Ghana left to pick up US$1.57 billion cost of healthcare infections - WaterAid Research

Infections acquired in healthcare facilities are costing Ghana US$1.57 billion each year leading to thousands of preventable deaths. At least half of these infections could be prevented by improved water, sanitation, and hygiene (WASH) in these facilities, WaterAid unveils today in brand new research.

The new data, using World Bank methodology highlights that, if healthcare-acquired infections were to halve, then at least 31,300 lives could be saved across Ghana every year and a staggering $72 million could be saved from the national budget.

Ghana is one of seven African countries featured in the data alongside Nigeria, Malawi, Ethiopia, Zambia, Uganda, and Mali. In total, the new data shows that infections caused by lack of handwashing facilities, clean water and decent toilets are costing Sub-Saharan Africa $8.4 billion each year.

The new data shows that poor cleanliness and hygiene during medical care and recovery are major causes of infection transmissions. According to WaterAid, the most common healthcare-acquired infections are surgical site infections, bloodstream infections and respiratory tract infections, including pneumonia. The highest rates are found in intensive care units, neonatal wards and pediatric medical wards.

These findings paint a bleak picture, not only of the needless loss of life from entirely preventable causes, but of the fact these infections cost an average of 1.98% of the country’s Gross Domestic Product (GDP) - whilst treating the illnesses consumes an average 4.6% of total health budgets every year. This is a cost that will only increase as a greater share of these infections becomes resistant to antibiotics, warns WaterAid.

Right now, 45% of healthcare facilities in Ghana lack access to clean water. The continued suffering caused by these infections in lower-middle income countries only highlights the deep inequalities within global society and the inadequacy of sustainable water, sanitation and hygiene access among the most vulnerable communities.

Increased investment from donors and international financial institutions for health care facilities is essential to break the chain of infection, decrease the demand for antibiotics and reduce the opportunity for a resistant infection to become dominant.

WaterAid is calling for:

• Increased investments in Ghana’s healthcare system to ensure every healthcare facility in the country has clean water, sanitation, and hygiene services – our first line of defence against antimicrobial resistance (AMR) for both people living this reality daily and the global economy.

• Donor countries, multilateral development banks, and other financing sources must support local governments with financing as a matter of priority to tackle the AMR crisis and to deliver improved water, sanitation, and hygiene, as identified in country national action plans.

Reacting to the World Bank data, Ewurabena Yanyi-Akofur, Country Director, WaterAid Ghana said “The absence of basic sanitation and hygiene facilities along with clean water is not just a health crisis, it’s an economic one. We call for immediate action to secure increased financing from the Ghanaian government, alongside contributions from donors, multilateral development banks, and the private sector to support Ghana’s national WASH Infection Prevention Control action plans. Ensuring every healthcare facility in Ghana has access to clean water, sanitation, and hygiene services is imperative. The moment to take action is now!"

The new data comes ahead of the UN High Level Meeting on AMR this September which will see global leaders gather to discuss the critical need for all countries to prepare and fight against future pandemics and antimicrobial resistance.

Clean water, decent sanitation and good hygiene are the first line of defence against infections in healthcare settings. Yet WaterAid says that half of the world’s healthcare facilities do not have basic hygiene services – rising to two thirds across the 46 least developed countries.

When hospitals and clinics do not have these essential services, infections can rapidly spread - putting all patients, including new mothers and babies, at risk and leaving doctors with little choice but to prescribe antibiotics.

Bukari, the physician in charge at the Worikambo Health Center, Upper East Region, shared his experience prior a WaterAid intervention which constructed a limited solar mechanised water system for the facility. Bukari painted an appropriate before and after scenario linking improved access to WASH and a reduction in infections:

“It posed a lot of challenges, people were using the pit latrine and couldn’t wash their hands but then went on to eat, cook, handle babies, causing infections. For the patients, not having water posed a threat to them. They would use a pit latrine or open defecation which exposed them to snakes and other dangers in the bush. Not having water led to infections. We also could not sterilise our equipment, and that led to poor wound care as well as transfer of infections between patients. Poor sterilisation led to more infections.”

Linking access to clean water to a decreased rate of infections, Bukari added that: "We used to have a lot of diarrhoea and were prescribed a lot of antibiotics, but now we have less cases and our use of antibiotics has drastically reduced”.

WaterAid Ghana has so far helped millions of people in the hardest to reach and most marginalised communities across the country with clean water, decent toilets, and good hygiene services. Right now, about 1.3 million people in Ghana still live without clean water and 17% practice open defecation because they lack access to a decent toilet. WaterAid’s goal to ensure everyone, everywhere has access to these basics is not one that can be achieved alone.