Evaluation of water, sanitation and hygiene status of COVID-19 healthcare facilities in Ghana using the WASH FIT approach

Access to improved water, sanitation and hygiene (WASH) is essential for the delivery of high-quality care in healthcare facilities and the prevention of hospital-acquired infections such as the transmission of the SARS-CoV-2. In addition, unimpeded access to WASH facilities in coronavirus disease 2019 (COVID-19) treatment centres (TCs) is central in facilitating compliance with infection prevention and control protocols. However, data for the WASH status of COVID-19 TCs in Ghana are limited. We evaluated the WASH status of seven COVID-19 TCs in Ghana using the WHO/UNICEF water and sanitation for health facility improvement tool (WASH FIT). The water domain had the highest number of indicators meeting standards with an average percentage score of 90.5% (range: 66.7–100%) across the seven TCs, followed by management (66.9%) and hygiene (58.7%). The TCs performed poorly in the sanitation and healthcare waste domain, with an average percentage score of 44.6% (range: 22.2–75%). These findings highlight the challenges being faced by COVID-19 TCs in implementing WASH services. Specific WASH interventions are urgently required to strengthen WASH services in the COVID-19 TCs. This should precede the prioritisation of resources to WASH infrastructure in the treatment facilities coupled with actions that involve all stakeholders.