Water, Sanitation, and Hygiene (WASH) and Infection Prevention and Control (IPC) in Primary Healthcare Facilities in Jordan in the Context of COVID-19

Water, Sanitation, and Hygiene (WASH) and Infection prevention and control (IPC) are essential for preventing and containing outbreaks of disease. Nowadays, infection prevention is getting more attention due to the COVID-19 pandemic. The assessment of WASH/IPC indicators in the health sector is a major step in the preparation and management of such a pandemic. A facility-wide WASH and IPC assessment is the cornerstone for designing, developing, and implementing specific WASH and IPC activities at healthcare facilities. This type of assessment helps to identify and prioritize surveillance and prevention activities at the facility and provide healthcare policy makers at all levels with the evidence to strengthen WASH services and infection control policies, practices, and resources in health facilities. Moreover, this helps to motivate facilities to intensify efforts where needed to prevent, respond to, and control the spread of COVID-19. An assessment was conducted in primary healthcare facilities in Jordan to identify the strengths and gaps in the WASH and IPC practices, activities, and resources and to identify areas for quality improvement. This report demonstrates the results of a nationwide assessment of 33 healthcare centres. The assessment included eight domains (areas) pertaining to WASH/IPC with more than 150 indicators. The assessment tools were developed and adapted from the Water and Sanitation for Health Facility Improvement Tool (WASH FIT), the Infection Prevention and Control (IPC) Assessment Framework (IPCAF), Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care, the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) tool, and COVID-19 Technical Guidance by WHO. The assessment revealed some deficiencies in basic WASH/IPC indicators such as lack of clear guidelines that support the management of health centres in planning and leadership, shortfalls in the budget needed to strengthen the infrastructure of WASH/IPC, inconsistent or under-provisioned training and education programmes for the development of staff skills to lead, plan, manage, and improve WASH/IPC at their facilities. Moreover, the report identified the unmet WASH/IPC needs at centres that should be addressed by policy makers and stakeholders as soon as possible for further steps of consideration in policy development. The report ends with specific recommendations to improve WASH/IPC services and practices.