Sanitation Safety Research Articles

To the issue of overtime work under the labor law of Ukraine

The article examines issues of labor legislation of Ukraine in connection with the involvement of employees in overtime work. The object of scientific research is the duties of employees determined by their work function, as well as the duties that employees are obliged to observe due to compliance with the rules of industrial sanitation, hygiene and occupational health and safety. At the same time, the authors substantiate that compliance with such duties, in particular in the case before the beginning of the working day (shift) or after it ends, is not overtime work and cannot be paid in a double amount, as it is provided for this type of work. For this purpose, the authors analyze the domestic legislation on overtime work, while special attention is paid to the grounds and conditions for involving employees in this type of work.
 They do not overlook the legislation on labor remuneration, in particular, the expediency of providing in the collective agreement additional payments to employees for the performance of duties that precede the beginning of the working day (shift) and the performance of duties after their completion is substantiated. The subject of the study is also the question of establishing such obligations by acts of a local nature. At the same time, the authors prove that employers are able to attract employees to work before the beginning of the working day (shift) or after it ends. However, employers must provide for such obligations by acts of a local nature, primarily by internal work order rules. This will contribute to employees' compliance with labor discipline and may serve as a necessary basis for bringing them to disciplinary responsibility in case of unwillingness to perform such duties, or their improper performance. The article ends with short conclusions reached by the authors based on the analysis of domestic legislation and case law materials.

Safety index of individual basic sanitation systems in rural area

The safe access to water and sanitary sewer are human rights, and there is a lack of indexes which evidence if rural areas have safe access levels to these services and others which compose basic sanitation in Brazil. The goal of this work was to elaborate a safety index of rural sanitation at household level, and to apply it in three typologies of rural communities in the state of Goiás: rural settlements, quilombola and riparian communities. For such, the research was developed in five steps: 1) Choice of indicators and sub-indicators; 2) Definition of goals and hierarchical structure; 3) Attribution of due weight to the indicators and sub-indicators; 4) Formulation of the rural sanitation index (ISSRural); and 5) Evaluation of the safety level in 48 rural areas. The proposed ISSRural was composed of six indicators, of which four are associated to basic sanitation components, one is related to habitability conditions and one related to health issues. Four sanitation safe levels have been established, according to the ISSRural score level: Critical, unsafe, partially safe and safe, being that only the last one guarantees the existing sanitation services’ safety. Applying the index in 48 rural areas, none of the communities have reached the “safe” level for the ISSRural and only three areas have reached such level for at least one indicator, which was Rainwater Management. This work proposed an index which has evidenced the safety levels associated to basic sanitation in rural areas, from data at household level, and can be applied with the goal of prioritizing investments, plans and projects which may have greater impact in the population’s sanitation safety, as well as contributing to ensure the human right of access to water and sanitary sewer.

Education on Sanitation and Hygiene Knowledge on Food Vendors in Semolowaru Culinary Tourism Center (CTC) Surabaya

The aims of this community service viceeise are to 1) increase the awareness of traders regarding the application of hygiene sanitation and food safety and 2) improve the skills of traders in maintaining the sanitation of the kitchen environment so that a healthy culinary tourism center will be created. Education is provided with presentations, demonstrations, and questions and answers. This research is a descriptive observational study, with a sample of 24 food and beverage traders. The data collection technique used a written test and observation. The results showed that 1) the traders' initial knowledge about sanitation hygiene and food safety was very low, and the awareness of traders regarding the application of hygiene sanitation, and food safety as seen from the traders' understanding of hygiene sanitation and food safety had increased significantly based on the results of the pre and post-test, and 2) The personal hygiene attitude of food vendors is quite good, but there is one very lacking indicator, namely the cleanliness of the equipment. This implies that educational activities regarding hygiene sanitation for food business actors are needed to improve food quality through changes in knowledge and attitudes in a positive direction so that consumer health will be more secure.

