Climate-Resilient WASH in Viet Nam's Healthcare Facilities: Beyond Water Access to Safe Care

Climate-Resilient WASH in Viet Nam's Healthcare Facilities: Beyond Water Access to Safe Care

IMPLEMENTATION INSIGHTS · CLIMATE-RESILIENT HEALTHCARE

Last reviewed: October 25, 2026

A healthcare facility may have running water, functioning toilets, hand hygiene stations, and a cleaning team working throughout the day. From an infrastructure perspective, the essential services appear to be in place. But whether they consistently support safe care is a different question.

A hand hygiene dispenser may be empty when a healthcare worker needs it. A patient using a wheelchair may be unable to enter an otherwise functioning toilet. Cleaning procedures may be documented, yet the staff responsible for carrying them out may lack appropriate training, equipment, or supervision.

These examples highlight an important distinction between the availability of water, sanitation, and hygiene services and their actual performance in healthcare settings.

Climate change makes this distinction increasingly relevant. Drought, flooding, changing water quality, and other environmental pressures can affect services that healthcare facilities depend on every day. Even where infrastructure is already available, its reliability may change as local conditions become more difficult.

This is why climate-resilient water, sanitation, and hygiene, commonly referred to as WASH, should be understood as part of healthcare quality and patient safety rather than simply an infrastructure or environmental concern.

For Viet Nam, the challenge is not necessarily to introduce entirely new systems. It is to understand whether existing arrangements are safe, accessible, appropriate for their intended purposes, and capable of continuing to support care as environmental conditions change.

Why the 2026 WHO/UNICEF Report Matters

On August 18, 2026, the World Health Organization (WHO) and UNICEF published Progress on Water, Sanitation, Hygiene, Environmental Cleaning and Waste Management in Health Care Facilities 2015–2025.

Prepared through the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP), the report provides updated estimates of essential WASH services in healthcare facilities worldwide.

For the first time, global estimates were available for all five basic service areas monitored by the program, including sanitation and environmental cleaning.

The findings reveal important differences between these services.

In 2025, an estimated 85% of healthcare facilities globally had basic water services, while 72% had basic hygiene services. However, only 40% met the requirements for basic sanitation, and 59% had basic environmental cleaning services.

The report also estimated that 71% of facilities had basic healthcare waste management services, an area with distinct operational, infection prevention, and environmental requirements.

These figures are important, but they need to be interpreted carefully.

The finding that only 40% of healthcare facilities had basic sanitation does not mean that the remaining 60% had no toilets. WHO and UNICEF reported that approximately 85% of facilities globally had usable toilets. Many facilities nevertheless failed to meet additional requirements concerning accessibility, privacy, menstrual hygiene, and the needs of patients and healthcare workers.

Similarly, the 59% estimate for basic environmental cleaning does not mean that cleaning was performed effectively in 59% of facilities. The indicator assesses whether appropriate cleaning protocols are available and whether personnel with cleaning responsibilities have received training. It does not directly measure the quality or consistency of cleaning practices.

The global estimates are also derived from available national data, which vary in coverage, collection periods, and completeness. They should not be presented as direct observations of every healthcare facility or interpreted as national coverage figures for Viet Nam.

Although the report identifies improvements in basic water, hygiene, and healthcare waste management services between 2015 and 2025, sufficient comparable data are not yet available to establish global trends for sanitation and environmental cleaning.

The significance of the report therefore extends beyond the percentages themselves. It demonstrates why monitoring needs to distinguish basic service availability from reliability, accessibility, safety, and actual performance.

For healthcare organizations, this distinction is fundamental. Meeting an international basic service indicator is an important starting point, but it does not necessarily establish that every relevant clinical or operational requirement has been met.

Water Safety Depends on How Water Is Used

Water is essential to healthcare, but not every activity requires water with the same technical characteristics.

Water may be used for personal hygiene, sanitation, environmental cleaning, food preparation, instrument reprocessing, laboratory operations, and specialized clinical procedures. The quality requirements for these activities can differ substantially.

The JMP definition of a basic water service requires water from an improved source to be available on the premises at the time of assessment.

This provides useful information about access, but it does not establish that water meets every applicable quality requirement, remains continuously available, or is suitable for all clinical purposes.

