene services at all.
  • Water: Four in five health care facilities (78 per cent) globally had basic water services, meaning water was available from an improved source on the premises in 2021. However, 1.7 billion people lacked basic water services at their health care facility, including 857 million people globally who had no water service at their healthcare facility.
  • Sanitation, environmental cleaning and waste management: There were not enough countries with national data to calculate regional and/or global coverage of basic sanitation, environmental cleaning, and waste management services. 41 countries representing 19 per cent of the global population had sufficient data to estimate national coverage of basic sanitation services in health care facilities. National data on basic environmental cleaning services were available only in 21 countries, representing 7 per cent of the global population, while national data on basic waste management services were available for 65 countries representing 24 per cent of the global population.

Globally, four out of five health care facilities (78 per cent) had a basic water service in 2021 with regional coverage ranging from 52 per cent in sub-Saharan Africa to 90 per cent in Eastern and South-Eastern Asia

Global and regional coverage of water services in health care facilities in 2021 (per cent)


Three out of eight SDG regions and 59 countries had sufficient data to estimate coverage of basic water services in 2021

Proportion of health care facilities with basic water services in 2021 (per cent)

Globally, 1 out of 10 health care facilities (10 per cent) had no sanitation service in 2021 with regional coverage ranging from 3 per cent in Latin America and the Caribbean as well as Eastern and South-Eastern Asia to 22 per cent in sub-Saharan Africa

Global and regional coverage of sanitation services in health care facilities in 2021 (per cent)


Three out of eight SDG regions and 41 countries had sufficient data to estimate coverage of basic sanitation services in 2021

Proportion of health care facilities with basic sanitation services in 2021 (per cent)

Globally, half of health care facilities (51 per cent) had a basic hygiene service in 2021 with regional coverage ranging from 38 per cent in sub-Saharan Africa as well as Eastern and South-Eastern Asia to 53 per cent in Northern Africa and Western Asia

Global and regional coverage of hygiene services in health care facilities in 2021 (per cent)


Three out of eight SDG regions and 40 countries had sufficient data to estimate coverage of basic hygiene services in 2021

Proportion of health care facilities with basic hygiene services in 2021 (per cent)

One out of three health care facilities in fragile contexts (32 per cent) and in least developed countries (34 per cent) had a basic health care waste management service in 2021

Global and regional coverage of waste management services in health care facilities in 2021 (per cent)


Only one out of eight SDG regions and 65 countries had sufficient data to estimate coverage of basic waste management services in 2021

Proportion of health care facilities with basic waste management services in 2021 (per cent)

  • 72 per cent of hospitals in Central and Southern Asia had a basic environmental cleaning service in 2021.
  • In sub-Saharan Africa, 26 per cent of rural health care facilities had a basic environmental cleaning service. 45 per cent had cleaning protocols, and 32 per cent had staff trained on environment cleaning.
  • 21 countries (representing 7 per cent of the global population) had sufficient data to estimate national coverage of basic environmental cleaning services in health care facilities.
  • There were not enough countries with national data on environmental cleaning to calculate regional or global estimates for basic environmental cleaning services.

Notes on the data

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