How much does it cost to meet the standards for making healthcare facilities water, sanitation, and hygiene (WASH) compliant?: analysis from Assam, India

Inadequate water, sanitation, and hygiene (WASH) standards in healthcare facilities (HCFs) pose a severe risk to those who seek treatment. In India, more than one in every four HCFs lack basic water service and only 55% of facilities have access to improved sanitation. The study aims to estimate the cost to meet the standards for making WASH compliant HCFs. This cross-sectional study was centered on assessing 60 selected HCFs of Assam. The assessment comprises four steps: in the first step, domains and sub-domains were identified; in the second step, gaps were analyzed for the selected domains; in the third step, the cost was estimated for the domains and sub-domains, and in the final step, costs were estimated to meet the standards. The findings show that the cost required for the improvement varied for different types of facilities. The total annual cost to make all the selected facilities WASH compliant was found to be USD 13,73,741. The majority (93.3%) of the cost is required for human resources. District hospitals would require significant investment, followed by the sub-divisional hospitals and first referral units. The least cost is required to improve the state dispensary.