For example, water that complies with the applicable requirements for domestic use should not automatically be considered suitable for hemodialysis. Such applications have additional technical requirements and may require specialized treatment systems, testing, maintenance, and monitoring.

Medical equipment reprocessing and other specialized activities may also require water of defined quality, depending on the procedure, equipment, and relevant technical guidance.

The appropriate question is therefore not simply whether water is available, but whether its quality and reliability are suitable for the activities that depend on it.

This includes considering what happens after water enters the healthcare facility.

Storage tanks, internal distribution systems, maintenance conditions, and the location of water outlets can influence service quality. A facility may receive an adequate supply while experiencing problems in particular departments or at certain times.

Climate-related environmental changes can introduce additional concerns.

Prolonged dry periods may affect source availability. Flooding can compromise water infrastructure and increase contamination risks. In coastal and delta areas, saline intrusion may affect source-water characteristics and the suitability of existing treatment arrangements.

The implications depend on the local environment, the water source, the facility's infrastructure, and the clinical services provided.

A coastal hospital, an inland urban clinic, and a rural health station may therefore require different approaches to water quality assurance and resilience.

Climate-resilient water management does not mean that every healthcare facility needs an identical treatment system. It means understanding which services depend on water, what quality those services require, where vulnerabilities exist, and what safeguards are appropriate.

Hand Hygiene Requires Reliable Conditions, Not Just Equipment

Hand hygiene remains a fundamental component of infection prevention and control. Yet the availability of a sink or alcohol-based hand rub dispenser does not automatically mean that effective hand hygiene can be performed consistently.

The JMP basic hygiene indicator requires functional hand hygiene facilities at points of care and handwashing facilities with water and soap at or near toilets.

At points of care, a functional hand hygiene facility may consist of alcohol-based hand rub or a basin with water and soap.

This definition is more meaningful than merely confirming that sinks are installed somewhere within a healthcare facility. It recognizes that hand hygiene materials must be available where care is delivered.

Nevertheless, the indicator primarily measures the availability of essential facilities and materials. It does not directly measure whether healthcare workers perform hand hygiene at the appropriate moments or use the correct technique.

In practice, hand hygiene depends on several interconnected conditions.

Materials must be consistently replenished, facilities need to be accessible, and established practices must fit clinical workflows. Staff also need appropriate training, feedback, and organizational support.

Alcohol-based hand rub is appropriate for many routine clinical indications when hands are not visibly soiled. Soap and water remain necessary in circumstances specified by applicable infection prevention guidance. Healthcare organizations should follow the relevant professional protocols rather than assume that one method can replace the other in every situation.

Patients, caregivers, and visitors may also require appropriate access to hand hygiene facilities, particularly when they participate in activities where infection prevention measures are necessary.

From a climate resilience perspective, healthcare organizations should consider whether the conditions supporting hand hygiene can be maintained when water availability, supply arrangements, or facility operations are affected by environmental pressures.

The goal is not simply to demonstrate that equipment exists. It is to maintain the practical conditions that allow safe hand hygiene to occur whenever required.

Sanitation Is Also About Accessibility, Privacy, and Dignity

Sanitation is sometimes assessed through the number or availability of toilets. However, a functioning toilet does not necessarily meet the needs of everyone who may need to use it.

Healthcare facilities serve people with different physical abilities, clinical conditions, and personal requirements.

An older patient may need assistance with mobility. Someone recovering from surgery may have difficulty using a conventional toilet. A wheelchair user may require sufficient space, accessible fixtures, and safe transfer arrangements.

Women and girls may need appropriate facilities for menstrual hygiene. Patients receiving care during pregnancy or after childbirth may have additional accessibility and hygiene needs. Healthcare workers also require suitable sanitation facilities throughout their working hours.

The WHO/UNICEF JMP definition of basic sanitation recognizes several of these requirements.

To qualify as a basic sanitation service, facilities must have improved and usable toilets that meet specified conditions, including arrangements for staff, sex separation, menstrual hygiene, and accessibility for people with limited mobility.

These are not merely matters of comfort.

A toilet that cannot be used safely by a patient with limited mobility may create practical difficulties and risks during care. Inadequate privacy can affect dignity. Poor maintenance or cleaning can undermine otherwise suitable infrastructure.

Sanitation services also require ongoing management.

