Together with SIDA, WaterAid Pakistan strengthened water, sanitation and hygiene services in health centres to ensure they are climate resilient, inclusive and sustainable.
Where did we work?
The 'Climate-resilient, inclusive and sustainable water, sanitation and hygiene (CRISWASH) for safe healthcare facilities' project focused on six basic and rural health centres in Lodhran District, Punjab Province, Pakistan.
Our survey of health centres across the district revealed that two thirds did not have handwashing facilities (with water and soap) at the entrance, and more than 83% did not have these essentials in waiting areas. The six centres selected for the project had access to water, but there were no filtration facilities and most water points were not inclusive. Four centres did not have toilets that met the needs of people who menstruate, and two did not have toilets separated by gender. None had functional sewer systems to safely dispose of human waste or adequate healthcare waste management services.
What did we do?
With a focus on women and girls, disabled people, healthcare workers and the community, the project had three key goals:
- Upgrade water, sanitation and hygiene (WASH) facilities in health centres to be climate-resilient, inclusive and sustainable
- Improve healthcare waste management services
- Enhance knowledge in communities through awareness and hygiene behaviour change campaigns
In addition to these activities, the project team developed a CRISWASH model that can be scaled to other health centres. It includes materials to support people to build their skills, influence policy and manage knowledge.
What did we achieve?
We improved water supply and sanitation services by:
- Installing climate-resilient reverse osmosis water filtration plants in two health centres, providing clean water for staff, patients and communities
- Constructing improved toilet blocks – with two toilets in each – for staff and patients in three centres
- Providing separate, women-friendly toilets in three health centres
We improved infection prevention and control measures by:
- Constructing an incinerator with advanced waste reduction and air pollution control technologies in Rural Health Centre 53M, improving healthcare waste management and environmental compliance
- Improving healthcare waste management processes so they are safe and sustainable
We increased the capacity of local communities to manage and mitigate climate-related risks by:
- Reaching more than 37,500 people – including healthcare workers, students, disabled people and older people – in awareness raising campaigns on climate-resilient WASH
- Implementing awareness campaigns on the importance of adopting green energy sources and planting indigenous trees
We strengthened the local governance and ownership of WASH facilities by:
- Training Lodhran District health department staff on the infrastructure, operation and maintenance of WASH facilities, and healthcare waste management processes
- Facilitating a partnership between the health department and the Lodhran District Health Authority
- Ensuring the health department has ownership of all project activities, and supports those implemented by community and health council members
We integrated gender and inclusion into all aspects of the project, including:
- Ensuring the participation of women healthcare workers in training sessions on how to operate and maintain WASH facilities, and infection prevention and control standards
- Ensuring women make up 30% of local WASH committee community meetings
- Encouraging the participation of women and girls in sessions on handwashing, domestic and personal hygiene practices, and street theatre activities
- Involving women in decision making on WASH facilities, such as selecting the sites for the reverse osmosis water filtration plants
We ensured project activities were sustainable by:
- Promoting sustainable practices, including energy efficiency, renewable energy, and non-hazardous healthcare waste management
- Neutralising the carbon footprint of the project by planting 460 indigenous trees
- Training communities on climate-resilient WASH practices, including raising awareness of the causes and effects of climate change, and promoting local climate change adaptation
Top image: Tahira Hafeez washes her hands with soap at the newly constructed handwashing station in Basic Health Unit Galleywal in Lodhran District, Punjab Province, Pakistan. March 2024