Water, sanitation, hygiene, and waste management in primary healthcare facilities in war-torn Tigray, Ethiopia: implications for infection prevention and control.

Background: Water, sanitation and hygiene (WASH) and infection prevention and control (IPC) are compromised during emergencies and in the post-conflict period. The IPC-WASH status of primary healthcare facilities in Tigray, Ethiopia, is not known. The aim of the study was to assess the IPC-WASH status of facilities in war-torn Tigray, Ethiopia. Methods: As part of a cross-sectional study, data were collected from January to February 2024 in 32 randomly selected primary healthcare facilities using an electronic Open Data Kit (ODK) based on a questionnaire. A descriptive analysis was conducted to describe the IPC-WASH services. The analyzed data were compared with the Joint Monitoring Program (JMP) service ladders and presented in texts, figures and tables. Results: Nearly seven out of ten primary healthcare facilities had improved water sources, nine out of ten had latrines with limited sanitation facilities, and four out of ten had handwashing facilities. Eight out of ten facilities had no access to personal protective equipment, and most facilities surveyed had very limited waste management services, IPC capacity building and IPC committee. According to JMP service ladders, almost one in four primary healthcare facilities had basic water supply, one in ten had basic sanitation, basic hygiene and basic waste disposal. Conclusions: The overall result of the study shows that access to IPC-WASH is low in primary healthcare facilities in war-torn Tigray, Ethiopia. Collaborative efforts to improve access to basic IPC-WASH facilities and IPC capacity building are essential to improve the quality of care.