A facility may meet its intended design requirements when first commissioned, but accessibility and hygiene conditions can deteriorate through inadequate maintenance, damaged fixtures, insufficient supplies, or changes in how spaces are used.

Climate-related pressures introduce additional considerations. Flooding may affect toilets, drainage, or wastewater systems, while water shortages may compromise the operation of certain sanitation facilities. The extent of these risks depends on the infrastructure and local conditions.

For healthcare organizations, the relevant objective is to maintain sanitation services that are usable, hygienic, accessible, and appropriate for the people they serve.

A small outpatient clinic and a large referral hospital will not require identical arrangements. However, both need to understand whether their sanitation facilities function safely in practice and how problems are identified and addressed.

Environmental Cleaning Is a Managed Patient Safety Process

Environmental cleaning is an important part of infection prevention and control because contaminated surfaces and care environments can contribute to the transmission of microorganisms.

Patient rooms, examination areas, treatment spaces, toilets, and frequently touched surfaces require cleaning arrangements appropriate to their functions and associated infection risks.

However, effective environmental cleaning involves more than having a written schedule.

The WHO/UNICEF 2026 report estimated that 59% of healthcare facilities globally met the definition of a basic environmental cleaning service in 2025.

Under the JMP framework, this requires cleaning protocols and training for all personnel with cleaning responsibilities.

These are important foundations, but they do not directly demonstrate that cleaning is performed correctly during every shift or that the intended level of cleanliness is consistently achieved.

Differences in implementation may arise from unclear responsibilities, insufficient supplies, unsuitable equipment, gaps in training, staffing arrangements, or inadequate supervision.

Cleaning needs also vary between clinical settings.

An administrative office, an outpatient examination room, an inpatient ward, and an isolation area do not necessarily require identical cleaning procedures or frequencies.

Cleaning methods, products, equipment, and monitoring arrangements should reflect the relevant infection risks, applicable professional guidance, and manufacturer instructions.

Cleaning and disinfection should not be treated as interchangeable in every circumstance. Whether disinfection is necessary, and which approach is appropriate, depends on the setting and the relevant infection prevention requirements.

The safety of cleaning personnel is equally important. Staff need appropriate training, equipment, protective measures, and instructions for handling and using cleaning products safely.

Where environmental cleaning is outsourced, the healthcare organization still needs suitable arrangements for overseeing the service and ensuring that it meets the requirements of the care environment.

Climate resilience adds another practical consideration. Changes in water availability, environmental contamination, or facility conditions may affect the resources and procedures needed to maintain safe cleaning services.

The organization therefore needs to understand how essential cleaning activities will be maintained or appropriately adjusted when normal conditions are disrupted.

Reliable environmental cleaning is ultimately an operational process involving people, resources, supervision, and continuous improvement. Documentation is necessary, but documentation alone does not establish effective performance.

What Makes WASH Climate-Resilient?

Climate-resilient WASH should not be understood as a separate set of hygiene practices introduced only during disasters.

It involves strengthening the ability of essential water, sanitation, hygiene, and related environmental health services to remain safe, suitable, and functional under current and changing climate conditions.

This requires more than routine infrastructure maintenance, although maintenance remains an important foundation.

Healthcare organizations need to understand the environmental pressures that could affect essential services and whether existing arrangements are sufficiently robust for the risks they face.

For example, flooding may affect water sources, distribution systems, storage facilities, sanitation infrastructure, or wastewater arrangements. Heavy rainfall can increase contamination risks, while prolonged drought may reduce water availability or place additional pressure on supply systems.

In some coastal and delta areas of Viet Nam, saline intrusion may require closer attention to source-water quality and the suitability of existing treatment systems.

Water supply may also depend on electricity for pumping, treatment, or distribution. An interruption to electricity can therefore become a WASH problem even when water remains available at the source.

These connections matter because healthcare services depend on several systems working together.

A water treatment system may be technically adequate but unable to operate during an extended power interruption. A storage arrangement may provide reserve capacity but require safeguards to maintain water quality. A sanitation system may function during ordinary conditions yet become vulnerable to flooding.

Climate resilience requires healthcare organizations to examine these dependencies rather than assess each component in isolation.

It is also important to distinguish climate-related risks from ordinary operational weaknesses.