Genomic epidemiology of Salmonella Typhi in Central Division, Fiji, 2012 to 2016

SummaryBackgroundTyphoid fever is endemic in some Pacific Island Countries including Fiji and Samoa yet genomic surveillance is not routine in such settings. Previous studies suggested imports of the global H58 clade of Salmonella enterica var Typhi (Salmonella Typhi) contribute to disease in these countries which, given the MDR potential of H58, does not auger well for treatment. The objective of the study was to define the genomic epidemiology of Salmonella Typhi in Fiji.MethodsGenomic sequencing approaches were implemented to study the distribution of 255 Salmonella Typhi isolates from the Central Division of Fiji. We augmented epidemiological surveillance and Bayesian phylogenomic approaches with a multi-year typhoid case-control study to define geospatial patterns among typhoid cases.FindingsGenomic analyses showed Salmonella Typhi from Fiji resolved into 2 non-H58 genotypes with isolates from the two dominant ethnic groups, the Indigenous (iTaukei) and non-iTaukei genetically indistinguishable. Low rates of international importation of clones was observed and overall, there were very low levels an antibiotic resistance within the endemic Fijian typhoid genotypes. Genomic epidemiological investigations were able to identify previously unlinked case clusters. Bayesian phylodynamic analyses suggested that genomic variation within the larger endemic Salmonella Typhi genotype expanded at discreet times, then contracted.InterpretationCyclones and flooding drove ‘waves’ of typhoid outbreaks in Fiji which, through population aggregation, poor sanitation and water safety, and then mobility of the population, spread clones more widely. Minimal international importations of new typhoid clones suggest that targeted local intervention strategies may be useful in controlling endemic typhoid infection. These findings add to our understanding of typhoid transmission networks in an endemic island country with broad implications, particularly across Pacific Island Countries.FundingThis work was supported by the Coalition Against Typhoid through the Bill and Melinda Gates Foundation [grant number OPP1017518], the Victorian Government, the National Health and Medical Research Council Australia, the Australian Research Council, and the Fiji Ministry of Health and Medical Services.

Seroprevalence of hepatitis E virus infection in the Americas: Estimates from a systematic review and meta-analysis.

Hepatitis E virus (HEV) infection is responsible for inflammatory liver disease and can cause severe health problems. Because the seroprevalence of HEV varies within different population groups and between regions of the continent, we conducted a systematic review on the topic in order to provide evidence for targeted prevention strategies. We performed a systematic review in PubMed, SCIELO, LILACS, EBSCO, and Cochrane Library and included reports up to 25 May 2021 (PROSPERO registration number: CRD42020173934). We assessed the risk of bias, publication bias, and heterogeneity between studies and conducted a random-effect meta-analysis for proportions using a (binomial-normal) generalized linear mixed model (GLMM) fitted by Maximum Likelihood (ML). We also reported other characteristics like genotype and risk factors. Of 1212 identified records, 142 fulfilled the inclusion criteria and were included in the qualitative analysis and 132 in the quantitative analysis. Our random-effects GLMM pooled overall estimate for past infection (IgG) was 7.7% (95% CI 6.4%-9.2%) with high heterogeneity (I2 = 97%). We found higher seroprevalence in certain population groups, for example in people with pig related exposure for IgG (ranges from 6.2%-28% and pooled estimate of 13.8%, 95% CI: 7.6%-23.6%), or with diagnosed or suspected acute viral hepatitis for IgM (ranges from 0.3%-23.9% and pooled estimate of 5.5%, 95% CI: 2.0%-14.1%). Increasing age, contact with pigs and meat products, and low socioeconomic conditions are the main risk factors for HEV infection. Genotype 1 and 3 were documented across the region. HEV seroprevalence estimates demonstrated high variability within the Americas. There are population groups with higher seroprevalence and reported risk factors for HEV infection that need to be prioritized for further research. Due to human transmission and zoonotic infections in the region, preventive strategies should include water sanitation, occupational health, and food safety.

Potential Contribution of African-American Migrants to Economic and Cultural Development in Africa

This article discusses the potential contributions of African American migrants to the economic and cultural development of destination countries in Africa. The study explores the contributions of migrants to the gross domestic product (GDP), labor market, and fiscal impact—measures used by the International Labor Organization (ILO) to assess the impacts of migrants on the economy of a destination country. Migrants may share their own life experiences in community citizenship with traditional authorities when dealing with community issues. For example, land use-planning, allocation of urban-rural land, siting of sanitation facilities, health and safety of community, and community economic planning are within the competence of migrants given their education backgrounds and their decision to follow a traditional style of governance. African-American migrants present an opportunity to form backward linkages to sources of finance and investment capital in the country of origin. Our study found no existing institutional mechanism to grow these backward linkages, and there is no recognized privateprivate partnership between migrants and U.S. financial sources. The study recommends increased theoretical and empirical studies in support of the economic and cultural contributions of African American migrants in Africa.

