WASH in health care facilities

Achieving and maintaining WASH services in health care facilities is critical for universal quality health coverage, infection prevention and control (IPC), patient safety, and child and maternal health, in particular the time around child delivery. WASH also extends beyond health impacts to issues of dignity and respect, staff morale, and performance and safety. Accordingly, WASH in health care facilities is part of the 2030 Sustainable Development Goal (SDG) targets related to WASH. The SDG targets 6.1 and 6.2 refer to universal and equitable access to drinking water, sanitation and hygiene for all. The term ‘universal’ implies all settings, including households, schools, health care facilities, workplaces and public spaces. Target 3.8 aims to provide access to quality essential health-care services for all. Moreover, WASH in health care facilities is directly related to a number of other health goals, namely reducing maternal mortality, and under-five and neonatal mortality (SDG targets 3.1 and 3.2).

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), through the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP), have been producing regular updates on water, sanitation and hygiene (WASH) since 1990. Together, they are responsible for monitoring the SDG targets related to WASH in households, schools and healthcare facilities. The JMP published a global baseline report WASH in health care facilities in 2019 and releases progress updates every two years. The most update was published in 2024 (with estimates up to the year 2023)

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The JMP uses service ladders to benchmark and track progress across countries. WASH services in healthcare facilities include water supply, sanitation and hygiene, but also health care waste management and environmental cleaning, which in health care settings are closely related to sanitation and hygiene.

JMP service ladders for WASH in health care facilities

a) Improved water sources are those that by nature of their design and construction have the potential to deliver safe water. These include piped water, boreholes or tubewells, protected dug wells, protected springs, rainwater and packaged or delivered water.
b) Improved sanitation facilities are those designed to hygienically separate human excreta from human contact. These include wet sanitation technologies such as flush and pour-flush toilets connecting to sewers, septic tanks or pit latrines, and dry sanitation technologies such as dry pit latrines with slabs, and composting toilets.

The JMP produces regional or global estimates when data are available from countries representing at least 30 per cent of the relevant regional or global population. In 2025, global estimates were available for all five basic WASH service levels, including, for the first time, estimates for basic sanitation and basic environmental cleaning. There were recent data from enough countries to produce estimates of the population with no water, no sanitation, and no hygiene service: in 2025, 907 million people (11 per cent of the global population) had no water service at their health care facility, meaning that the facility had no water source, used an unimproved water source like an unprotected well or spring, or had to collect water from an improved source more than 500 metres away. Likewise, 936 million people (11 per cent) had no sanitation service at their health care facility (the facility had no toilets or only unimproved sanitation facilities), and 652 million people (8 per cent) had no hygiene service (no functional hand hygiene facilities at points of care or at toilets).

In 2025, global estimates were available for all five basic WASH service levels, including, for the first time, estimates for basic sanitation and basic environmental cleaning

This report presents national, regional and global estimates for WASH in health care facilities up to the year 2025.

Key findings

In 2025,

• A total of 84 countries and three SDG regions had estimates for basic water services in health care facilities.
• Globally, 85% of health care facilities had basic water services, up from 76% in 2015.
• There was no water service at 11% of health care facilities (covering 907 million people)
• Globally, 40% of health care facilities had basic sanitation services.
• There was no sanitation service at 11% of health care facilities (covering 936 million people)
• Globally, 72% of health care facilities had basic hygiene services, up from 55% in 2015.
• There was no hygiene service at 8% of health care facilities (covering 652 million people)
• Globally, 59% of health care facilities had basic environmental cleaning services.
• There was no environmental cleaning service at 18% of health care facilities (covering 1.5 billion people)
• Globally, 71% of health care facilities had basic health care waste management services, up from 59% in 2015.
• There was no waste management service at 7% of health care facilities (covering 571 million people)

In 2025, global estimates were available for all five WASH service ladders for the first time

Global coverage of water, sanitation, hygiene, environmental cleaning and waste management services in health care facilities, 2025 (per cent)

Source: WHO/UNICEF JMP Global data update on WASH in health care facilitiein 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Number of national data sources used in the JMP updates, by type of data source, between 2018 and 2025

Source:  WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Basic water services in health care facilities

Water is needed at health care facilities for drinking, hand hygiene, bathing, cleaning, cooking and a variety of medical uses. Water is critical to maintain health and for recovery. Women, in particular, may need large quantities of drinking water during childbirth and while breastfeeding.

In 2025:

• A total of 84 countries and three SDG regions, representing 52% of the global population, had estimates for basic water services in health care facilities.
• Globally, 85% of health care facilities had basic water services, up from 76% in 2015.
• Coverage ranged from 57% in sub-Saharan Africa to 89% in Central and Southern Asia.
• In fragile contexts, 64% of health care facilities had basic water services.
• Coverage was higher in hospitals (89%) than in non-hospitals (79%).
• Urban coverage (92%) exceeded rural coverage (75%).
• There was no water service at 11% of health care facilities (covering 907 million people).
• In 24 countries, at least 1 in 10 health care facilities had no water service, meaning water was not available from an improved water source within 500 m.

