Improving WASH in Health Care Facilities of Kanker district, Chhattisgarh

WaterAid India

WaterAid India regional team in Chhattisgarh, in collaboration with its partner NGO Samarthan, has initiated a dialogue with the district health department and Jivan Deep Samiti (JDS) of all Primary Health Centres (PHCs), Community Health Centres (CHCs), and district medical hospitals, to improve water, sanitation, and hygiene (WASH) facilities in healthcare centres. Jivan Deep Samiti is a committee formed in every primary, community, and district health care centre that receives funds for its overall management.

With 167 maternal deaths per 1,00,000 live births and 28 newborn deaths per 1,000 live births, India has one of the highest rates of maternal and neonatal mortality in the world. One in five newborn deaths could be prevented by ensuring access to clean water, and by providing a clean birthing environment. To develop a greater understanding of the status of water, sanitation, and hygiene (WASH) in health care facilities, WaterAid India carried out an assessment of WASH, last year, in 343 facilities in 12 districts across six states over a period of 18 months. The findings highlighted the poor status of WASH in health care facilities.

Furthermore, last year, WaterAid India launched a campaign ‘Healthy Start’ with an aim to integrate safe WASH in health care facilities.

Mr Devidas, from Samarthan, addressing the audience
Mr Devidas, a team member from NGO Samarthan, addressing the audience

The regional team in Chhattisgarh held an orientation workshop on 30 June 2017. The primary objective of the workshop was to create an understanding amongst the JDS members about the importance of WASH in health care facilities (HCF) and plan for improvement of WASH facility in their respective hospitals. Mr Sanjaya and Mr Devidas from WaterAid’s NGO partner, Samarthan, facilitated the workshop. It was attended by the secretary and members of JDS’s executive committee from 36 PHCs, 7 CHCs, and a civil and district hospital each, including the Chief District Medical Officer (CDMO), Dr J. L. Uike.

The workshop began with a discussion on the Healthy Start Campaign – its importance, objectives and a broad action plan. This was followed by a session on WASH in HCF, to discuss the impact of poor WASH facilities on the health of child and mother, and the various standard parameters of WASH facilities. A brief session was held on Kayakalp Awards, its process and possible benefits of being a part of a programme like this.

In order to understand the problems, analyse them, and plan further, a group exercise was conducted based on the five themes – i) present WASH facilities in HCF and gaps identification, ii) participatory planning process for WASH improvement, iii) maintaining transparency in work, iv) mobilising and utilisation of budget for implementation of a plan, and v) effective monitoring of all activities. This extensive group discussion deduced out the following critical points –

  • Regular supply of clean water, in adequate quantity, is a major challenge spread across all HCFs.
  • Less number of supporting and cleaning staffs and their capacity is also a concern for all.
  • Some hospitals lack appropriate infrastructures for WASH.
  • Less participation of JDS members in planning and monitoring processes.
  • External political pressure if and when budgets are involved.
  • Lack of transparency in budget utilisation and annual plan.
Group exercise in progress, as the participants brainstorm
Group exercise in progress, as the participants brainstorm

Dr Uike committed to develop an action plan for HCF, with the support of WaterAid India and its partners, for monitoring and assessment of the same.

To ensure better WASH facilities in HCFs WaterAid India and Samarthan will –

  • Orient JDS members on WASH in HCF, at their respective health care centres.
  • Set up a meeting with CDMO and Block Medical Officer (BMO) to develop a plan for assessment of WASH facilities in health care centres.
  • The team will support JDS, at the specified hospitals, in developing an improvement plan, monitoring as well as quarterly assessment.

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