What to know
CDC collaborates with partners to assess new WASH (water, sanitation, and hygiene) solutions in healthcare facilities, particularly areas where resources are limited. These settings often need innovative or modified strategies to tailor community WASH approaches to healthcare environments. Using a blend of epidemiology, lab methods, and behavioral science, CDC conducts thorough evaluations worldwide. These assessments generate vital data, offering implementers and stakeholders at all levels evidence-based insights to shape policy and enhance public health.
Novel latrine improvement
Little work has been done to improve sanitation in healthcare facilities in resource-limited settings, especially short-term improvements to the users' experience. CDC worked with the Safe Water and AIDS Project (a Kenyan non-governmental organization) and the County Health Office of Kisumu County, Kenya, on a field trial of plastic inserts for latrine dropholes with hinged, self-closing covers that were emptied by pouring water into the pan. These inserts were designed to reduce odors and flies and make the latrine easier to clean.
The goal of the evaluation was to understand whether these inserts improved the experience of using the latrine by assessing users' perceptions of odor and cleanliness, measuring the number of flies in the latrines before and after installation, and interviewing cleaners about the effect of the new latrine inserts on their daily work.
Container-based sanitation
While toilets with onsite waste containment, such as septic tanks and pit latrines, are common in healthcare facilities in resource-limited settings, they are typically located outside of the patient care area and require users to be mobile enough to reach them.
CDC collaborated with Sanivation, a nongovernmental organization that implements and manages container-based toilets, to evaluate the feasibility and acceptability of these toilets among outpatients and inpatients in wards. Container-based toilets were mobile and could be easily moved between wards. They were raised, making them easier to use for people hospitalized with injuries or illnesses that prevented them from squatting. They were covered to contain odors and could be serviced more regularly and managed more safely than traditional bedpans.
Although sustainable container-based sanitation projects for households already existed in Ghana, Haiti, Kenya, and other resource-limited settings, this was the first set of evaluations in healthcare facilities in Kenya. The evaluation project aimed to help understand whether this technology was appropriate for healthcare facilities.
Locally produced alcohol-based hand rub
CDC has collaborated with the Infectious Diseases Institute (Makerere University, Uganda), Kabarole District Health Office, and the International Water and Sanitation Centre (IRC) WASH to understand whether alcohol-based hand rub, an established method for clinical hand hygiene in healthcare settings, can be produced and distributed on a local scale in a resource-limited setting.
Starting in 2018, CDC began evaluating a project in Uganda to test the feasibility, acceptability, and effectiveness of local production and district-wide distribution of alcohol-based hand rub at improving hand hygiene among healthcare providers.