Half of the world’s health care facilities are unsanitary and incubators of infection.

A global survey of health care facilities by the World Health Organization (UNICEF) found that half lack basic sanitation services, leaving nearly 3.85 billion people vulnerable to disease and death.

The study is based on data from 40 countries representing 35% of the world’s population. It presents a worrying picture of health facilities lacking water and soap for hand washing, dirty toilets and unable to control healthcare waste.

Lack of access to clean water, sanitation and basic hygiene services, known as WASH, in health facilities can lead to many deaths, he says. Rick Johnston leads the WHO-UNICEF Joint Monitoring Program for the Spot Washing Program. He said sepsis, which is the leading cause of death worldwide, can be prevented by improving hygiene in healthcare.

“It causes about 11 million deaths every year. And in health care settings, we know that sepsis deaths are linked to poor care, including poor sanitation… There are still 670,000 neonatal deaths from sepsis. So there’s a huge burden there that can be improved,” he said.

Evidence shows that the situation is better in hospitals than in small health care facilities. According to the World Health Organization, 46 developed countries are lagging behind in sanitation services, and 32 percent of health care facilities provide sanitation services.

Johnston said sub-Saharan Africa is the geographic region with the lowest coverage of basic services, which is a third lower than the global average.

“I mentioned hand hygiene services at 51% globally. Only 38% in sub-Saharan African countries… Water services globally at 78%, only 52% in sub-Saharan African countries… So a lot of work needs to be done in sub-Saharan African countries.” He said.

The World Health Organization estimates the cost of providing universal access to basic sanitation at less than $10 billion in 46 least developed countries. While that may seem like a lot, it amounts to less than $1 per person per year, according to World Health Organization officials. Officials say this is a fraction of what is currently spent on health care in those countries.