WHO and UNICEF Find Major WASH Gaps in Health Facilities

The report, Progress on water, sanitation, hygiene, environmental cleaning and waste management in health-care facilities 2015–2025, provides global estimates across all five basic service areas for the first time.

Millions of patients and health workers worldwide continue to receive or provide care in facilities without adequate sanitation and environmental cleaning, even as access to water, hygiene and waste management has improved over the past decade, according to a new report from the World Health Organization and UNICEF.

The report, Progress on water, sanitation, hygiene, environmental cleaning and waste management in health-care facilities 2015–2025, provides global estimates across all five basic service areas for the first time. The findings show that 85 per cent of health-care facilities had basic water services in 2025, while 72 per cent met basic hygiene standards and 71 per cent had basic health-care waste management services.

Sanitation and cleaning present a much weaker picture. Only 40 per cent of facilities met the basic sanitation standard, while 59 per cent achieved the requirements for basic environmental cleaning, leaving major gaps in some of the services needed to prevent infections and provide safe, dignified care.

Toilets may exist without meeting patients' basic needs

The low sanitation figure does not mean most health facilities lack toilets entirely. WHO and UNICEF found that 89 per cent had some form of sanitation and 85 per cent had usable toilets, but the requirements for a basic sanitation service go further than simply having a functioning toilet.

Facilities must provide improved and usable toilets that meet the needs of patients and staff, including women and girls and people with limited mobility. Only around half had sex-separated toilets, accessible facilities or provisions for menstrual hygiene, with shortcomings in accessibility and menstrual hygiene among the main reasons facilities failed to reach the basic standard.

Evariste Kouassi Komlan, UNICEF's Director of WASH, said toilets cannot provide adequate protection when they are unsafe, inaccessible or unsuitable for women, girls and people with disabilities. These shortcomings carry particular risks for women giving birth, newborn babies and young children, making inclusive sanitation an important part of healthcare quality rather than simply an infrastructure issue.

Around one in ten health-care facilities still had no water service in 2025, and a similar proportion had no sanitation service at all.

Cleaning gaps increase infection risks inside health facilities

Environmental cleaning remains another major weakness, with only 59 per cent of facilities meeting the basic global standard. To qualify, a facility needs both appropriate cleaning procedures and staff who have been trained to carry them out.

Neither requirement was met in 18 per cent of health-care facilities, representing facilities serving an estimated 1.5 billion people. Conditions were particularly concerning in the world's least developed countries, where just 24 per cent met the basic environmental cleaning standard.

Effective cleaning covers spaces where patients and health workers face direct exposure risks, including wards, patient rooms, operating theatres, examination and treatment areas, toilets and sanitation facilities.

Poor cleaning can contribute to health care-associated infections and the spread of antimicrobial resistance, making it an important part of infection prevention and control. Bruce Gordon, WHO's Unit Head for Water, Sanitation and Health, said reliable water, sanitation, hand hygiene, cleaning and safe waste management need to be built into health planning, financing and monitoring.

Progress since 2015 leaves major work ahead

Global coverage of basic water, hygiene and health-care waste management services improved between 2015 and 2025, with hygiene recording the largest increase. The latest assessment also represents an improvement in available information, with 39 countries now providing estimates for all five services compared with 29 in the previous Joint Monitoring Programme update.

Significant information gaps remain, preventing WHO and UNICEF from calculating global trends for sanitation and environmental cleaning. The agencies are calling on governments to improve routine monitoring so assessments look beyond whether equipment or infrastructure exists and examine whether services are reliable, clean, safe and accessible in everyday use.

The findings arrive as international attention to WASH services in health facilities grows. In May 2026, the UN General Assembly adopted a resolution calling for stronger national standards, regular reporting and properly financed plans for sustainable water, sanitation, hygiene, waste and electricity services.

For health systems, the figures underline a basic challenge: quality care depends not only on medicines, equipment and trained clinicians, but also on clean rooms, safe toilets, functioning water supplies and effective hygiene practices that protect everyone entering a health facility.