The top 100 global water questions: Results of a scoping exercise

<h2>Summary</h2> Global water security presents a complex problem for human societies and will become more acute as the impacts of climate change escalate. Water security connects the practical water and sanitation challenges of households to the dynamics of global hydroclimates and ecosystems in the Anthropocene. To ensure the successful deployment of attention and resources, it is necessary to identify the most pressing questions for water research. Here, we present the results of a scoping exercise conducted across the global water sector. More than 400 respondents submitted an excess of 4,000 potential questions. Drawing on expert analysis, we highlight 100 indicative research questions across six thematic domains: water and sanitation for human settlements; water and sanitation safety risk management; water security and scarcity; hydroclimate-ecosystem-Anthropocene dynamics; multi-level governance; and knowledge production. These questions offer an interdisciplinary and multi-scalar framework for guiding the nature and space of water research for the coming decades.

Barriers to Water and Sanitation Safety Plans in Rural Areas of South Africa—A Case Study in the Vhembe District, Limpopo Province

The implementation of water and sanitation safety plans (WSSP) has the potential of greatly improving the challenge of resource-limited drinking-water supplies. However, the most effective tool to make WSSP successful is understanding of the factors that contribute to hindering the implementation of these plans, specifically in rural communities. This study therefore aimed at assessing the status of basic services and determining the factors that contribute to hampering the process of WSSP in rural communities. A survey was conducted between March 2020 and March 2021 in rural communities of the Vhembe District, Limpopo Province, South Africa. The overall results indicate that poverty, unemployment, lack of access to purified water, and inadequate sanitation facilities have resulted in waterborne diseases reported within the communities and have a major impact in hindering WSSP. Other barriers observed are inequality regarding financial power, absent and degrading water and sanitation infrastructures, and lack of protection and maintenance of natural water sources. Therefore, there is a need for community members to be educated on proper behavior and perceptions towards sanitation, including working hand-in-hand with different stakeholders, men and women from communities, and different cultures and religions to overcome these barriers, so that human disease associated with water supply, wastewater reuse, and sanitation in rural communities can be alleviated.

A community-based survey to assess risk for one health challenges in rural Philippines using a mobile application

BackgroundRecent emerging and re-emerging diseases in animals and humans show the vulnerability of humans, animals, and crops to disease outbreaks and the large potential impact on health, food security, and economies worldwide. A technology-enabled One Health (OH) surveillance program offers an opportunity for early detection and response as well as prevention of disease outbreaks in resource-limited settings. As an initial step toward developing the surveillance program, we aimed to identify at-risk groups of households for potential shared health challenges at the human-animal-environmental interface in a rural community of the Philippines.MethodsA cross-sectional household survey was conducted in the municipality of Los Baños in proximity (63 kilometers south) to Metro Manila by enumerators living in the same community. Twenty-four enumerators conducted household interviews asking a) household characteristics including ownership of animals and crops; b) awareness, beliefs and knowledge about OH; c) family-level health practices related to sanitation, hygiene, and food safety; and d) risk factors for potential OH issues. All data collection and transferring process were streamlined using a mobile application.ResultsOf 6,055 participating households, 68% reported having one or more of gardens, farms, and animals for various reasons. While only 2% of the households have heard about OH, 97% believed they can get disease from animals, plants or the environment. A latent class analysis with nine risk factors for potential OH issues suggested that 46% of the households were at moderate to high risk for exposure to zoonotic pathogens and environmental contaminants.ConclusionOur findings indicate that there are unaddressed threats to human, animal, and plant health. Given the importance of the interconnections between the health of humans, animals, and plants, further evaluations of the at-risk households would be necessary to mitigate potential shared health threats in the community. Further, our study demonstrates that mHealth technology can provide an opportunity to systematically assess potential one health problems in the rural communities with limited internet connection.

