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Background: Inadequate drinking water, sanitation, and hygiene (WASH) in health care facilities impacts the health, particularly in low and middle-income countries. There is limited knowledge on the status of WASH in such settings. Objective: The primary objective of this study was to assess WASH conditions in health care facilities in four EM countries; Jordan, Morocco, Lebanon, and Pakistan. Methods: This study was based on secondary data analysis of the regional study on WASH services in health facilities. Separate samples of health care facilities were selected from Jordan (19 hospitals), Morocco (8 hospitals), Lebanon (14 hospitals), and Pakistan (8 hospitals) and were assessed using the WHO/CEHA tool WSH in the health facilities assessment tool. The assessment tool consisted of items to assess the WSH services availability, adequacy, and functionality. Results: All health care facilities (100%) in Jordan and Morocco, 71.4% of hospitals in Lebanon and none of the hospitals in Pakistan had a safe water source. Overall, all hospitals in Jordan, Morocco, and Lebanon and 71.4 % of hospitals in Pakistan had improved and gender separated toilets in inpatients settings (One per 20 users). About 84.2% of hospitals in Jordan, none in Morocco, 28.6% in Lebanon, and all hospitals in Pakistan had sufficient improved and gender separated toilets in outpatients setting. Overall, 84.2% of hospitals had sufficient and functioning handwashing basins with soap and water and 79.0% of hospitals had sufficient showers. The majority of hospitals in the selected countries have a policy for the safe management of healthcare waste but inadequate training program on healthcare waste. Conclusions: WASH services are not well implemented in health care facilities of the selected countries. The countries have to develop and implement a monitoring system for WASH services or at least support inclusion of WASH services in routine monitoring of health care services. [iproc 2018;4(1):e10543]

Assessment of Water, Sanitation and Hygiene (WASH) within Healthcare Facilities in Selected Eastern Mediterranean Countries