Analysis of the current situation with water, sanitation and hygiene (WASH) in rural hospitals

Abstract

BackgroundDuring the COVID-19 pandemic, the implementation of Sustainable Development Goals (SDG) 6 and SDG 3 in rural areas of Kazakhstan is a huge problem that the state must address as soon as possible. Therefore, it is necessary to examine the state of the infrastructure and the quality of water, sanitation and hygiene (WASH) services in rural hospitals.MethodsThe study was descriptive and included an analysis and assessment of the current situation on the ground. The analysis of the situation was based on the official data. The current services were assessed using an observational cross-sectional study based at the hospital of Abay district (49°37′52″ N 72°50′17″ E, 6725 km2) of Central Kazakhstan.ResultsThe hospital in Abay district do not have a set of agreed WASH standards. When such standards exist, their implementation is limited by the lack of necessary conditions, sufficient funding or the interest of authorities. The budget of public health service is usually categorized by a disease group and covers expenditures for drugs and vaccines. The quality of WASH infrastructure in the hospital is poor due to deterioration or initial non-compliance with safety requirements. Investing in WASH infrastructure and its maintaining require effective intersectoral collaboration and financial resources. Another problem is the lack of motivation for improving WASH services among staff and managers of the hospital. If the former have no desire and knowledge in WASH due to their high workload, the latter often consider this problem insoluble and therefore do not want to spend their limited resources on it.ConclusionsThus, rural residents are at high risk of contracting and spreading COVID-19 due to deterioration of WASH infrastructure, non-compliance with requirements and insufficient funding of rural hospitals.AcknowledgementThis research is funded by the Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan (Grant No. AP09058465).Key messages The lack of data on WASH services in hospitals by region and on a nationwide scale is currently an obstacle to an effective response to the COVID-19 pandemic in Kazakhstan.Fatal outbreaks and epidemics will continue until the WASH infrastructure and hygiene skills of the population improve at both the household and hospital’s levels.