A new WHO and UNICEF report reveals significant gaps in essential water, sanitation, hygiene and environmental health services in health-care facilities worldwide. Despite notable gains since 2015, only four in ten facilities meet basic sanitation standards and fewer than six in ten achieve basic environmental cleaning standards such patient rooms and wards, operating theatres, examination and treatment areas, toilets and sanitation facilities, leaving patients and health workers exposed to preventable health risks.
Progress on water, sanitation, hygiene, environmental cleaning and waste management in health-care facilities 2015–2025 , published today by the World Health Organization (WHO) and UNICEF, through the Joint Monitoring Programme on for Water Supply, Sanitation and Hygiene (JMP), provides the clearest global picture yet of these essential services in health-care facilities.
For the first time, global estimates are available for all five basic service areas, including the first estimates for basic sanitation and environmental cleaning.
In 2025, an estimated 85% of health-care facilities had a basic water service, 72% had basic hygiene services and 71% had basic health-care waste management services. However, only 59% met the basic standard for environmental cleaning and 40% met the requirements for a basic sanitation service.
“The findings show important progress but also expose major gaps in the foundations of safe, high-quality care,” said Bruce Gordon, Unit Head, Water, Sanitation and Health (WSH), WHO. “Reliable water, accessible sanitation, hand hygiene, effective environmental cleaning and safe waste management must be integrated into health planning, financing and monitoring.”
The finding that only 40% of health-care facilities had basic sanitation services does not mean that 60% had no toilets. Globally, 89% had some form of sanitation and 85% had usable toilets.
To qualify as a basic sanitation service, toilets must be improved and usable and meet the needs of patients, staff, women and girls, and people with limited mobility. Only around half of facilities had sex-separated toilets, accessible toilets or facilities for menstrual hygiene. The lack of menstrual hygiene facilities and accessible toilets were the most common factors preventing facilities from meeting the basic standard.
“A toilet is not enough if it is unsafe, inaccessible or does not meet the needs of women, girls and people with disabilities,” said Evariste Kouassi Komlan, Director of WASH, UNICEF. “Without basic WASH services, health care facilities can pose serious risks to women during childbirth, newborns and young children. Safe, inclusive and dignified WASH services are essential to delivering quality care and protecting health.”
Environmental cleaning also remains a major concern. Only 59% of facilities met the basic standard, which requires both cleaning protocols and trained cleaning staff. Neither requirement was met by 18% of facilities, corresponding to facilities serving a population of approximately 1.5 billion people. In least developed countries, only 24% met the basic standard.
Environmental cleaning is a core part of infection prevention and control because contaminated health care environments can contribute to health care-associated infections and the spread of antimicrobial resistance.
There has nevertheless been progress. Between 2015 and 2025, global coverage improved for basic water, hygiene and waste management services, with the largest increase recorded for hygiene. Even so, around one in ten health-care facilities still had no water service and a similar proportion had no sanitation service.
The number of countries with estimates for all five services increased from 29 in the previous JMP update to 39 in 2025. Important data gaps remain, and global trends could not yet be calculated for sanitation or environmental cleaning.
The report calls on countries to strengthen routine monitoring and move beyond measuring whether infrastructure is present. Monitoring should increasingly assess reliability, safety, accessibility and cleanliness, as well as whether services meet the needs of patients and health workers.
The new data come amid growing political momentum for action on WASH in health-care facilities. In May 2026, the United Nations General Assembly adopted a new resolution calling for stronger national standards, regular monitoring and reporting, and costed and financed plans for sustainable and resilient WASH, waste and electricity services. The resolution recognizes WHO and UNICEF as co-coordinators of global efforts and calls on them to continue supporting countries and expanding data coverage through the Joint Monitoring Programme.