50 out of 84 countries with estimates had >75 per cent coverage of basic water services in 2025

Proportion of health care facilities with basic water services in 2025 (per cent)

Note: Statistics in this report refer to countries, areas and territories.
Source: WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Basic sanitation services in health care facilities

Sanitation services in health care facilities are essential to the provision of quality care and directly impact the health, welfare and dignity of patients and staff. Healthcare facilities with basic sanitation services have improved and usable sanitation facilities with at least one toilet dedicated for staff, at least one sex-separated toilet with menstrual hygiene facilities, and at least one toilet accessible for people with limited mobility.

In 2025:

• A total of 70 countries and three SDG regions, representing 48% of the global population, had estimates for basic sanitation services in health care facilities.
• Globally, 40% of health care facilities had basic sanitation services, but data were insufficient to assess trends.
• Regional coverage ranged from 23% in sub-Saharan Africa to 55% in Central and Southern Asia.
• In LDCs, LLDCs and fragile contexts, fewer than one in five health care facilities (19%) had basic sanitation services.
• 11% of health care facilities (covering 936 million people) had no sanitation service.
• In 30 countries, at least 1 in 10 health care facilities had no sanitation service, meaning that no improved toilets were available.

13 out of 70 countries with estimates had >75 per cent coverage of basic sanitation services in 2025

Proportion of health care facilities with basic sanitation services in 2025 (per cent)

Note: Statistics in this report refer to countries, areas and territories.
Source: WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026:Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Basic hygiene services in health care facilities

Hand hygiene is one of the most effective ways to prevent disease transmission. Handwashing facilities at the toilets in health care facilities can help reduce the spread of disease between patients and health care workers.

In 2025:

• A total of 67 countries and three SDG regions, representing 46% of the global population, had estimates for basic hygiene services in health care facilities.
• Globally, 72% of health care facilities had basic hygiene services, up from 55% in 2015.
• Coverage ranged from 34% in sub-Saharan Africa to 82% in Central and Southern Asia.
• In LDCs, LLDCs and fragile contexts, fewer than half of health care facilities had basic hygiene services.
• Eight out of nine health care facilities (89%) had functional hand hygiene facilities at points of care, but only three out of four (75%) had handwashing facilities with water and soap at toilets.
• There was no hygiene service at 8% of health care facilities (covering 652 million people).
• In 18 countries, at least 1 in 10 health care facilities had no hygiene service, meaning that no functional hand hygiene facilities were available either at points of care or at toilets.

32 out of 67 countries with estimates had >75 per cent coverage of basic hygiene services in health care facilities in 2025

Proportion of health care facilities with a basic hygiene service in 2025 (per cent)

Note: Statistics in this report refer to countries, areas and territories.
Source: WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Basic waste management services in health care facilities

Health care waste should be segregated into at least three categories (general non-hazardous waste, infectious waste, and sharp waste), then safely treated and disposed to prevent the spread of infection.

In 2025:

• A total of 79 countries and four SDG regions, representing 52% of the global population, had estimates for basic health care waste management services in health care facilities.
• Globally, 71% of health care facilities had basic health care waste management services, up from 59% in 2015.
• Coverage ranged from 24% in sub-Saharan Africa to 71% in Oceania.
• In fragile contexts, only 25% of health care facilities had basic waste management services.
• Globally, 80% of facilities had materials for safe segregation, and 80% provided adequate treatment for health care waste.
• There was no waste management service at 7% of health care facilities (covering 571 million people).
• In 16 countries, at least 1 in 10 health care facilities had no health care waste management service, meaning that waste was neither safely segregated nor treated and disposed of safely

30 out of 79 countries with estimates had >75 per cent coverage of basic waste management services in health care facilities in 2025

Proportion of health care facilities with basic waste management services in 2025 (per cent)

Note: Statistics in this report refer to countries, areas and territories.
Source: WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

Basic environmental cleaning services in health care facilities

Effective environmental cleaning at health care facilities is a fundamental intervention for infection prevention and control and significantly reduces the transmission of health care associated infections. Health care facilities should establish written protocols for cleaning and regularly train health care workers on effective implementation of those protocols. Healthcare facilities have basic environmental cleaning services when protocols for cleaning are available, and staff with cleaning responsibilities have all received training.

In 2025:

• A total of 54 countries and two SDG regions had estimates for basic environmental cleaning services in health care facilities.
• Globally, 59% of health care facilities had basic environmental cleaning services, but data were insufficient to assess trends.
• Coverage ranged from 46% in Northern Africa and Western Asia to 65% in Central and Southern Asia.
• In LDCs, only a quarter (24%) of health care facilities had basic services.
• There was no environmental cleaning service at 18% of health care facilities (covering 1.5 billion people).
• In 28 countries, at least 1 in 10 health care facilities had no environmental cleaning service, meaning that cleaning protocols weren’t available and no staff had received training

17 out of 54 countries with estimates had >75 per cent coverage of basic environmental cleaning services in health care facilities in 2025

Proportion of health care facilities with basic environmental cleaning services in 2025 (per cent)

Note: Statistics in this report refer to countries, areas and territories.
Source: WHO/UNICEF JMP Global data update on WASH in health care facilities in 2026: Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025

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