Analysis of infection prevention and control, and water, sanitation, and hygiene in healthcare facilities in the climate-vulnerable districts of Eastern Uganda

Background Water, sanitation, hygiene, infection prevention, and control in healthcare facilities are essential for quality care and improved patient outcomes. However, limited evidence and data gaps in many countries, including Uganda, compromise effective WASH and IPC programming, particularly in regions like Eastern Uganda. This study describes the gaps in services, infrastructure, capacity, and guidelines on WASH-IPC at HCFs contributing to the national data space and addressing the JMP requirement for data availability. Findings support WASH-IPC programming and preparedness, contributing to the Sustainable Development Goals. Methodology A cross-sectional study was conducted in 56 healthcare facilities across Busia, Tororo, and Mbale City districts in Eastern Uganda. The WASH service levels were assessed using questions from the WASHFIT, a risk-based management tool for improving WASH in healthcare facilities. Data collection involved a structured questionnaire and observational checklist designed using the KoboCollect. Data were cleaned in Microsoft Excel and analyzed using STATA version 14.0, focusing on five domains water, sanitation, hand hygiene, healthcare waste management, and environmental cleaning domains. Data were presented using descriptive statistics. Results Overall, 35.7% (20/56) of the HCFs were in Busia, 32.1% (18/56) in Mbale City, and 32.1% (18/56) in Tororo of which 32.1% (18/56) were HCIIs, 51.8% (29/56) HCIIIs, and 16.1% (9/56) HCs or hospitals. About 89.3% (50/56) had an IPC focal person, 82.5 (46/56) had an IPC committee, and 69.6% (39/56) of staff were not frequently trained on IPC. About 76.8% (43/56) of the HCFs had basic water service, 83.9% (47/56) had limited sanitation service, 42.9% (24/56) had limited hand hygiene, 35.7% (20/56) had limited environmental cleanliness service and 19.6% (11/56) had a limited waste management service. Conclusions The widespread inadequacies observed in the IPC, water supply, sanitation facilities, environmental cleanliness, hand hygiene, and waste management prove gaps that impede patient safety and overall healthcare quality. It is therefore fundamental to improve these indicators through increased training of the healthcare workers, increased funding of WASH and IPC programs at HCFs, continuous education for behaviour changes use of better-performing facilities to motivate the poor-performing ones. Additionally, this study suggests similar assessments to be conducted within other regions of the country.