Evaluation of water, sanitation, and hygiene practices in healthcare facilities of Pakistan through the WASH FIT approach: a cross-sectional study

Graphical abstract presenting assessment of WASH conditions in healthcare facilities in Pakistan using the WASH FIT tool. This study aimed to evaluate the WASH (water, sanitation, and hygiene) status of healthcare facilities (HCFs) in Pakistan using the World Health Organization's WASH Facility Improvement Tool (WASH FIT). A simple descriptive, cross-sectional study was conducted in various HCFs, selected through stratified purposive sampling from seven cities in the three regions of Pakistan (i.e., Sindh, Punjab, and the Capital Territory). Data were collected from the staff of the nominated HCF. Simple descriptive statistics and Fisher's Exact test were applied to present data, and a p-value of <0.05 was considered statistically significant. Overall, compliance of HCFs with WASH FIT standards was suboptimal. Only 35.7% (n = 5) of HCFs were categorized in the ‘Good’ WASH category. Reliable drinking water criteria were fulfilled by 50.0% (n = 7) of the HCFs, while 57.1% (n = 8) had safe waste segregation and disposal arrangements. Similarly, functional hand hygiene infrastructure was available in 57.1% (n = 8) of assessed areas. A significant association was found between WASH status and HCF type. Most HCFs required urgent improvements in infrastructure and management to achieve WASH FIT standards. Better monitoring, resource allocation, and training systems are crucial to ensure patient-centered care and infection prevention in HCFs in Pakistan.