Only 4 in 10 Health-Care Facilities Meet Basic Sanitation Standards, New Report Finds
Only four in 10 health-care facilities worldwide meet basic sanitation standards, while fewer than six in 10 meet basic environmental cleaning standards, exposing patients and health workers to preventable health risks, a new report by the World Health Organization (WHO) and UNICEF has found.
The report, ‘Progress on Water, Sanitation, Hygiene, Environmental Cleaning and Waste Management in Health-Care Facilities 2015–2025’, provides the first global estimates covering all five basic service areas, including sanitation and environmental cleaning.
According to the report, about 85% of health-care facilities had basic water services, 72% had basic hygiene services and 71% met the basic standard for health-care waste management in 2025. However, only 40% had basic sanitation services, while 59% met the basic standard for environmental cleaning.
The findings highlight persistent gaps in the basic services needed to provide safe, dignified and quality health care, despite progress recorded since 2015.
“The findings show important progress but also expose major gaps in the foundations of safe, high-quality care,” said Bruce Gordon, Unit Head of Water, Sanitation and Health at WHO.
“Reliable water, accessible sanitation, hand hygiene, effective environmental cleaning and safe waste management must be integrated into health planning, financing and monitoring,” he added.
Sanitation goes beyond having a toilet
The report cautions that the finding that only 40% of health-care facilities had basic sanitation services does not mean that the remaining 60% had no toilets.
Globally, 89% of health-care facilities had some form of sanitation, while 85% had usable toilets.
To qualify as a basic sanitation service, however, toilets must be improved and usable and meet the needs of patients, staff, women and girls, and people with limited mobility.
Only around half of facilities had sex-separated toilets, accessible toilets or facilities for menstrual hygiene. The lack of menstrual hygiene facilities and accessible toilets were among the most common reasons facilities failed to meet the basic sanitation standard.
“A toilet is not enough if it is unsafe, inaccessible or does not meet the needs of women, girls and people with disabilities,” said Evariste Kouassi Komlan, Director of WASH at UNICEF.
“Without basic WASH services, health care facilities can pose serious risks to women during childbirth, newborns and young children. Safe, inclusive and dignified WASH services are essential to delivering quality care and protecting health,” he added.
Environmental cleaning remains a concern
Environmental cleaning is another major weakness identified by the report.
Only 59% of health-care facilities met the basic environmental cleaning standard, which requires both cleaning protocols and trained cleaning staff.
The report estimates that 18% of facilities met neither requirement, representing facilities serving a population of approximately 1.5 billion people worldwide.
The situation is particularly concerning in least developed countries, where only 24% of health-care facilities met the basic environmental cleaning standard.
Environmental cleaning is a critical component of infection prevention and control. Poorly cleaned health-care environments can contribute to health-care-associated infections and facilitate the spread of antimicrobial resistance.
Despite the gaps, the report highlights improvements in several areas between 2015 and 2025.
Global coverage of basic water, hygiene and health-care waste management services increased over the decade, with hygiene recording the largest improvement.
Nevertheless, around one in 10 health-care facilities still had no water service, while a similar proportion had no sanitation service in 2025.
The number of countries with available estimates for all five service areas also increased from 29 in the previous JMP update to 39 in 2025.
However, significant data gaps remain. The available information was not yet sufficient to calculate global trends for basic sanitation and environmental cleaning.
Call for stronger monitoring and investment
WHO and UNICEF are urging countries to strengthen routine monitoring of WASH and environmental health services in health-care facilities.
The report recommends moving beyond simply measuring whether infrastructure exists and instead assessing whether services are reliable, safe, accessible and clean, and whether they adequately meet the needs of patients and health workers.
The findings come amid growing international momentum for stronger action on WASH in health-care facilities.
In May 2026, the United Nations General Assembly adopted a resolution calling for stronger national standards, regular monitoring and reporting, as well as costed and financed plans for sustainable and resilient WASH, waste management and electricity services.
The resolution also recognizes WHO and UNICEF as co-coordinators of global efforts and calls on the two organizations to continue supporting countries and expanding data coverage through the Joint Monitoring Programme.
The latest findings underscore that safe health care requires more than medical staff and equipment. Reliable water, adequate sanitation, hand hygiene, clean environments and safe waste management remain fundamental to protecting patients, health workers and communities from preventable infections and other health risks.
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