Dirty Deliveries: why clean water is essential to surviving childbirth

Water and sanitation facilities can help protect mothers and their babies during childbirth, and act as a crucial defence against the rise of superbugs. To do this, water, sanitation and hygiene must be a part of national maternal health strategies and, crucially, funding for it must increase. 

Every year, more than one million mothers and babies die from preventable infections. Many of these deaths could have been avoided with better access to water, sanitation and hygiene (WASH) facilities, which play a crucial role in improving maternal health outcomes during pregnancy and delivery, and after giving birth.  

This policy brief, developed in collaboration with the Karolinska Institutet, outlines why WASH is a life-saving measure in healthcare settings, and the actions donors, policy makers and government officials can take to ensure equal, safe and clean deliveries for all women. For this to happen, we suggest the following: 

• Prioritise WASH. The alarming rate of maternal and child mortality can be reduced with better WASH facilities.
• Increase funding for WASH. There has been little or no increase in the provision of WASH services in healthcare facilities since 2015. Although health budgets have grown significantly over this period, little appears to be allocated to the construction and maintenance of WASH facilities within healthcare settings.
• Improve WASH to address antimicrobial resistance. The widespread risk of infection due to inadequate WASH drives an overuse of antibiotics – not only to treat but also to prevent infections – particularly among health workers and in maternity services.
• Embed WASH in national maternal health strategies. The costs of investing in basic WASH in healthcare facilities could be recovered from the savings in medical costs made by not having to treat as many healthcare-associated infections. Governments must integrate WASH into national frameworks for strengthening maternal health.
• Develop national standards for WASH in health policies. WASH services in healthcare facilities are a high priority for women, and influence their care-seeking decisions. Governments should develop and enforce standards and accountability mechanisms to include WASH in health policies for improved maternal and newborn care.

Top image: Elisa Ravaoarisoa, 28, and her newborn baby at their home in Madagascar, November 2020.