ArticlePloS one2019
Extending the use of the World Health Organisations' water sanitation and hygiene assessment tool for surveys in hospitals - from WASH-FIT to WASH-FAST.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- When It Is Not Measured, How Then Will It Be Planned for? WaSH a Critical Indicator for Universal Health Coverage in Kenya.International journal of environmental research and public health · 2020Pooled it
- Implementation and adaptation of WASH FIT in healthcare facilities: A systematic scoping review.World development sustainability · 2026Article
- Qualitative assessment of the water and sanitation for health facility improvement tool (WASH FIT) implementation in Zimbabwe.Discover public health · 2026Article
- Dissecting WASH Assessment Tools and Recommending a Comprehensive Tool for Indian Healthcare Facilities.Risk management and healthcare policy · 2023Review
- Safe infant feeding in healthcare facilities: Assessment of infection prevention and control conditions and behaviors in India, Malawi, and Tanzania.PLOS global public health · 2023Article
- Using the Water and Sanitation for Health Facility Improvement Tool (WASH FIT) in Zimbabwe: A Cross-Sectional Study of Water, Sanitation and Hygiene Services in 50 COVID-19 Isolation Facilities.International journal of environmental research and public health · 2021Article
- Potential secondary transmission of SARS-CoV-2 via wastewater.The Science of the total environment · 2020Article
- COVID-19: an opportunity to improve infection prevention and control in LMICs.The Lancet. Global health · 2020Article
- Infection prevention and control during the COVID-19 pandemic: challenges and opportunities for Kenyan public hospitals.Wellcome open research · 2020Article
- Evaluating hospital performance in antibiotic stewardship to guide action at national and local levels in a lower-middle income setting.Global health action · 2019Article
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Authors and funding
10 authors.
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Abstract
backgroundPoor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations' Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system.
methodsWe adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability.
resultsWe present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals' overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees.
conclusionWe propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.
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