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. 2022:27:6.
doi: 10.1265/ehpm.21-00272.

Status of water, sanitation, and hygiene and standard precautions in healthcare facilities and its relevance to COVID-19 in Afghanistan

Sharifullah Alemi  1 , Keiko Nakamura  1 , Kaoruko Seino  1 , Shafiqullah Hemat  2
Affiliations

Status of water, sanitation, and hygiene and standard precautions in healthcare facilities and its relevance to COVID-19 in Afghanistan

Sharifullah Alemi et al. Environ Health Prev Med. 2022.

Abstract

Background: To protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces.

Methods: We analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces.

Results: Of the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces.

Conclusion: Our findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.

Keywords: COVID-19; Hygiene; Sanitation; Standard precautions; Water.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of healthcare facilities selected for the analysis
Fig. 2
Fig. 2
Plots of total COVID-19 infected HCWs per 100K population against WASH indicators and standard precautions in HCFs
Fig. 3
Fig. 3
A map of Afghanistan showing the distribution of total COVID-19 cases excluding infected HCWs per 100,000 population by provinces from February 24, 2020 to November 03, 2020.
Fig. 4
Fig. 4
A map of Afghanistan showing the distribution of total infected healthcare workers per 100,000 population by provinces from February 24, 2020 to November 03, 2020.
Fig. 5
Fig. 5
Scatter plot of total COVID-19 cases excluding infected HCWs and total COVID-19 infected HCWs per 100,000 population per province from February 24, 2020 to November 03, 2020.
See this image and copyright information in PMC

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