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WASH assessment and surveillance system to improve sustainability and quality of health services in the Gaza Strip 5 th Arab Water Week 3-7 March 2019, Jordan implemented by GVC, funded by UNICEF WASH assessment and surveillance system in health institutions in the Gaza Strip

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  1. WASH assessment and surveillance system to improve sustainability and quality of health services in the Gaza Strip 5thArab Water Week 3-7 March 2019, Jordan implemented by GVC, funded by UNICEF WASH assessment and surveillance system in health institutions in the Gaza Strip “The content of this presentation are the sole responsibility of GVC and can in no way be taken to reflect the view of UNICEF”

  2. Structure of the presentation Introduction to the project Scope of the work WASH Assessment Surveillance system Preliminary findings Conclusions

  3. Introduction of GVC Non-governmental, secular and independent organization founded in Bologna, Italy in 1971, and active in the occupied Palestinian territory since 1992. Currently, GVC works both in humanitarian aid and development, aiming at: 1. Provide access to basic services and available natural resources. 2. Strengthen the protection of vulnerable communities. 3. Enhance socio-economic development.

  4. Introduction to the project Several major rounds of destructive conflicts and 11 years blockade have led to a severe deterioration in access to basic WASH and Health services Information gaps on the conditions and functioning of water and sanitation infrastructures and hygiene practices in health care facilities Many concerns were raised about the quality of care, infectious disease and antimicrobial resistance inside the health facilities

  5. Introduction to the project

  6. Scope of work A1, A2: creation of a WASH-in-Health Working Group A3, A4: WASH Assessment and Surveillance System A5: cross-checking with secondary data A6: prioritization of WASH-in-Health interventions A7, A8: capacity building activities for health workers to adopt life-saving WASH practices inside health facilities

  7. Cross check with WSP data & 2ry data Surveillance system Key Data Feedback Gaps Occurrence of Waterborne diseases Isolates and notification of microorganism PHC centers Medical Laboratory Region Investigation at HH level Hospital • Lack of feedback and reporting • Lack of investigations and medical practices • Unavailability of special investigations Confirmation Identification and Report Epidemiological Unit Notification of microorganism Special Investigation Report Microbiology Laboratory Preventive medicine Unit

  8. WASH Assessment - targets 16 Primary Healthcare facilities and 5 hospitals, managed by the Ministry of Health

  9. WASH Assessment - methodology • Assessed Fields: • Water • Sanitation • Hygiene • WASH management • Medical waste management • Methodology: • Face-to-face interview with key personnel in the health facilities including: facility director, engineering department, O&M technicians • Inspection check list for WASH facilities infrastructures and supplies • Resources: • Core questions and indicators for monitoring WASH-in-Health care facilities in the Sustainable Development Goals, 2016 (UNICEF/WHO) • Joint Monitoring Programme (UNICEF/WHO) • Water and Sanitation for Health Facility Improvement Tool, WHO 2017 • WASH Assessment at Household Level in The Gaza Strip, GVC, 2017. • Service Availability and Readiness Assessment (SARA), WHO, 2015. • Infection Control Assessment Tool (ICAT), USAID, 2009. • Essential environmental health standards in health care, WHO, 2008. • WHO drinking water quality Guidelines volume 4.

  10. Preliminary findings - general 21 facilities represent 33% Ministry of Health and 12% of all run facilities in Gaza Targeted PHC treated 32% of cases (59,000) [dashboard MoH 2018] Targeted hospitals treated 57% of cases (4.6 M) [dashboard MoH 2018] • Assessed Fields: • Water • Sanitation • Hygiene • WASH management • Medical waste management

  11. Preliminary findings – water(source)

  12. Preliminary findings – water (material of infrastructures)

  13. Preliminary findings – sanitation

  14. Preliminary findings – sanitation (policies and behaviours)

  15. Preliminary findings - hygiene

  16. Preliminary findings – WASH management

  17. Preliminary findings – medical waste management

  18. Conclusions • Surveillance system • Already established, will be strengthened through identification of key actors and responsibilities during emergencies (outbreaks) • WASH assessment • Main findings, data elaboration is still ongoing • Similar study is missing - pioneering • Condition of WASH-in-Health is poor, and needs urgent intervention • Gap analysis aiming at prioritize limited resources

  19. Thank you Giovanni Cesari GVC – Gruppo di Volontariato Civile Emergency Coordinator in oPt giovanni.cesari@gvc-italia.org +972 (0)59 5271198

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