Water and Sanitation for Health Facility Improvement Tool (WASH FIT)

This tool provides a framework to assess, prioritize, and implement a plan to improve services, ensuring clean and safe facilities for staff and patients. WASH FIT encompasses infrastructural changes, maintenance, and repair, as well as behavioral changes, such as hand hygiene behavior. The tool is designed for primary and secondary care facilities in low- and middle-income countries, including health centers, health posts, and rural district hospitals. It is primarily intended for use by health staff, particularly facility managers or infection prevention and control leads, who make up the WASH FIT team. The guide also provides a range of ready-to-use tools to implement WASH FIT, helping to improve WASH services and related safety aspects in a healthcare facility. Improving WASH services is essential for infection prevention and control, patient safety, and overall health outcomes. The WASH FIT approach has been used in various countries, including Chad, Liberia, and Mali, as part of broader efforts to improve WASH in healthcare facilities and households. The tool is flexible and adaptable to local needs and conditions, and users are encouraged to share feedback to allow for future improvements and knowledge exchange. The WASH FIT framework consists of several stages, including assembling a WASH FIT team, conducting an assessment of the facility, identifying strengths, hazards, and risks, and developing and implementing an incremental improvement plan. The tool also includes a range of indicators and assessment forms to help implement WASH FIT and monitor its effectiveness. The World Health Organization (WHO) and UNICEF have committed to improving access to WASH services in healthcare facilities through a global action plan. Achieving and maintaining WASH services in healthcare facilities is a critical element in providing quality services and achieving universal health coverage. WASH FIT is designed to improve these services, integrating WASH into healthcare facility management to help ensure quality and safe services. The WASH FIT approach is aligned with the WHO Guidelines for Drinking-water Quality and the Sanitation Safety Planning (SSP) approach. It also draws upon recommendations for infection prevention and control. The tool is an adaptation of the water safety plan (WSP) approach, which is recommended as the most effective way of ensuring continuous provision of safe drinking-water. The WASH FIT guide is primarily designed to be used by health staff, including facility managers or IPC leads, who make up the WASH FIT team. It may also be useful for community health or water committees, local government authorities, nongovernmental organizations (NGOs), or other community-based organizations that support provision of healthcare. The guide can help inform district or regional health sector planners and donors seeking to understand and support improvements and ongoing maintenance of WASH services. The WASH FIT framework is designed to be a continuous improvement process, with ongoing monitoring and evaluation to ensure that improvements are sustained over time. The tool provides a range of indicators and assessment forms to help implement WASH FIT and monitor its effectiveness.