WASH in Health Facilities Project – Overview NATIONAL WASH COORDINATION MEETING 9 th Oct 2015 Implemented by ERC, MoHS & MoWR

In this presentation: 1.Health Sector Recovery Plan 2.Project Titles & Goal 3.Expected Results 4.Target Locations; Hospitals Vs Partners; CHCs Vs Partners 5.Scope of WASH activities 6.Expected Hardware Outputs in Hospitals and CHCs 7.Progress To-date 8.Challenges/Opportunities

Health Sector Recovery Plan Linked to the Presidential Health Sector Recovery Plan (1 st phase - 9 months) Health Sector Recovery Framework – 5 Outputs: Patient & Health worker Safety, Health work force, Essential Healthcare Services, Community Ownership & Information & Surveillance. Immediate outcome Indicators (ERC to contribute to) % of health facilities compliant with infection prevention and control measures % of 40 Hospitals and 149 CHCs with triage and isolation capacity % of Hospitals and CHCs with access to safe water % of PHUs with improved sanitation facilities

Project Titles & Goals Project Titles: Support to WASH facilities in Community Health Centres (CHCs) Strengthening Infection Prevention Control & WASH Infrastructure in Government Hospitals in Sierra Leone Project Timelines: 25 th May 2015 to 25 th April 2016 – CHC Project 15 th April 2015 to 28 th February 2016 – Hospitals IPC Project Goal (both projects): Resurgence of Ebola is Prevented Outcome: Increased safe access to comprehensive health services at CHCs for patients in Sierra Leone Increased safe access to comprehensive health services at government hospitals for patients in Sierra Leone.

Expected Results CHC Project: To Improve water supply and distribution systems in 128 CHCs to meet the minimum water demands in order to deliver safe health services and comply with IPC protocals To improve sanitation in 128 to meet the sanitation standards and improve IPC To improve the waste management infrastructure in 128 CHCs to meet the minimum standards for IPC To improve the facility management of WASH infrastructure at 128 CHCs to ensure sustainability of the system through proper operation and maintenance To ensure that all 128 CHCs have screening stations for out patients and safe isolation areas for patients suspected of EVD or another highly communicable disease. Hospitals IPC Project: To improve WASH services and infrastructure in 22 government hospitals to ensure staff are able to adhere to IPC protocols and standards.

Target Locations Koinadugu Bombali Kambia Port Loko Kono Kenema Kailahun Bo Pujehun Bonthe Moyamba Tonkolili Western Area Rural Western Area Urban Koinadugu Oxfam GB WASH in CHCs Kono GOAL WASH in Koidu Government Hospital MUWODA WASH in CHCs Kenema GOAL WASH in Kenema Government Hospital WASH in CHCs Pujehun Save the Children IPC & WASH in Pujehun Government Hospital WASH in CHCs Bonthe Solidarities WASH in CHCs Moyamba ACF IPC & WASH in Moyamba Government Hospital WASH in CHCs Bombali GOAL IPC & WASH in Makeni Government Hospital WASH in CHCs Kambia ACF WASH in Kambia Government Hospital WASH in CHCs Port Loko GOAL IPC & WASH in Lungi Government Hospital WASH in CHCs Western Area KINGS / WELBODI / GOAL WASH in Hospitals Bo IRC WASH in Bo Government Hospital GOAL WASH in CHCs Tonkolili Concern WASH in CHCs WASH in Magburuka Hospital Kailahun Save the Children WASH in Kailahun Government Hospital WASH in CHCs

Hospitals Vs Partners DistrictERC partnerHospital KenemaGOALKenema KonoGOALKoidu KailahunSAVEKailahun KambiaACFKambia TonkoliliCONCERNMagburaka BombaliGOALMakeni Port LokoGOALLungi MoyambaACFMoyamba BoIRCBo PujehunSAVEPujehun Western Area RuralGOALLakka Western Area UrbanGOALKissy Mental Western Area UrbanGOALMacauley Satellite Western Area UrbanKingsLumley Western Area UrbanKing's34 Military Western Area UrbanKing'sConnaught Western Area UrbanKing'sKing Harman Road Western Area UrbanIOMKingtom Police Western Area UrbanIOMPrison Western Area UrbanWelbodiOla During Children's Western Area UrbanWelbodiPCM Western Area UrbanWelbodiRokupa

