Towards a systemic approach to water, sanitation and hygiene in healthcare facilities

This learning brief demonstrates that sustainable improvements in WASH in healthcare facilities are achieved not through isolated investments, but by strengthening the underlying systems that govern how services are planned, financed, delivered and monitored. Applying a systems approach, linking WASH to health policies, financing mechanisms, workforce capacity, governance structures, and information systems enables countries to move from temporary gains to lasting health outcomes. Drawing on global evidence and country experiences from Ethiopia, Ghana, Nigeria, Bangladesh, Sierra Leone, Mali and others, the brief highlights practical entry points for integrating WASH into core health system functions. It goes beyond existing guidance by translating systems thinking into actionable strategies that can be adapted across contexts and levels of the health system.