Strengthening Health Systems: WASH Measures to Combat Infectious Diarrhoea in Healthcare Settings

A comprehensive WHO operational guide highlights the critical importance of water, sanitation, hygiene (WASH), and infection prevention and control (IPC) in managing infectious diarrhoea in healthcare settings. The report emphasizes steps to ensure clean water, safe sanitation, effective food safety management, and robust infection control to prevent outbreaks, especially in resource-limited environments. Proper WASH infrastructure is essential for patient safety and reducing healthcare-associated infections (HAIs).

Infectious diarrhoea is a pressing health concern in healthcare settings worldwide, with the potential to cause severe outbreaks if not properly controlled. To combat this risk, the World Health Organization (WHO) has released a vital operational guide detailing the necessary water, sanitation, hygiene (WASH), and infection prevention and control (IPC) measures that health facilities should adopt. This guide, titled Water, Sanitation and Hygiene and Infection Prevention and Control Measures for Infectious Diarrhoea in Healthcare Settings: Operational Guide (September 2024), underscores the importance of a well-structured system to prevent the transmission of infectious diseases, especially in environments with limited resources.

Ensuring Safe Water and Sanitation

Water and sanitation infrastructure is the cornerstone of infection prevention in healthcare. The guide stresses the necessity of providing a continuous supply of clean water, not just for patient use but also for sanitation, cleaning, and other critical healthcare operations. Health facilities must have a safe water storage capacity of at least two days to safeguard against supply interruptions.

Additionally, sanitation plays a crucial role in minimizing contamination risks. Healthcare facilities need to provide adequate toilets for both patients and staff, with separate facilities for male and female users. Where space is limited, pit latrines may be a feasible alternative, provided that they are constructed safely to prevent environmental contamination. Frequent cleaning and disinfection of toilets are paramount, and care should be taken to avoid the spread of infectious agents through aerosolization during toilet flushing.

Food Safety Management in Healthcare

Food safety management is another crucial component of infection control. In healthcare environments, patients often have weakened immune systems, making them more susceptible to infections transmitted through contaminated food. To mitigate this risk, healthcare facilities must enforce strict guidelines on food handling, preparation, and storage.

The WHO guide recommends implementing food safety systems such as the Hazard Analysis Critical Control Point (HACCP) approach to reduce the chances of foodborne illnesses. Key practices include the separation of raw and cooked foods, ensuring food is thoroughly cooked, and maintaining safe temperatures for both storage and consumption. Healthcare staff must also be vigilant about personal hygiene and proper cleaning of utensils and surfaces to prevent cross-contamination.

Infection Prevention and Control (IPC) Protocols

The guide emphasizes that comprehensive IPC measures are essential to preventing the spread of diarrhoeal diseases. Screening patients for diarrhoea symptoms upon arrival and isolating suspected cases are critical steps to contain infections early. The placement of patients with confirmed infections in single rooms and the use of contact precautions—such as wearing personal protective equipment (PPE)—are also recommended.

In addition to patient placement, maintaining a clean and disinfected environment is fundamental. High-touch surfaces and patient-care areas must be regularly cleaned using appropriate disinfectants, with special attention given to areas contaminated by bodily fluids.

Protecting Healthcare Workers and Patients

The health and safety of healthcare workers are equally important in the fight against infectious diarrhoea. Regular training on WASH and IPC measures ensures that all staff members are well-equipped to handle potential outbreaks. The guide advises health facilities to develop protocols for managing occupational exposures, especially in cases where staff come into direct contact with infectious materials.

Healthcare-associated infections (HAIs) are a significant concern, and the guide encourages active surveillance of patients to identify and manage any signs of infections early. Routine monitoring and timely reporting can prevent small outbreaks from turning into major health crises.

The Need for Vigilance and Preparedness

The WHO operational guide is a crucial resource for healthcare facilities striving to prevent and manage infectious diarrhoea. By reinforcing the basics of water, sanitation, and hygiene, alongside robust infection control measures, health facilities can reduce the risk of healthcare-associated infections and ensure safer environments for both patients and staff.

In resource-limited settings, where outbreaks can have devastating impacts, following these guidelines becomes even more vital. The WHO’s guide serves as a blueprint for healthcare administrators, WASH specialists, and infection control professionals, helping them create a safer, more resilient healthcare system capable of withstanding the threat of infectious diseases.