An empty hand hygiene dispenser is not necessarily a consequence of climate change. A poorly maintained water tank may reflect routine management problems. However, weaknesses that already exist during normal operations can make a facility less capable of coping with additional environmental pressures.

Strengthening routine performance and preparing for climate-related disruptions are therefore complementary activities.

The appropriate response should remain proportionate to the facility's location, clinical services, resources, and identified risks. Not every healthcare organization needs the same infrastructure investments or technical solutions.

The central objective is to maintain essential conditions for safe care, including when environmental circumstances become more challenging.

Translating Climate Risks Into Practical Readiness

Understanding climate resilience becomes more useful when healthcare organizations connect environmental risks with specific clinical and operational consequences.

A practical starting point is to identify which essential services depend on water, sanitation, hand hygiene, and environmental cleaning.

For a hospital, these dependencies may include patient care, infection prevention activities, food services, medical equipment reprocessing, and specialized treatments. A smaller clinic may have fewer technical systems, but it still needs to maintain appropriate hygiene, sanitation, and cleaning conditions.

Once these dependencies are understood, the organization can consider which environmental events or gradual changes could affect them.

The assessment should reflect credible local risks rather than assume that every potential climate hazard is equally relevant.

For example, a facility exposed to flooding may need to examine the location and protection of water storage, pumps, electrical equipment, drainage, and sanitation infrastructure. A facility facing recurring water scarcity may place greater emphasis on supply reliability, demand, storage arrangements, and the suitability of alternative sources.

The next question concerns preparedness.

Where a critical service depends on a single system, healthcare managers may need to consider how a failure would be detected, what alternatives are feasible, who can authorize corrective action, and which clinical activities would be affected.

Backup arrangements should be designed according to the facility's actual requirements. Simply providing an alternative water source is not sufficient if its quality has not been assessed for the intended use.

Similarly, restoring water supply after a disruption does not automatically establish that the water is suitable for every clinical activity. Inspection, testing, flushing, disinfection, or other measures may be necessary according to the circumstances and applicable technical requirements.

Plans also need clear operational responsibilities.

Engineering or maintenance personnel may understand the technical limitations of a water system, while infection prevention professionals can identify clinical hygiene implications. Healthcare managers must connect this information with service priorities, resources, and decisions about continued operations.

A multidisciplinary approach helps ensure that environmental concerns are translated into decisions relevant to patient care.

The purpose is not to create elaborate emergency plans for every conceivable situation. It is to identify credible risks, understand their consequences, establish proportionate safeguards, and ensure that relevant personnel know how to respond.

Using WASH FIT to Support Practical Improvement

WHO and UNICEF developed the Water and Sanitation for Health Facility Improvement Tool, commonly known as WASH FIT, to help healthcare facilities assess and improve essential environmental health services.

The second edition, published on April 25, 2022, provides a risk-based quality improvement approach covering water, sanitation, hand hygiene, environmental cleaning, healthcare waste management, and selected aspects of energy, buildings, and facility management.

It also gives greater attention to climate and environmental considerations, gender, equity, inclusion, and sustainable implementation.

The practical value of WASH FIT lies in connecting assessment with improvement.

Rather than treating WASH as a collection of isolated infrastructure requirements, the approach encourages healthcare organizations to understand their existing conditions, identify risks, prioritize improvements, implement actions, and review progress over time.

This is particularly relevant where responsibility for essential services is distributed across several departments.

Healthcare managers, infection prevention professionals, engineering and maintenance personnel, cleaning staff, procurement teams, and other relevant workers may each hold different information about the same operational problem.

For example, inadequate hand hygiene conditions may arise from equipment location, supply shortages, maintenance issues, or inconsistent clinical practices. Addressing the problem requires understanding its causes rather than assuming that a single intervention will be sufficient.

The same principle applies to water quality, sanitation accessibility, and environmental cleaning.

In February 2025, WHO and UNICEF published a global report on WASH FIT implementation, examining experiences from different countries and approaches to adoption, improvement, and long-term sustainability.

The report demonstrates growing international use of WASH FIT while also recognizing continuing challenges, including institutional integration, financing, and sustained implementation.

These experiences can inform healthcare improvement efforts in Viet Nam, but they should not be interpreted as evidence that every application will produce identical outcomes.