The WHO Guidelines for Safe Wastewater Use in Agriculture: A Review of Implementation Challenges and Possible Solutions in the Global South

Globally, the use of untreated, often diluted, or partly treated wastewater in agriculture covers about 30 million ha, far exceeding the area under the planned use of well-treated (reclaimed) wastewater which has been estimated in this paper at around 1.0 million ha. This gap has likely increased over the last decade despite significant investments in treatment capacities, due to the even larger increases in population, water consumption, and wastewater generation. To minimize the human health risks from unsafe wastewater irrigation, the WHO’s related 2006 guidelines suggest a broader concept than the previous (1989) edition by emphasizing, especially for low-income countries, the importance of risk-reducing practices from ‘farm to fork’. This shift from relying on technical solutions to facilitating and monitoring human behaviour change is, however, challenging. Another challenge concerns local capacities for quantitative risk assessment and the determination of a risk reduction target. Being aware of these challenges, the WHO has invested in a sanitation safety planning manual which has helped to operationalize the rather academic 2006 guidelines, but without addressing key questions, e.g., on how to trigger, support, and sustain the expected behaviour change, as training alone is unlikely to increase the adoption of health-related practices. This review summarizes the perceived challenges and suggests several considerations for further editions or national adaptations of the WHO guidelines.

Sanitation planning for resettlement sites in Laos

Abstract Hydropower plants have been making both direct and indirect impacts on the environment and society on many levels in Laos as they require people who live in downstream and upstream areas to relocate to new resettlement sites. A sanitation planning process for resettlement sites in Laos is evaluated by an evaluating tool which has been developed according to three international sanitation planning guidelines, namely Community-Led Urban Environmental Sanitation Planning (CLUES), the Sanitation Safety Planning methodology by the WHO, and Sanitation 21. Four resettlement sites were selected, based on their differences in terms of project developers, scales, consultancy companies, and the number of people impacted. All four cases had positive performances in their project preparation and the implementation phases which showed a strong institutional arrangement and high engagement by the stakeholders. However, the technical planning phase was overlooked and given a low priority, the boundary of the systems was roughly defined, and there was no clear support to develop a treatment system for the reuse of wastewater, and no health risk assessment. We propose six concise sanitation planning steps and resource-oriented sanitation for resettlement sites which aim to support project developers' decision-making and planning for sanitation systems in resettlement sites.

Use of ozonation technology to combat viruses and bacteria in aquatic environments: problems and application perspectives for SARS-CoV-2

ABSTRACT COVID-19 is a global health threat with a large number of confirmed cases and deaths worldwide. Person-to-person transmission through respiratory droplets and contact with aerosol-infected surfaces are the main ways in which the virus spreads. However, according to the updated literature, the new coronavirus (SARS-CoV-2) has also been detected in aqueous matrices, with the main route of transmission being feces and masks from patients diagnosed with the disease. Given the emergence of public health and environmental protection from the presence of lethal viruses and bacteria, this review article aims to report the major challenges associated with the application of ozonation in water contaminated with viruses and bacteria, in order to clarify whether these communities can survive or infect after the disinfection process and if it is efficient. Available data suggest that ozonation is able to increase the inactivation effect of microorganisms by about 50% in the logarithmic range, reducing infectivity. In addition, the evidence-based knowledge reported in this article is useful to support water and sanitation safety planning and to protect human health from exposure to cited contaminants through water.

Making sense of sewage sludge as a renewable resource in the urban U.S.

Prior to industrialization, human excrement was commonly employed as a resource for agricultural fertilization. Following the advent of the hydraulic sanitation system, however, it became increasingly channeled into waterways rather than reincorporated into terrestrial agro-ecosystems. To counter this trend, more and more industrial cities are seeking to utilize treated sanitation waste, or “biosolids,” as a renewable resource that can be applied as a soil amendment in urban recreational settings, including parks, gardens, and golf courses. This article examines how the use of biosolids in the American city of Chicago comes to “make sense”—experientially, economically, and ecologically—to users and wastewater experts. Furthermore, it considers how sanitation infrastructures, social norms, and safety concerns both contour and constrain such usage. Ultimately, this article identifies how direct sensorial experiences (particularly of odors or their absence) as well as notions of economic and ecological “good sense” contribute to the social acceptability of biosolids usage. However, contaminants of emerging concern that are barely perceptible in sanitation waste raise more profound questions about the challenges of urban sustainability in this period known as late industrialism.&#x0D;

