Cost of healthcare infections hits US$1.57bn yearly due to lack of WASH in health facilities

Infections acquired in healthcare facilities are costing Ghana US$1.57bn each year, leading to thousands of preventable deaths. At least half of these infections could be prevented by improved water, sanitation and hygiene (WASH) in these facilities, WaterAid unveiled yesterday in brand new research.

The new data, using World Bank methodology, highlights that if healthcare-acquired infections were to halve, then at least 31,300 lives could be saved across Ghana every year and a staggering US$72million could be saved from the national budget.

Ghana is one of seven African countries featured in the data alongside Nigeria, Malawi, Ethiopia, Zambia, Uganda and Mali. In total, the new data shows that infections caused by lack of handwashing facilities, clean water and decent toilets are costing Sub-Saharan Africa US$8.4billion each year.

The new data shows that poor cleanliness and hygiene during medical care and recovery are major causes of infection transmissions. According to WaterAid, the most common healthcare-acquired infections are surgical site infections, bloodstream infections and respiratory tract infections, including pneumonia. The highest rates are found in intensive care units, neonatal wards and paediatric medical wards.

These findings paint a bleak picture not only of the needless loss of life from entirely preventable causes, but of the fact these infections cost an average of 1.98 percent of the country’s gross domestic product (GDP) – while treating the illnesses consumes an average of 4.6 percent of total health budgets every year. This is a cost that will only increase as a greater share of these infections becomes resistant to antibiotics, warns WaterAid.

Right now, 45 percent of healthcare facilities in Ghana lack access to clean water.  The continued suffering caused by these infections in lower-middle income countries only highlights the deep inequalities within global society and the inadequacy of sustainable water, sanitation, and hygiene access among the most vulnerable communities.

Increased investment from donors and international financial institutions for healthcare facilities is essential to break the chain of infection, decrease the demand for antibiotics and reduce the opportunity for a resistant infection to become dominant.

WaterAid is calling for increased investments in Ghana’s healthcare system to ensure every healthcare facility in the country has clean water, sanitation and hygiene services – our first line of defence against antimicrobial resistance (AMR) for both people living this reality daily and the global economy.

Donor countries, multilateral development banks and other financing sources must support local governments with financing as a matter of priority to tackle the AMR crisis and to deliver improved water, sanitation and hygiene, as identified in country national action plans.

Reacting to the World Bank data, Ewurabena Yanyi-Akofur, Country Director, WaterAid Ghana, said: “The absence of basic sanitation and hygiene facilities along with clean water is not just a health crisis, it’s an economic one. We call for immediate action to secure increased financing from the Ghanaian Government, alongside contributions from donors, multilateral development banks and the private sector to support Ghana’s national WASH Infection Prevention/Control action plans. Ensuring every healthcare facility in Ghana has access to clean water, sanitation and hygiene services is imperative. The moment to take action is now”!

The new data comes ahead of the UN High Level Meeting on AMR this September, which will see global leaders gather to discuss the critical need for all countries to prepare and fight against future pandemics and antimicrobial resistance.

Clean water, decent sanitation and good hygiene are the first line of defence against infections in healthcare settings. Yet, WaterAid says that half of the world’s healthcare facilities do not have basic hygiene services – rising to two thirds across the 46 least developed countries. When hospitals and clinics do not have these essential services, infections can rapidly spread – putting all patients, including new mothers and babies, at risk and leaving doctors with little choice but to prescribe antibiotics.

Bukari, the physician in charge at the Worikambo Health Center, Upper East Region, shared his experience prior to a WaterAid intervention which constructed a limited solar mechanised water system for the facility. Bukari painted an appropriate before and after scenario, linking improved access to WASH and a reduction in infections.

“It posed a lot of challenges; people were using the pit latrine and couldn’t wash their hands but then went on to eat, cook, handle babies – causing infections. For the patients, not having water posed a threat to them. They would use a pit latrine or open defecation which exposed them to snakes and other dangers in the bush. Not having water led to infections. We also could not sterilise our equipment, and that led to poor wound care as well as transfer of infections between patients. Poor sterilisation led to more infections.”

Linking access to clean water to a decreased rate of infections, Bukari added: “We used to have a lot of diarrhoea and we prescribed a lot of antibiotics; but now we have less cases and our use of antibiotics has drastically reduced”.

WaterAid Ghana has, so far, helped millions of people in the hardest to reach and most marginalised communities across the country with clean water, decent toilets and good hygiene services. Right now, about 1.3million people in Ghana still live without clean water, and 17 percent practise open defecation because they lack access to a decent toilet. WaterAid’s goal to ensure everyone everywhere has access to these basics is not one that can be achieved alone.

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