Our project has trained and assessed 38 health facilities in conflict-affected regions of Ukraine using the WASH FIT improvement framework.

WASH FIT is a risk-based quality improvement tool covering the aspects of WASH and Infection Prevention and Control (IPC) in the Health Facility:

1. Water Supply
2. Sanitation
3. Hand Hygiene
4. Waste Management
5. Environmental cleaning
6. Energy and Environment
7. Human Resource and Facility Management

In today’s article, we will analyze the key findings of the Water Supply Domain.

Waste Management Domain Analysis – Methods

We assess sanitation facilities infrastructure across 20 standard WASH FIT indicators, each of which is scored 0, 1, or 2 depending on the criticality of the issue:

• 0: Gap (Non-functional)
• 1: Partially addressed
• 2: Fully functioning

To get the relative final score, we devided absolute score by max value of 40 (14*2) and multiplied by 100% (as a percentage of the maximum).

For example, if the facility scored 16 points, the relative score is 40% (16/40*100%).

Analysis: Criticality and Context

We break down that percentage into three criticality categories:

• Severe (<50%),
• Moderate (50–70%),
• Mild (>70%).

Looking at our first graph, the situation is largely manageable: less than 25% of assessed facilities fall into the “Critical” category (Relative score < 50%) with major gaps in their water domain.

Waste Management as Worst and Best perfoming Domain

Finally, we contextualize against the other six domains in the WASH FIT assessment (such as water supply or sanitation). We analyze whether Waste Management lands in a facility’s “Top 3” or “Bottom 3” performing areas.

The Analysis leaves very little room for doubt:

Waste Management is the most critical area of concern in Ukraine.

It frequently ranks in the Bottom 3 worst-performing domains, significantly underperforming across all geographical areas.

The bottom line:

There are 4-fold chances of the Water domain underperforms comparing to the domains such as Water Supply, Energy, and Enviroment, Environmental cleaning, or Sanitation.

Water Supply and Waste Management Domains

When you place water supply and waste management side by side, they read like mirror reflections. Water supply is very likely to come out ahead of other domains in WASH FIT studies, while waste management is four times more likely to fall behind the rest.