Polski
Business and economics, Issue 4/2026
Investment in WASH in maternity care – cheaper than the cost of neglect
Apr
A baby is born somewhere in the world every two seconds, and the facility where it takes place lacks access to clean water, safe sanitation and proper hygiene. The situation is most dire in sub-Saharan Africa and the Pacific part of Asia, where mothers routinely die from sepsis. Experts say the drama in the delivery rooms can be stopped by investing in WASH services.
WASH (from Water, Sanitation and Hygiene) stands for safe drinking water, sanitation and basic hygiene. Access to these is the sixth Sustainable Development Goal (SDG 6), and according to the World Health Organization, investments made in this area between 1990 and 2015 helped reduce deaths from diarrhea by 50 percent.
Drama in maternity hospitals
Born without water – that’s the title of a new report WaterAid has on the crisis in African and Asian maternity hospitals. The document analyzes the situation in 16 countries, where some 3,800 babies could be saved from death from sepsis each year. women. The remedy is shockingly simple: clean water, a decent toilet and basic handwashing and personal hygiene products. Unfortunately, 76 percent of births in Africa and 64 percent in Asia take place without this luxury.
The report’s authors conducted face-to-face interviews with more than 1,000 mothers from Uganda and 800 women from Malawi. Reports from the delivery rooms are dramatic. Water in hospital taps is either non-existent or brown; patients’ families often have to donate water by buckets from nearby streams or boreholes. Women have no way to wash themselves or their newborn after giving birth, and toilets are often clogged or unusable. Patients in Malawi spoke of overflowing latrines, standing sewage and bloody water in drainage channels outside maternity wards. This is not only a source of humiliation and a blatant example of gender inequality, but above all a huge health risk.
Sepsis the leading cause of death among those giving birth without water
As many as 1 in 9 deaths in Africa is caused by sepsis in the parturient (the worldwide rate is 1:1100). This serious infection in sub-Saharan countries carries a 144 times higher risk of death than in Europe. Dangerous pathogens spread because maternity staff do not have the opportunity to wash their hands, and hospital instruments and surfaces are not sterile. According to the report’s authors, improving WASH conditions in healthcare facilities would prevent more than 8,500 maternal deaths from sepsis and 9.7 million cases of illness each year.
WaterAid estimates that in some regions less than 30 percent of maternity wards have access to safe water. For this reason, many women choose to give birth at home, which does not improve their situation at all. Statistics show that each additional 1 percent of home births generates another death for one of the 400 mothers.
WASH infrastructure costs are lower than medical costs
The WaterAid report found that in low- and middle-GDP countries, an investment of $0.52-1.04 per capita per year would be enough to ensure that all health facilities have access to WASH services. In the 16 countries studied, this would result in a total savings of more than $200 million in avoided costs for treating sepsis in women after childbirth.
More generally, investments in WASH reduce the burden on health facilities, improve staff morale (70 percent of whom are women) and improve the quality of services – from immunizations to chronic disease management. They also reduce hospital-acquired infections(HAIs), which cost African economies about 1.14 percent of GDP and 5.6 percent of total health spending.
WASH services in healthcare facilities are also crucial in the fight against antimicrobial resistance (AMR). In 2019. Drug-resistant bacterial infections have caused 1.27 million deaths worldwide. They are also responsible for some 230,000 neonatal deaths from sepsis. Global health care costs associated with AMR are already $66 billion a year, and could rise to $159 billion by 2050. WASH services are one of the few interventions that reduce these costs in an immediate way.
Analysis by WaterAid indicates that every $1 invested in WASH yields more than $8.60 in health and economic benefits per person. Reducing maternal and neonatal morbidity has a direct impact on total health care costs and economic development.
Investment priority – WaterAid recommendations
The WaterAid report urges national governments to make WASH services in hospitals an absolute priority and allocate adequate resources for their implementation. All patients will benefit from the investment, but it is the special needs of women that should be prioritized. Hence, it is important for women to be involved in the planning and implementation of new facilities. Past experience unfortunately shows that male architects and engineers neglect many practical considerations, crucial for safe and easy access to water and sanitation.
Investment in WASH services requires extensive involvement of the financial sector. This requires a systematic review of financing gaps, identification of priority areas for investment in national and local budgets, and inclusion of WASH in external financing plans.
Water, sanitation and hygiene are not mercy – they are a right. Let’s prioritize them, and we will all benefit – says Walter Omoko, a Maternal and Child Health Department official in northern Uganda, quoted in the WaterAid report.
pic. main: Polina Koroleva/Unsplash
In writing the article, I used:
Born without water: the crisis in our delivery rooms, WaterAid, March 18, 2026.
