Only 40% of health-care facilities worldwide met basic sanitation standards in 2025, according to a new report from the World Health Organization (WHO) and UNICEF. The assessment also found that only 59% met basic environmental-cleaning standards, leaving major gaps in two essential services used by patients and health workers.
The report, Progress on Water, Sanitation, Hygiene, Environmental Cleaning and Waste Management in Health-Care Facilities 2015–2025, was released on August 18 through the WHO-UNICEF Joint Monitoring Programme. It provides the first global estimates covering all five basic service areas in health-care facilities.
Water, Hygiene and Waste Services Have Higher Coverage
The 2025 data shows that 85% of health-care facilities had basic water services, while 72% had basic hygiene services and 71% had basic health-care waste management.
Coverage has improved since 2015 for water, hygiene and waste management, with hygiene recording the largest increase. However, about one in 10 facilities still had no water service, and a similar proportion had no sanitation service.
Sanitation Standards Remain Difficult to Meet
The 40% sanitation figure does not mean that most facilities lacked toilets. WHO and UNICEF found that 89% of facilities had some form of sanitation, while 85% had usable toilets.
The basic sanitation standard requires improved and usable toilets that meet the needs of patients and staff, including women, girls and people with limited mobility.
Only around half of facilities had sex-separated toilets, accessible toilets or menstrual-hygiene facilities. These missing features were among the main reasons facilities failed to meet the basic sanitation standard.
Environmental Cleaning Reaches 59%
Environmental cleaning requires both cleaning protocols and trained cleaning staff under the report’s basic standard.
Only 59% of health-care facilities met that standard in 2025. About 18% met neither requirement, covering facilities that serve a population of approximately 1.5 billion people.
The situation was worse in least developed countries, where only 24% of health-care facilities met the basic environmental-cleaning standard.
WHO identifies environmental cleaning as part of infection prevention and control because contaminated health-care environments can contribute to health-care-associated infections and antimicrobial resistance.
Global Data Coverage Is Expanding
The latest assessment increased the number of countries with estimates across all five service areas from 29 to 39.
However, important data gaps remain. WHO and UNICEF said global trends could not yet be calculated for sanitation or environmental cleaning, limiting comparisons over the full 2015–2025 period for those two services.
The organizations are calling for stronger routine monitoring that measures the reliability, safety, accessibility and cleanliness of services rather than only recording whether infrastructure is present.
UN Calls for Stronger Health-Care Facility Standards
The report follows a May 2026 UN General Assembly resolution calling for stronger national standards, regular monitoring and reporting, and costed and financed plans for sustainable and resilient WASH, waste and electricity services in health-care facilities.
The resolution also recognizes WHO and UNICEF as co-coordinators of global efforts and calls for continued support to countries and expanded data coverage through the Joint Monitoring Programme.
The Global Picture
The latest data shows a clear difference across essential health-care services. Water coverage reached 85%, compared with 72% for hygiene and 71% for waste management. Sanitation remained the lowest at 40%, while environmental cleaning reached 59%.
The report provides the first global baseline for sanitation and environmental cleaning, while also showing that countries still lack enough data to measure long-term global trends for those services.
WHO and UNICEF are now urging governments to strengthen monitoring, standards and financing so health-care facilities can provide basic water, sanitation, hygiene, cleaning and waste-management services consistently.
Bottom Line
Only four in 10 health-care facilities met basic sanitation standards in 2025, while fewer than six in 10 met the basic environmental-cleaning standard. Although water, hygiene, and waste-management services have improved since 2015, the latest assessment shows that major gaps remain in the basic infrastructure and services required across healthcare facilities worldwide.
