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icddr,b study finds poor toilet access, hygiene in Dhaka hospitals

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The government hospitals in the city have around 68 per cent functional toilets, and only 33 per cent of them are clean, according to an icddr,b study.

The private hospitals, on the other hand, have 92 per cent functional toilets with only 56 per cent of them being clean, it added.

The data comes from a recent study that was carried out across 12 government and private hospitals in Dhaka. The icddr,b scientists in collaboration with partners at the University of Technology Sydney, Australia, and the Directorate General of Health Services (DGHS) conducted the study and recently published the results in the journal PLOS ONE.

The study evaluated 2,459 toilets in Dhaka's healthcare facilities to assess the availability, functionality, and cleanliness of toilets.

Poor toilet access and hygiene pose significant health risks, potentially spreading diseases like cholera and typhoid.

High user-to-toilet ratios were observed in outpatient facilities, with one toilet for every 214 users in government hospitals and 94 users in private hospitals, significantly below the recommended standards set by WaterAid.

According to their guidelines for the construction of institutional toilets in outpatient facilities, there should be one toilet for every 20–25 patients or carers, up to the first 100 individuals, with an additional toilet for every additional 50 patients or carers, said the study.

Additionally, both government and private hospitals failed to meet the criterion of one toilet per six inpatient beds by the Bangladesh national WASH standard and implementation guidelines from 2021.

There were 17 users for each toilet in government hospitals and 19 users per toilet in private hospitals. Beyond basic functionality, hygiene, and availability, less than 1 per cent of toilets had facilities for disabled people, and only 3 per cent of toilets had a trash bin for menstrual pads and solid disposal.

The researchers defined toilet functionality according to criteria used by the World Health Organization (WHO) and UNICEF and assessed toilet cleanliness based on the presence of visible faeces on any surface, strong faecal odour, flies, sputum, insects, rodents, and solid waste.

“The actual sanitation conditions in Dhaka hospitals may be worse than what we found as our study was conducted in the aftermath of the Covid-19 pandemic when many hospitals were shifting from mainly treating Covid-19 patients to general medical care,” icddr,b’s Associate Scientist and principal investigator of the study Dr Md Nuhu Amin was quoted in a statement of icddr,b.

"This could have led to reduced patient flow and toilet usage,” he noted.

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