Healthcare facility water, sanitation, and hygiene service status and barriers in Addis Ababa, Ethiopia

Assessing the Water, Sanitation and Hygiene (WASH) service status and exploring its barriers will help in the development of an intervention. Therefore, the aim of this study was to assess the state of basic WASH services at public healthcare facilities in Addis Ababa. Convergent parallel mixed design was conducted among 86 public healthcare facilities in Addis Ababa city. The stratified sampling technique was used to select healthcare facilities. A semi-structured World Health Organization observational checklist tool was used to measure the availability of services, and face-to-face interview was conducted with 16 purposively selected key informants. Thematic data analysis was done to identify the barriers. This study found that no single healthcare facility had basic access to overall water, sanitation, and hygiene services. Independent WASH domain analysis showed that 86% of healthcare facilities had basic water access, 100% had limited sanitation access, and 88.4% had limited hand hygiene service. Infrastructure, resource availability and management, lack of governance and collaborative work, lack of capacity and awareness building, and the absence of monitoring and evaluation framework were identified as barriers to the service provision. The study revealed lack of access to basic WASH services at healthcare facilities.