Sustainable water, sanitation and hygiene (WASH) services in health care facilities (HCF) are critical for providing quality, safe health care. There is increasing recognition that many health care facilities, especially in low- and middle-income countries, lack even the most basic water, sanitation and hygiene services. The #COVID19 pandemic has further exposed this inadequacies in health centres, which in addition to jeopardizing the health of workers and patients, is also a clear violation of their basic human rights.

 This lack of WASH services in HCFs compromises the ability to provide basic, routine services and the ability to prevent and control infectious diseases such as COVID, Lassa fever, Zika Virus, ebola, etc.

Healthcare workers are usually at the frontline to save lives but working in a HCF without access to water, do not only limit their ability to save lives, it also limits their rights and lives. People go to healthcare facilities to get better but end up compounding their sickness, when they visit HCFs without water, sanitation and hygiene (WASH) facilities. The situation is more severe with the prevalence of highly infectious disease agents that thrive in unsanitary conditions. Despite these glaring facts, it is disturbing that about 896 million people, globally, still use health facilities that lack water for basic hand hygiene with increased risk of infection while “One out of six health care facilities (16%) globally have no hygiene service, meaning they lacked hand hygiene facilities at points of care, as well as soap and water at toilets”.

For healthcare workers to save their lives and that of the patients, especially in times of pandemic such as COVID19, respecting their rights to water is non-negotiable

Nigeria’s healthcare system is plagued with chronic underfunding and limited infrastructure and the government has repeatedly fallen short on its 2001 commitment under the Abuja Declaration to spend at least 15 percent of its budget on health. In 2018, only 3.9 percent was allocated, and in 2020, this marginally increased to 4.5 percent.

The outbreak of Coronavirus has exposed and drawn government’s attention to the gross inadequacy in the health sector. The premise on which the federal government provided NGN 102.5 billion for direct interventions in the healthcare sector. Also, the upgrade of healthcare facilities has been identified as a major component of the NGN500 billion COVID-19 Crisis Intervention Fund, provided by the federal government.

Since it took the pandemic to draw government’s attention to the debacle in the health sector, this is the right time to address pertinent questions about WASH in Nigeria’s healthcare facilities: Is there provision for WASH in Healthcare facilities in the COVID19 crisis intervention funds? What is the status of the WASH in HCFs in Nigeria, at the moment? What improvement is expected as an outcome of the intervention? Are workers and patients aware that their rights are been violated when they lack access to WASH in HCFs?

Enugu state is one of the focal states where Hope Spring Water Charity Foundation, in collaboration with other partners have made tremendous progress in mobilizing rights-holders and duty-bearers to demand and respect human rights to water, respectively. Building on the success of the Claim-Your-Water-Rights campaign in the state, the team is focusing on mobilizing healthcare workers and patients to know and demand their rights to safe water in HCFs. One of the objectives of this renewed campaign is to leverage on the increased interest in HCFs to mobilize political will and direct resources to address WASH needs in HCFs.

Considering the present lockdown in the state, the team is utilizing its network of members located in various parts of the state to gather case studies and distribute questionnaires in at least two health care facilities in each of the 17 (seventeen) Local Government Areas of the state. An online link to questionnaire was provided for healthcare workers who have access to the internet to remotely complete, while those who are offline were reached through community contact persons and team members in the various LGAs.

Health workers and patients whose rights are violated and would like to complain are been provided with online link to the Complaint form of National Human Rights Commission. The links are included in the online questionnaire provided by the team with guidance from team members assigned to every LGA on steps to filling the form.  

Feedbacks from this study, which serves as an accountability tool, are not only publicized to draw government’s attention to the status of WASH in the state’s health care facilities; it also serves as a guide for respective authorities to know where and how to direct resources for WASH interventions.

Hope Spring will be carrying out this campaign in the following states of Nigeria:

• Federal Capital Territory, Abuja
• Enugu (Enugu metropolis)
• Ogun (Abeokuta, Ijebu ode)

Cat Hartwell

Cat Hartwell is a Global Health MPH Candidate at NYU School of Global Public Health. Before graduate school, she spent a decade working as a documentary tv producer covering issues related to public health. Her public health interests include disaster preparedness and building climate change resilience in vulnerable populations, as well as urban health.

Ruichao Shi

Ruichao Shi is studying biostatistics at NYU School of Global Public Health. He hopes to do statistical analysis work or continue on with Ph.D. studies after finishing his Master’s degree.

Oumou Dao

Oumou Dao holds a Bachelor of Science in Human Services from Stevenson University in Maryland. She currently is a Master of Public Health candidate at New York University School of Global Public Health, with a focus on Sustainable Development Goals. Her interests include health systems strengthening and health communication.

Kelilah Liu

Kelilah Liu is from St. Louis Missouri, USA and is studying global health at New York University. After NYU, she hopes to continue working on global epidemics and expanding healthcare access.

Susan Dara

Susan Dara is a Doctor from Hyderabad, India currently pursuing her Master’s degree at New York University with a concentration in Global Public Health. She loves medicine and has a passion to reach out to as many people as possible. Susan believes that the foundation for a healthy community starts with good public health measures incorporating health in every aspect of our lives. She hopes to facilitate that as a public health practitioner during and following her studies at NYU.

Ifeoma Cheta Okonkwo

Ifeoma Cheta Okonkwo is a graduate of Food Science Technology from Nnamdi Azikiwe University, Awka. She fulfilled her mandatory National Youth Service Corp program in Sokoto State, where she was awarded the best Youth Corp member of the Batch A set in 2019.

Ifeoma is a WASH advocate. She currently works as a project officer with Hope Spring Water Charity Foundation, an NGO committed to alleviating water poverty in Nigeria.