Water, sanitation, and hygiene services in health care facilities in the Autonomous Province of Vojvodina, Serbia.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Factors Influencing Students Intention to Choose Career of Halal Food Industry in Malaysia using Theory of Planned Behavior

Background: The food industry in Malaysia has experienced significant development, especially in the halal food sector. The halal food industry is a market segment involved with food items and beverages that are strictly prepared according to rules underlined by the Islamic dietary law. In addition, the concept of halal covers not only Syariah law, but also hygiene, sanitation and food safety requirements. Malaysia has become a major global halal hub in delivering halal food to local and international levels. The significant development of halal food industry in Malaysia creates significant job opportunities for new graduating students. Therefore, this study aims to evaluate factors that influence student intention to choose a career for the halal food industry in Malaysia. Research Methodology: This study using a quantitative research method with questionnaire development in assessing the factors that influence intention of students to involve in halal food industry as their future career. The underpinning theory is Theory of Planned Behavior (TPB). The independent variables are Attitude (A), Subjective Norm (SN) and Perceived Behavioral Control (PBC). This study developed four questions for each variable. Unit of analysis for respondents is university students in Malaysia. The sample size is 40 students that have an interest in working for halal food industry in Malaysia. The correlation analysis was analyzed using Pearson Correlation coefficient analysis. Meanwhile, the causal relationship was analyzed using multiple regression analysis. Results: The skewness values for four variables in this study are between -1 and +1 that indicates normal distribution. The value of Cronbach’s alpha statistical test for measuring internal reliability is larger than 0.7 for all four variables. Therefore, four constructs exhibit good reliability that indicates the suitability of internal consistency. Next, the value of R-squared for model fit in this study is 0.675 that indicates a good model fit that explained 67.5% of variance in dependent variable. Multiple regression analysis indicates Attitudes (A), Subjective Norm (SN) and Perceived Behavioral Control (PBC) are significant in predicting the value of Intention (I) to select a career in halal food industry. Conclusion: This study supported the hypothesis that indicates there is a positive and significant relationship of Attitude (A), Subjective Norm (SN) and Perceived Behavioral Control (PBC) towards Intention (I). The findings of this study add value to theoretical knowledge of career selection among university students. At the same time, this study provides guideline for government in developing better policy in cultivating interest among university students to be highly involved in the halal food industry.

The Effect of Food Safety and Hygiene Education on The Knowledge Levels of Tourism Students in Turkey

This study aims to reveal the effect of food safety and hygiene lesson on the food safety knowledge level of the students studying in the tourism management department. The lesson has included hygiene, sanitation and food safety concepts, hygiene and sanitation in tourism businesses, personal hygiene, microbiological, physical and chemical degradation of foods, food safety systems. Questionnaire consisting of a total of forty questions on food and foodborne diseases, personnel hygiene, kitchen and equipment, contamination, temperature control, and food preservation was used as a data collection tool. The study was administered to tourism management and hospitality undergraduate students studying in Turkey. Students had the lowest range of food safety knowledge about temperature control and food preservation (20.6%-89.2%) on temperature control and food preservation before the food safety and hygiene lesson. In other groups, students showed a level of knowledge in the average 86.5%-92.8% range. The lesson showed a significant difference in all parts regarding the level of food safety knowledge. When evaluated in general, the present study showed that with a lesson like food safety and hygiene, deficiencies in food safety information can be overcome.

Pelatihan Tata Hidangan bagi Masyarakat di Desa Kedonganan, Badung, Bali

Kedonganan Village is famous as a culinary tourism village. Developments and increasingly fierce competition, the village considers it necessary to prepare human resources who can provide maximum service to tourists. In response to this, training is needed on excellent service, hygiene, sanitation and work safety as well as the manufacture of mixed drinks for the community. The purpose of this activity is to provide an overview of the field of hospitality and service excellence to the community in Kedonganan Village, to provide an understanding of hygiene, sanitation and work safety as well as basic knowledge of beverages to the community in Kedonganan Village, as well as to provide training on how to making and serving mixed drinks for the community in Kedonganan Village. The participants of the activity were a total of 60 people, consisting of representatives from 6 Banjars in Kedonganan Village. This activity is carried out with 3 (three) methods, namely in the form of lectures, discussions and direct practice. The results of this activity can be seen from the enthusiasm of the participants in participating from the first day to the end and the participants gave very positive responses to this activity. They hope that such activities can be carried out continuously with different materials.

