Maternal and Child Health, and Health Facility Quality and Safety, World Health Organization Western Pacific Regional Office, United Nations Avenue, Manila, Philippines.
Health and the Environment, World Health Organization Western Pacific Regional Office, United Nations Avenue, Manila, Philippines.
J Glob Health. 2019 Dec;9(2):020430. doi: 10.7189/jogh.09.020430.
Water, sanitation and hygiene (WASH) services are critical to providing quality maternal and neonatal care in health facilities. This study aimed to investigate availability of WASH policies, standards, and services for childbirth and newborn care in hospitals in East Asia and the Pacific.
Descriptive analysis of survey data and observations of water, sanitation and hygiene services in maternity and neonatal care rooms and of deliveries in 147 hospitals in Cambodia, Lao People’s Democratic Republic, Mongolia, Papua New Guinea, Philippines, Solomon Islands, and Viet Nam. The main outcome measures were availability of national policies and standards; availability of water, sanitation, and hygiene services in maternity rooms and neonatal care units; and practice of hygiene at childbirth.
Four of eight countries had national WASH policies and four had standards for health facilities. Seventy-seven percent of hospitals had a sink with water and soap or alcohol hand rub in delivery rooms, 78% in neonatal care rooms and 43% in postnatal care rooms. Only 45% of hospitals had clean sinks with water, soap and hand drying methods in the delivery room, 37% in neonatal care units and 10% in postnatal care rooms. Flush toilets were available in or next to delivery rooms and neonatal care units in 53% of 15 hospitals with data. Countries with WASH standards had a higher proportion of hospitals with water and hand hygiene services. Appropriate hygiene was practiced by health workers in 66% of 388 deliveries observed, and more likely in delivery rooms with a sink, water and soap.
Coverage of WASH services for maternal and newborn care must be improved to reduce risks of maternal and newborn morbidity and mortality.
水、环境卫生和个人卫生（WASH）服务对于在卫生设施中提供优质的孕产妇和新生儿护理至关重要。本研究旨在调查东亚和太平洋地区医院中分娩和新生儿护理用水、环境卫生和个人卫生服务的 WASH 政策、标准和服务的提供情况。
对柬埔寨、老挝人民民主共和国、蒙古、巴布亚新几内亚、菲律宾、所罗门群岛和越南 147 家医院的产妇和新生儿护理室的水、环境卫生和个人卫生服务以及分娩情况进行调查数据的描述性分析和观察。主要结局指标是国家政策和标准的提供情况；产妇室和新生儿护理单元的水、环境卫生和个人卫生服务的提供情况；以及分娩时的卫生实践情况。
8 个国家中有 4 个国家有 WASH 政策，4 个国家有卫生机构标准。77%的医院在分娩室、78%在新生儿护理室和 43%在产后护理室配备了带水和肥皂或酒精免洗手消毒剂的水槽，只有 45%的医院在分娩室配备了带水、肥皂和手干燥方法的清洁水槽，37%在新生儿护理单元，10%在产后护理室。在有数据的 15 家医院中，有 53%的医院在分娩室和新生儿护理单元配备了冲水马桶。有 WASH 标准的国家，拥有水和手部卫生服务的医院比例更高。在 388 次观察到的分娩中，有 66%的卫生工作者采取了适当的卫生措施，在有水槽、水和肥皂的分娩室中更有可能采取适当的卫生措施。
必须改善孕产妇和新生儿护理的 WASH 服务覆盖范围，以降低孕产妇和新生儿发病率和死亡率的风险。