CHCs Vs Partners

Scope of WASH Activities Water Supply: Establishing sustained water supply through rehabilitation of existing/establishing new water sources, rehabilitation of existing/installing new storage facilities, rehabilitating water distribution systems and ensuring functional water access points at all locations where medical procures are undertaken through rehabilitation of the existing non-functional facilities/installation of new facilities. Water Quality: Supporting Hospital staff and the MoWR on water quality testing and monitoring Sanitation: Establishing toilets and shower/bathroom facilities through rehabilitating existing dilapidated facilities/constructing new ones, rehabilitation of existing waste water systems and onsite waste water disposal facilities (septic tanks) or construction of new ones where applicable. Healthcare Waste Management: Establishing health care waste segregation system through provision of color coded waste collection bins at all locations where waste is generated. Establishing health care waste management facilities (Incinerators, Ash pits, Organic pits and sharps pits) through rehabilitation of the dilapidated existing facilities/construction of new ones. Training: Support Strengthening the capacity of hospital staff in operation, maintenance and management of the WASH facilities in Health Facilities.

Expected Hardware outputs in CHCs Water Supply & Quality: New/rehabilitated water supply sources equipped with pumps New/rehabilitated water storage tanks - elevated New/rehabilitated water distribution systems; water access points Existing water quality testing, treatment and monitoring mechanism Sanitation: New/rehabilitated gender disaggregated toilets/latrines and showers/bathroom facilities New/rehabilitated septic tanks, soak away pits Functional hand washing facilities Surface run off drainage systems (where applicable) Healthcare Waste Management: Provision of waste collection bins and onsite transportation Functional waste pits [organic/placenta, sharps] New/repaired incinerators with ash pits Fenced off waste management area Screening & Isolation Facilities:

Expected Hardware outputs in Hospitals Water Supply & Quality: New/rehabilitated water supply sources equipped with pumps (shared with UNOPS) New/rehabilitated water storage tanks - elevated New/rehabilitated water distribution systems; water access points Existing water quality testing, treatment and monitoring mechanism Sanitation: New/rehabilitated gender disaggregated toilets/latrines and showers/bathroom facilities New/rehabilitated septic tanks, soak away pits Functional hand washing facilities Surface run off drainage systems (where applicable) Healthcare Waste Management: (Fully being undertaken by UNOPS) Provision of waste collection bins and onsite transportation [ERC Partners] Functional waste pits [organic/placenta, sharps] New/repaired incinerators with ash pits Fenced off waste management area Screening & Isolation Facilities:

Progress to-date: All Coordination efforts between ERC and UNOPS completed – Water sources and Health care waste management facilities activities in 20 Hospitals Working towards strengthening coordination efforts between ERC and FWC Strengthened coordination efforts with all actors targeting health facilities for any infrastructure activities (ERC, UNFPA, UNOPS, UNICEF) All ERC partners have resubmitted their SLAs as required by the MoHS (Approvals, reviews) Engagement of partners and MoHS in developing ‘Standards/Basic Guidelines and Designs’ to harmonize WASH infrastructure activities in health facilities Out of 20 Hospitals, 1 has made substantial progress in water supply (sources, storage, access points within various service points) and sanitation activities. Activities on going in the other targeted Hospitals (after UNOPS/ERC coordination matrix completed) MoHS & MoWR supported by ERC partners led WASH assessments targeting PHUs in 12 districts led by MoHS & MoWR – MoHS to lead in generating the Assessment report.

Challenges/Opportunities Strengthening Coordination of (WASH) Infrastructure activities in all health facilities; also be part of National WASH Coordination forum. Strengthened MoHS involvement in Coordinating activities through introduction of the SLA approach for all projects targeting health facilities An opportunity for all partners implementing WASH in Health facilities, MoHS and MoWR to start thinking of developing basic guidelines/standards for WASH in health facilities (Harmonized) Access to in-door sanitation facilities by the disabled persons in some of the existing health facilities??? Screening/Isolation Guidelines/Procedures at Various facility levels – define scope of facilities to be put up Increased scope of assessments to cover all PHUs in 12 districts; having information on coverage is critical for future planning of improvements. Availability of certain critical project inputs in the local market – refractory bricks, Taps, pumps

THANK YOU