Water, Sanitation, Hygiene

Field intelligence improves WaSH technology in Health Centres

Posted On
Tuesday, May 8, 2018


Nitya Jacob

Lead, WaSH

Inadequate Water, sanitation, and hygiene (WaSH) account for about 10 percent of all infections. Good WaSH infrastructure and hygiene practices, especially hand washing, are very critical in health centers. Patients in with already-weak immune systems are more susceptible to hospital-acquired infections (HAIs). The most common HAIs are infections of the urinary tract, bloodstream, surgical site and pneumonia. All have strong links to WaSH, especially hand hygiene. Poor WaSH is linked to maternal mortality and morbidity, especially sepsis. A review in 2011 of HAIs showed that in some developing countries up to one in every two patients (45.6 percent) left hospital with an infection they had not had on arrival.

Swasti undertook a study on the status of WaSH in Health Care Facilities in four states, Karnataka, Madhya Pradesh and Odisha. The study found staff in these centers are indifferent to taking basic hygiene and sanitation-related precautions to prevent HAIs. The indicator was for water, with 70 percent reporting adequate quantity. But less than 40 percent of facilities met quality norms. While nearly all had toilets, 40 percent were dysfunctional or unusable. The worst performance was with hygiene; 60 percent of conservancy staff were not trained on how and when to clean the health centers even though cleaning material was available. There was a rural-urban divide in terms of human resources and the condition of the facilities. Water supplies were better in urban than in rural centers. In the former, more than 90 percent of the staff posts were filled compared to less than half in rural centers. Toilets in urban centers were cleaner and more usable than those in villages. However, hygiene practices, especially handwashing and cleaning, were equally poor in both.

The Ministry of Health and Family Welfare (MoHFW), Government of India, issued Kayakalp – Swacchta Guidelines for Public Health Facilities to improve the hygiene and cleanliness of health facilities and reduce HAIs. The study showed these guidelines have not had a major impact because the monitoring tool is paper-based. The need of the hour was recognized to be a fast, cheap and reliable way to report, assess and act – ideally a mobile app.

In response,Swasti Health Catalyst supported by its sister organisations in the Catalyst Group created the WaSH app.

The solution consists of an Android app and web platform that helps hospitals monitor and execute healthy WaSH practices. The app is aimed towards providing healthcare facilities and higher administration, real-time access to WaSH information. With regular real-time monitoring resulting in enhanced WaSH standards maintained in healthcare facilities, the quality of health services will eventually improve. This would inevitably prevent infection and thereby reduce maternal and neonatal morbidity and mortality.

Created in accordance with the Government of India’s Kayakalp Guidelines prepared for healthcare facilities, the solution enables hospitals to monitor and execute healthy WaSH practices at different levels through informed data-driven decisions. None of the current solutions assess hospitals in accordance with these parameters.

In simple terms, it can be downloaded by medical officers or healthcare staff. They can install it on their personal devices and monitor their centers or hospitals as per a fixed schedule. The application generates dashboards that can be monitored according to the Kayakalp indicators at various levels at the hospital levels from the village to the district.

This mobile app puts data in the hands of health officials. It is GPS-enabled and flexible. The data entered is instantly visible and verifiable by district, state, and national authorities. The tool provides real-time information to decision-makers and managers to act promptly.

This is a major step forward in improving WaSH in health centers and saving lives, based on ground intel.


  1. Purva Mathur, 2011. Hand hygiene: Back to the basics of infection control, Indian Journal of Medical Research, 2011 Nov; 134 (5): 611–620
  2. Angela Chaudhuri, Nitya Jacob, 2017. Data and Decisions: Improving WASH in Health Centres, Swasti Health Resource Centre, Bangalore, 2017
  3. Swachhata Guidelines for Public Health Facilities (2015). Ministry of Health and Family Welfare, Government of India

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