By Our Correspondent
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have warned that millions of patients and healthcare workers around the world continue to face avoidable health risks because many healthcare facilities lack basic water, sanitation, hygiene and environmental-cleaning services.
A joint assessment covering the past decade shows that while significant progress has been made since 2015, the improvement remains far from sufficient to guarantee safe and quality healthcare. The report, released under the WHO-UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene, provides one of the most comprehensive assessments so far of basic services in healthcare facilities worldwide.
According to the findings, only around 40% of healthcare facilities meet the basic standard for sanitation. Similarly, just 59% meet the basic requirements for environmental cleaning, while about 85% have access to a basic water service, 72% to basic hygiene facilities and 71% to improved systems for healthcare waste management.
The figures highlight a troubling contradiction: hospitals and health centres are expected to protect people from disease, yet a large proportion of them still lack the basic infrastructure needed to prevent infections.
Environmental cleaning remains a major gap
Environmental cleanliness is one of the biggest weaknesses identified in the report. Only 59% of healthcare facilities globally meet the basic environmental-cleaning standard, which requires clear cleaning procedures and appropriately trained personnel.
At approximately 18% of facilities, neither of these essential requirements is adequately available. These facilities serve an estimated 1.5 billion people, meaning that a huge number of patients may be receiving treatment in environments where basic infection-prevention measures are inadequate.
The situation is considerably worse in low- and middle-income settings. In developing countries, only around 24% of healthcare facilities meet the basic standard for environmental cleaning.
Poor cleaning systems can allow bacteria, viruses and other pathogens to survive and spread inside hospitals and clinics. This can increase the risk of healthcare-associated infections, particularly among newborns, elderly patients, people undergoing surgery and those with weakened immune systems.
WHO’s WASH team head Bruce Gordon said the findings demonstrate important progress while also exposing major gaps in the basic requirements for safe and quality healthcare.
Toilets alone do not mean adequate sanitation
Sanitation is another major concern. A basic sanitation service requires more than simply having toilets inside a healthcare facility. Toilets must be functional, safe, usable and accessible to patients, healthcare workers, women, girls and people with disabilities.
The report indicates that only around half of healthcare facilities provide separate toilets for women and men, accessible toilets for people with disabilities, or adequate menstrual-hygiene facilities.
UNICEF’s Director for Water, Sanitation and Hygiene, Evereste Kouassi-Komlan, stressed that the mere presence of a toilet should not be considered sufficient. A facility cannot be regarded as meeting basic standards if its toilets are unsafe, inaccessible or fail to address the needs of women, girls and people with disabilities.
This issue becomes particularly important for maternity centres. Pregnant women, mothers, newborns and young children can face serious risks when healthcare facilities lack safe water, clean toilets and adequate hygiene arrangements.
Progress since 2015, but millions remain at risk
The WHO-UNICEF assessment shows that basic water, hygiene and healthcare-waste management services have improved globally between 2015 and 2025. Hygiene recorded the most significant progress during the period.
However, the pace of improvement remains insufficient. Around 10% of healthcare facilities still do not have a basic water service, while a similar proportion has no sanitation facility at all.
This means that healthcare workers may be required to treat patients without reliable access to clean water for handwashing, cleaning equipment or maintaining basic hygiene standards.
The absence of these services can have consequences beyond individual hospitals. Inadequate infection control can contribute to the spread of infectious diseases within communities and increase pressure on already stretched healthcare systems.
India faces its own sanitation challenge
The global findings are particularly relevant for India, where the expansion of healthcare infrastructure has been accompanied by a growing focus on sanitation, clean water, infection control and biomedical-waste management.
India has made substantial progress in expanding sanitation infrastructure and improving access to toilets and drinking water, including through national programmes such as the Swachh Bharat Mission. However, ensuring that sanitation facilities are available inside and around healthcare institutions, properly maintained and consistently usable remains an important challenge.
The issue is particularly significant in rural and remote areas, where primary health centres, community health centres and smaller government hospitals may face shortages of infrastructure, maintenance staff, water supply and waste-management facilities.
India’s large and diverse healthcare system also means that standards can vary considerably between facilities. Major urban hospitals may have sophisticated sanitation and waste-management systems, while smaller facilities can face difficulties with regular water supply, functioning toilets, cleaning personnel and disposal of biomedical waste.
For India, the WHO-UNICEF findings therefore underline the need to move beyond simply building infrastructure. The focus must increasingly shift towards maintenance, reliability, monitoring and quality of services.
A clean toilet that remains locked, a water connection that does not provide regular supply, or a waste-management system without trained personnel cannot deliver meaningful public-health protection.
Women, children and vulnerable patients need greater protection
The sanitation gap also has a strong gender and social dimension. Women and girls require safe and private sanitation facilities, particularly when they are pregnant, giving birth or seeking treatment.
For children, especially newborns, poor hygiene can be particularly dangerous. Hospitals and health centres are supposed to provide a safe environment for vulnerable patients, but inadequate water and sanitation can instead expose them to preventable infections.
People with disabilities also face barriers when toilets and other facilities are not designed to be accessible.
The report therefore calls for healthcare infrastructure to be assessed not merely on whether facilities exist, but on whether they are safe, functional, accessible and capable of meeting the needs of all patients.
Stronger monitoring needed
WHO and UNICEF have called on countries to strengthen systems for regularly monitoring water, sanitation, hygiene, environmental cleaning and healthcare-waste services.
Monitoring should examine not only the availability of infrastructure but also its reliability and quality. Governments need accurate information on whether water supplies function consistently, toilets are usable, cleaning protocols are followed and waste is safely disposed of.
A United Nations General Assembly resolution adopted in May 2026 also highlighted the need for stronger national standards, regular monitoring and reporting, and effective plans for water, sanitation, healthcare waste management and electricity in healthcare facilities.
The resolution recognised WHO and UNICEF as joint coordinators for global efforts in this area and called for continued support to member states and expanded data collection through the Joint Monitoring Programme.
Healthcare cannot be safe without basic services
The WHO-UNICEF findings send a simple but important message: a hospital cannot provide completely safe healthcare if its basic water, sanitation and hygiene systems are failing.
Medical technology, advanced medicines and highly trained doctors are critical, but they cannot substitute for clean water, functioning toilets, trained cleaning staff and safe waste disposal.
For India and other developing countries, the next phase of healthcare development must therefore focus not only on adding hospitals and increasing the number of beds, but also on ensuring that every healthcare facility meets minimum standards of cleanliness, sanitation, hygiene and accessibility.
The global progress made over the past decade is encouraging. But with millions of people still receiving treatment in facilities lacking basic services, the WHO-UNICEF report makes clear that the task is far from complete. Safe healthcare begins with the most basic requirements—and those basics must reach every hospital, clinic and health centre.