World News
Four in ten health facilities worldwide meet the basic sanitation standard, first global estimate finds
By Staff Writer | 19 August 2026
A joint monitoring report published on Tuesday gives the first worldwide figures for sanitation and environmental cleaning in health buildings. Eighty five per cent have a basic water service. Forty per cent have a sanitation service that meets the standard.
Two United Nations agencies published a report on Tuesday setting out, for the first time, global estimates for all five basic water and sanitation services in health buildings. The headline number is the one on sanitation. In 2025 an estimated 40 per cent of health facilities worldwide met the basic sanitation standard. The report covers the decade from 2015 to 2025 and was produced through the joint monitoring programme the two agencies run together.
The findings show important progress but also expose major gaps in the foundations of safe, high-quality care
Bruce Gordon, Unit Head, Water, Sanitation and Health, World Health Organization
The other four figures for 2025 sit above it. An estimated 85 per cent of health facilities had a basic water service, 72 per cent had basic hygiene services and 71 per cent had basic health care waste management services. Fifty nine per cent met the basic standard for environmental cleaning, which is the other measure being reported globally for the first time.
What the sanitation figure does and does not mean
The report is explicit that 40 per cent meeting the standard does not mean the other 60 per cent have no toilets. Globally 89 per cent of facilities had some form of sanitation and 85 per cent had usable toilets. The standard is higher than the presence of a toilet. To qualify, toilets must be improved and usable and must 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, and the absence of those two provisions was the most common reason a facility fell short.
A toilet is not enough if it is unsafe, inaccessible or does not meet the needs of women, girls and people with disabilities
Evariste Kouassi Komlan, Director of WASH, UNICEF
The split between regions is wide. Drawing on data from 70 countries, the report puts basic sanitation services at 23 per cent of facilities in sub-Saharan Africa against 55 per cent in central and southern Asia. More than one in ten health facilities globally had no sanitation service at all, in buildings serving 936 million people.
Cleaning is the quieter number
The environmental cleaning standard requires two things together: written cleaning protocols and trained cleaning staff. Neither was met by 18 per cent of facilities, which between them serve a population of about 1.5 billion. In the least developed countries only 24 per cent met the standard. That measure rests on data from 54 countries.
Environmental cleaning is part of infection prevention and control. Contaminated health care environments contribute to infections acquired in hospital and to the spread of antimicrobial resistance.
Between 2015 and 2025 coverage improved globally for basic water, hygiene and waste management, with the largest rise in hygiene. Even so, around one in ten health facilities still had no water service, and a similar proportion had no sanitation service. The number of countries with estimates for all five services rose from 29 in the previous update to 39 in 2025. Global trends still cannot be calculated for sanitation or environmental cleaning, because the data does not yet go back far enough.
Why a construction readership should care
The report asks countries to change what they measure. Its recommendation is to move beyond recording whether infrastructure is present and to assess reliability, safety, accessibility and cleanliness, and whether the service meets the needs of patients and staff. That is a shift from a completion test to a performance test, and it is the same shift the industry has been through on energy, air tightness and fire safety. A ward with a toilet that a wheelchair cannot enter has been built and handed over, and it fails.
In May 2026 the United Nations General Assembly adopted a resolution calling for stronger national standards, regular monitoring and reporting, and costed and financed plans for sustainable water, waste and electricity services in health facilities. Where those plans are written, they become procurement documents. Anyone designing or bidding health work in a developing market should expect the accessible cubicle, the menstrual hygiene provision and the cleaning schedule to move from good practice into the employer's requirements.