Improving hygiene in health facilities


By Steria Manda  

Latest Joint Monitoring Progress (JMP 2021) Report statistics indicate that 5.7 million Malawians do not have adequate access to safe drinking water, with about 40 percent of the population having access to an improved sanitation facility.

The 40 percent includes those families who share one toilet with two or more other families. Would it be surprising, therefore, that the country has registered unprecedented cases of waterborne illnesses such as cholera this year?


The most disturbing revelation is that even health centres, where sanitation and hygiene were supposed to be the catchword, are lacking these basic sanitation and hygiene facilities.

Before WaterAid partnered with other organisations and intervened in 2018 in Machinga, for instance, Chikwewo and Kawinga health centres had been operating without adequate water, sanitation and hygiene (Wash) facilities for years, forcing pregnant women to seek refuge in bushes.

District Nursing and Midwifery Officer at Machinga District Health Office, Memory Bwanali, stated that the absence of bathrooms and toilets at the two health centres discouraged pregnant women from giving birth there.


“Lack of Wash facilities posed a serious health risk to mothers and their babies. Hence, most women shunned hospitals because there were no sanitation facilities,” Bwanali said.

Various studies have shown that without appropriate Wash infrastructure and services, patients, healthcare workers and communities are at an increased risk of disease.

The studies say, for example, that if patients or staff drink unsafe water when they are thirsty, or when taking oral medications, they could get sick with a waterborne disease.

Studies further show that four percent of Malawi’s maternal mortality can be linked to poor Wash.

These deaths can be prevented through improving the status of Wash in homes and institutions such as Health Care Facilities (HCFs).

“Both healthcare workers and patients need access to hand hygiene supplies to reduce the risk of spreading infections through unwashed hands,” says a paper by the Centres for Disease Control and Prevention (CDC).

WaterAid, an international non-profit making organisation working in the Wash sector, is among those working to improve sanitation and hygiene conditions in Malawi.

The organisation is supporting 150 health care facilities across the country and has committed to directly support 75 of these facilities and to further lobby for government and its partners to invest in improving Wash facilities.

The commitment, popularly known as the ‘150 Health Care Facility Challenge’, is an attempt to mobilise resources and advocate for Wash prioritisation at national and district levels.

So far, the organisation has mobilised resources towards the improvement of Wash services in 33 health care facilities in Kasungu, Machinga, Nkhotakota, Ntchisi, Lilongwe and Ntcheu districts with support from donors such as the Scottish Government, Scottish Water, Wimbledon Foundation and Georgio Armani.

Thanks to GIZ support, WaterAid will also expand its reach to improve Wash services in 15 additional health care facilities.

Speaking during a media tour in Machinga and Zomba districts recently, WaterAid Malawi Country Director Mercy Masoo said the goal of the multimillion kwacha initiative is to complement efforts by the Malawi Government to achieve Universal Health Coverage (UHC).

“Our healthcare facilities in Malawi lack basic needs such as safe water, sanitation and hygiene, which is contributing to failure by the country to reach UHC recommendations,” Masoo said.

She asked other partners to join the campaign by supporting the other 75 health facilities to beat the 2025 target.

She estimated that out of 600 health centres and dispensaries in Malawi, 300 need attention as far as improvement of Wash is concerned.

Principal Secretary in the Ministry of Water and Sanitation, Elias Chimulambe, acknowledged shortfalls in the Wash sector in Malawi.

Chimulambe said government decided to create a Department of Sanitation and Hygiene, which will spearhead, advance, and promote Wash issues across the board.

“Our ministry will soon be recruiting personnel who will be working hand in hand with partners across the country,” he explained.

In appreciating efforts by other partners, Bwanali said the construction of the Wash facilities by WaterAid in Malawi, with support from WaterAid UK, UK Government, Scottish Government and Scottish Water, has motivated pregnant women to start delivering in the hospitals.

She added that the area has now registered a significant reduction in home deliveries, thus minimising risk of sickness and death among expectant women and new-borns.



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