CREATING A NEW REALITY IN ZAMBIA HEALTH SECTOR

THE “value of Water” is this year’s World Water Day theme. It highlights the key area of importance in Zambia’s National development especially given the role water plays in various social and economic spheres.

Access to clean and safe water services in Healthcare facilities (HCFs) across Zambia has had a major impact on the quality of services delivered in the health sector. Poor Water, Sanitation and Hygiene (WASH) services in HCFs in many rural communities in Zambia has been a contributing factor to the high mortality rate of women, with many avoiding going to HCFs to give birth because of a lack of cleanliness, privacy and safety. In a 2018 survey conducted by WaterAid, 95% of facilities did not reach the Joint Monitoring Program (JMP) basic service level for hygiene, a situation that has left patients, healthcare workers and surrounding communities at risk of infection and even death .

National statistics indicate that at least 60% of HCFs provide less than a ‘basic service’ for water, some facilities have no water, sanitation or hygiene (WASH) services at all. At least 7% of facilities do not even have a toilet . The impact of the inadequate WASH in HCFs is devastating and contributes to preventable infection-related deaths each year. These infections also result in prolonged hospital stays, long-term disability, increased antibiotic resistance, and increase the economic burden on families and healthcare systems.

WaterAid Zambia has remained dedicated to its commitment to provide the Zambian people and communities access to better, inclusive, clean and safe water. For the past three (3) years, WaterAid embarked on “Improving WASH services in Schools and Healthcare Facilities” the flagship project, that identified Forty (40) HCFs across five (5) rural districts in three (3) provinces of Zambia. The project has been implemented in Mwandi District in Western Province, Kazungula and Monze Districts in Southern Province, and Mwense and Samfya Districts in Luapula Province. WaterAid Zambia recognizes that communities have a crucial part to play in development projects right from the start. Communities helped create an accurate picture of the status of existing HCFs by supporting and participating in accessibility audits. They shaped and facilitated the design process – for example, helping to determine the look and location of the toilets for a labour ward, ensuring optimal proximity, safety and privacy for patients. The project focused beyond the project outputs to achieve a broader outcome of improving health outcomes for mothers and children. The project ensured wider ownership of the efforts beyond the life of the program, by prioritizing the creation of investment partnerships at the National government agencies, Institutional, and Community levels.

Through our work across the 40HCFs and in light of the COVID-19 outbreak, emphasis and sharp focus has been placed on the need to have adequate WASH services in HCFs and highlighted gaps in access to WASH services that need to be urgently addressed to help ensure the quality of care and safety of health workers and patients. The flagship project created a new reality for communities and HCFs and is a model employed to demonstrate how new standards of WASH services at HCFs, with access to sustainable water supply can easily be adopted under the Nation Healthcare developmental agenda in practice, taking into the design include the need for; medical waste management structures, infrastructure that accommodate Persons with disabilities and other impairments within the communities.

In close cooperation with Ministry of Water Development, Sanitation, and Environmental Protection (MWDSEP) and the support of the Ministry of Health (MOH),WaterAid Zambia through this project has been able to achieve; the development and delivery of standards for WASH in HCFs to ensure quality interventions at HCFs and improved access to sustainable WASH services in HCFs for all people throughout their lifetime, championing and Influencing for the integration of WASH services in healthcare strategies with adequate resourcing for maintenance and the continuous operation of HCFs. During project implementation, the focus was placed on bridging the gap between policy and practice, with the MoH pledging their commitment to the provision of piped water schemes in HCFs and under WaterAid Zambia’s HCFs-WASH procurement system. The evidence from assessments will equip the MoH and partners with the information they need to form an action plan to improve the condition of HCFs. The action plan, once developed, can be used to direct the efforts of donors and NGOs, avoiding in effective and piecemeal development. Implementing the Creating a new reality for WASH in HCFs has been an indicator to both Government and institutional WASH stakeholders on the gaps detected between policy and practice in rural area settlements across Zambia. Further WaterAid has secured funding to improve WASH in 60 more healthcare facilities. In two provinces; Southern and Western. The project is the second phase of the creating a new reality dubbed from Resolution to Revolution

Through our work across the 40HCFs and in light of the COVID-19 outbreak, emphasis and sharp focus has been placed on the need to have adequate WASH services in HCFs and highlighted gaps in access to WASH services that need to be urgently addressed to help ensure the quality of care and safety of health workers and patients.