Water sanitation and hygiene practices has be regarded as a global issue because of improper management practices that leads to the health challenges [1]. At the community levels, World Health Organization [2] reported that to maintain a hygienic environment, health facilities require an acceptable amount and quality of water to keep a good environment. In a study conducted by Venkataramanan et al. [3], Platzer et al. [4] and United Nations Children Education Fund [5], reported that 45% of infections in a community is attributed or linked to poor water sanitation and hygiene practices. UNICEF [5] and Platzer et al. [4] concluded that diarrheal, schistosmiasis, water contact infections and nosocomial infections and some many other diseases can be control with improvements in sanitation, efficient waste disposal, and personal hygiene. In the community level, primary health centers are first point of contact for patients and also record with a high prevalence of infectious disease agents in which patients, staff, and neighbors of the health-care can face risks of infection if water sanitation and hygiene practices is inadequate [6, 7 & 8]
Following the report of WHO [1], every community health centers should have consistent running water, clean toilets, safe refuse disposal, clean beds and areas for birthing and they should improve on infrastructure and avoid overcrowding in community health facilities. Sustainable Sanitation Alliance (SuSanA) [9] supported the recommendations by World Health Organization (WHO), because increases the risk of infections may prevent patients from visiting the community health facilities, especially when hospitalization is necessary for the patient. Therefore, community health facilities should supply 40–60 liters of water per patient per day in emergency settings, and an extra 5 liters of water per outpatient per day in non-emergency settings [9, 6]. After evaluating the impact of WASH on community health centers, Paranipe [10] issued a call to action for improved water, sanitation, and hygiene (WASH) for maternal and newborn health, stating that improved WASH should be: 1) integrated into infrastructure and supply budget priorities, 2) emphasized in maternal and child health campaigns, and 3) embedded in national and global targets and monitoring frameworks.
Globally, the findings of a research study conducted on water, sanitation, and hygiene (WASH) showed that 74 countries lacked improved water supply and 34 of the 74 countries were in Africa and 13% of community health facilities lacked improved water supply [5]. The UNICEF further went to report the insufficient information on WASH impact in community health centers where majority of available data focuses on WASH in hospitals and recorded low data on the condition of WASH in secondary community health facilities [2].
According to a survey conducted by the United Nations World Water Assessment Programme [11], health facilities provide primary care in rural regions. In Nigeria, there are around 400 health clinics, each with a catchment population of over 20,000 people [7].
It is highly necessary to look at WASH practices at the community healthcare facilities because, most of semi-urban and rural health institutions record about 100 patients each day for basic emergency treatment, prenatal care, normal delivery, post-partum care, family planning, pediatric care and nutrition, and regular clinics [12, 13, 14, 15 & 16]. The problem of poor WASH practices has attracted high attention of health practitioners globally, because of several infections and illnesses that are linked to water sanitation and hygiene [17, 18, 7, & 1]. Poor water supply and hygiene have been attributed diseases such as diarrheal, schistosmiasis, water contact infections and nosocomial infections etc [13, 14 & 15].
From the study conducted by Federal Ministry of Health [19], thirty seven (29) percent of health centers in Nigeria have piped water within the institution and 28 percent have year-round water provided by tap or available within 500 meters of the institution [11].
United Nations World Water Assessment Programme [11] also stated that 59 percent of health facilities had power or a backup generator with fuel during service hours, and 58 percent had a working client toilet, a waiting room shielded from the sun and rain, and basic standards of cleanliness. On comparison aspect, Nigeria has a national strategic plan for management of healthcare waste and has demonstrated better access to infection control materials in HCFs than other countries in Africa. Therefore, this study was considered necessary to help to bridge the knowledge gap through assessment of Water Sanitation and Hygiene Practices in the selected Primary Healthcare Centers in Owerri West Local Government Area (LGA), Imo State, Nigeria.