Assessing Provision of Water, Sanitation and Hygiene Services within Comprehensive Primary Health Care Delivery Settings in Gujarat, India: A Cross-sectional Study

Introduction: Provision of basic water, sanitation and hygiene (WASH) services are foundational to safe health care. Poor WASH in low-resource settings exacerbate preventable deaths and infections. This study was aimed at assessing the WASH system in Ayushman Arogya Mandir-Sub Health Centres (AAM-SHCs) of Gujarat. Materials and Methods: A cross-sectional study of 99 AAM-SHCs was conducted using a WASH Facility Improvement Tool-adapted (WASH FIT-adapted), with scoring based on the Joint Monitoring Programme ladder (0–2) and analysis done in Microsoft Excel. Results: The study found most facilities met basic service levels for hand hygiene ( n = 59), waste management ( n = 76), sanitation ( n = 48) and water supply ( n = 57). A few had limited services: hand hygiene ( n = 2), waste management ( n = 7), sanitation ( n = 8) and water ( n = 4). Many needed improvements in hand hygiene ( n = 38), waste management ( n = 16), sanitation ( n = 43) and water supply ( n = 38). Conclusion: Many facilities meet basic WASH standards, with scope for improvement in sanitation, hand hygiene and water services. Enhancing these areas calls for capacity building, efficient funding, regular monitoring and supportive supervision.