Water, sanitation, and healthcare waste management are essential services in healthcare facilities to ensure the quality of care and minimize infection risk. World Health Organization (WHO) Cox Bazar's sub-office supported the implementation of the Water and Sanitation for Health Facility Improvement Tool in 21 purposively selected HCFs in Rohingya refugee settlements. A total of 16 WASH FIT indicators from three of the seven WASH FIT domains (five on water, five on sanitation, and six on healthcare waste management) were monitored for 1 year employing a mixed method approach. After 1 year 67% of indicators in all three domains met minimum WASH FIT standards, indicating a significant (p ≤ 0.01) contribution to improved quality of care compared to 29% at the start in August 2018. By domain, 81% of water indicators (vs. 67% at the start), 76 vs. 24% for sanitation, and 48 vs. 33% for healthcare waste management met standards. Key informant interviews and focus group discussions affirm improvement in all three domains, including quality of care, staff satisfaction, and awareness of occupational risks and mitigation measures. Challenges remain, including limited budget, lack of leadership and absence of formal programs for improving water supply infrastructure, sanitation and healthcare waste management.

水、卫生设施和医疗废物管理是医疗机构的基本服务，可确保护理质量并最大程度地降低感染风险。世界卫生组织 (WHO) 考克斯巴扎尔分办事处支持在罗辛亚难民安置点的 21 个特意选定的卫生保健中心实施供水和卫生设施改善工具。采用混合方法对来自 7 个 WASH FIT 领域中的 3 个领域（5 个与水有关、5 个与卫生设施有关、6 个与医疗废物管理有关）的总共 16 项 WASH FIT 指标进行了为期一年的监测。一年后，所有三个领域的 67% 的指标均达到最低 WASH FIT 标准，这表明与 2018 年 8 月开始时的 29% 相比，对改善护理质量做出了显着贡献 ( p ≤ 0.01)。按领域划分，81% 的水指标（相对于开始时的 67%），卫生设施方面达到标准的比例为 76% 对 24%，医疗废物管理方面达到标准的比例为 48% 对 33%。关键知情人访谈和焦点小组讨论确认了所有三个领域的改进，包括护理质量、员工满意度以及对职业风险和缓解措施的认识。挑战依然存在，包括预算有限、缺乏领导力以及缺乏改善供水基础设施、卫生和医疗废物管理的正式计划。