Features and Applications of Urine Stabilization Methods: A Review

The recovery of nutrients from unconventional water such as domestic sewage is considered as a sustainable solution to environmental sanitation, personal hygiene, water, and food safety issues. Source separation of urine and the sequenced treatment techniques are the promising approaches to recover the resources from this unconventional water. However, in the storage of urine, urea is hydrolyzed under the action of urease, resulting in odor, precipitation and the loss of ammonia, which is a challenge to be overcome in the process of urine recycling. This review collates research related to urine stabilization, and aims to summarize the characteristics and applications of existing urine stabilization methods, such as acidification, alkalization, electrochemistry, inhibitors and etc. Overall, acidification and alkalization have higher dosage requirements and have an attentional impact on the environment; electrochemical technology is suitable for decentralized sanitation facilities, but the inhibition duration is short; inhibitors are the least effective and are usually used to regulate urease activities in soil environment rather than for urine stabilization. Choosing the appropriate approaches of urine stabilization should focus on the overall perspective of urine resource utilization, consider the separation method and recovery form, and combine it with the concentration technology.

Development of a semi-quantitative approach for the assessment of microbial health risk associated with wastewater reuse: A case study at the household level

This study proposes a modified methodology for semi-quantitative microbial risk assessment (SQMRA) based on the risk matrix presented in the World Health Organization (WHO) Sanitation Safety Planning manual adding the variable ranking for probability of infection in the estimations of risk scores, which composes the risk matrix. The approach is applied to cases where quantitative microbial risk assessment (QMRA) studies are hindered by the lack of information regarding pathogens in the (waste)water, collected as a set of primary data. The methodology is fully described and its application is demonstrated by comparing the microbial risk to which individuals are exposed within a residence in different scenarios of direct or indirect exposure to wastewater. Three current scenarios and one proposed scenario, with four sub-scenarios, focused on the use of a decentralized treatment system and greywater reuse in a single-family residence. Scenarios were selected for application of the SQMRA to elucidate if solutions considering source separation and reuse would bring more health-related risks, or attenuate the existing ones related to the conventional onsite wastewater treatment and soil disposal. None of the studied alternatives achieved risk score above 160 (very high). Considering the average score of each alternative by exposed group, the current scenarios, representing low-cost, informal solutions, posed the highest risks for children. All proposed reuse types reduced the risks from high to medium (score 43.9) for children and from medium to low (score 22.2) for adults. The adapted approach was demonstrated to be a useful tool, aiding the decision-making process and clarifying uncertainties raised when source separation and household reuse are proposed.

Gaps in Infection Prevention and Control in Public Health Facilities of Sierra Leone after the 2014-2015 Ebola Outbreak.

Background: High compliance to infection prevention and control (IPC) is vital to prevent health care-associated infections. In the worst 2014–2015 Ebola-affected district in Sierra Leone (Kenema), we assessed (a) average yearly IPC compliance (2016–2018) using a National IPC assessment tool in the district hospital and peripheral health units (PHUs), and (b) gaps in IPC activities, infrastructure and consumables in 2018. Methods: This was a cross-sectional study using secondary program data. Results: At the district hospital, compliance increased from 69% in 2016 to 73% in 2018 (expected minimal threshold = 70%; desired threshold ≥ 85%). Compliance for screening/isolation facilities and decontamination of medical equipment reached 100% in 2018. The two thematic areas with the lowest compliance were sanitation (44%) and sharps safety (56%). In PHUs (2018), the minimal 70% compliance threshold was not achieved in two (of 10 thematic areas) for Community Health Centers, four for Community Health Posts, and five for Maternal and Child Health Units. The lowest compliance was for screening and isolation facilities (range: 33–53%). Conclusion: This baseline assessment is an eye opener of what is working and what is not, and can be used to galvanize political, financial, and material resources to bridge the existing gaps.