WASH FIT is an international quality improvement resource. It is not, by itself, a statutory hospital licensing requirement in Viet Nam, nor does its use constitute independent WHO accreditation or certification.

Healthcare organizations can draw on its methods while remaining responsible for complying with applicable Vietnamese laws, technical regulations, and professional requirements.

Managing and Measuring WASH as Part of Healthcare Quality

Essential WASH services are often managed by different departments within the same healthcare organization.

Facilities personnel may oversee water infrastructure and sanitation systems. Infection prevention teams may develop hygiene and environmental cleaning protocols. Cleaning personnel carry out daily activities, while procurement teams arrange supplies and external services.

These responsibilities are individually important, but the reliability of WASH depends on how effectively they are coordinated.

A recurring cleaning problem may not be resolved by revising a procedure if the underlying issue is insufficient equipment or delayed procurement. Similarly, a water quality concern may require technical investigation beyond the responsibilities of the clinical department where the problem was first identified.

Healthcare organizations therefore benefit from clearly defined responsibilities, practical communication arrangements, and mechanisms for escalating concerns.

Monitoring is equally important, but the measures used should reflect what the organization is trying to understand.

The JMP indicators provide a useful international framework for describing basic service coverage. They do not replace more detailed assessments of clinical suitability, operational reliability, or actual performance.

For example, the presence of hand hygiene facilities does not demonstrate hand hygiene compliance. Cleaning protocols and training records do not establish that every required cleaning activity has been completed correctly.

Likewise, evidence that water is available on the premises does not establish that water quality is appropriate for every intended use.

A more informative approach considers several related dimensions: whether a service is available, whether it is suitable for its intended purpose, whether people can use it safely, whether it operates reliably, and whether problems are identified and corrected.

The evidence required will differ according to the service and the risks involved.

Water quality testing may be necessary for particular parameters or clinical applications. Inspection and maintenance records can provide information about infrastructure performance. Professional observation can help assess selected practices, while feedback from patients and staff may identify accessibility or usability problems that are not apparent from technical records.

Healthcare organizations should also avoid assuming that improvements in a single WASH indicator automatically demonstrate reductions in healthcare-associated infections.

WASH is an important foundation of infection prevention, but infection rates and other clinical outcomes are influenced by multiple factors. Claims about the effects of specific interventions should therefore be supported by appropriate evidence.

Monitoring should help decision-makers understand whether essential services are becoming safer and more reliable, where weaknesses remain, and whether corrective actions are working.

The purpose is not simply to generate favorable scores. It is to support informed and sustained improvement.

What Experience From Viet Nam Tells Us

Viet Nam has already gained practical experience linking climate resilience, environmental sustainability, and essential WASH services in healthcare settings.

On December 22, 2023, WHO Viet Nam reported on a pilot project involving three district hospitals selected to explore a model of climate-resilient and environmentally sustainable healthcare facilities between 2021 and 2023.

The project involved the National Institute of Occupational and Environmental Health, WHO, and the Viet Nam Health Environmental Management Agency.

The model was organized around four groups of activities, known in Vietnamese as the 4Ns. These covered water, sanitation, hygiene, and healthcare waste management; capacity building and awareness; energy efficiency and green energy; and improvements in infrastructure, technology, and products.

WHO described the pilot as an opportunity to review implementation experiences and contribute to the development of national guidance.

This experience is relevant because it shows that climate resilience and WASH have already been considered together within healthcare facilities in Viet Nam.

It also illustrates the importance of approaching climate-resilient healthcare through more than one technical system.

Safe water services, appropriate sanitation, trained personnel, functioning infrastructure, and reliable energy arrangements are interconnected. Improvements in one area may depend on decisions or resources managed elsewhere.

However, the pilot should not be presented as evidence that all interventions produced the same outcomes, that the model has been validated for every type of healthcare facility, or that it has been implemented nationally.

Its value lies in the practical experience and questions it raises for future improvement.

How should a healthcare facility identify the environmental risks most relevant to its operations? Which improvements are feasible within its available resources? How can engineering, infection prevention, clinical, and management teams coordinate their responsibilities? What evidence is needed to determine whether improvements remain effective over time?

These questions are relevant to healthcare organizations across Viet Nam, although the appropriate answers will vary.

A district hospital in a flood-prone area may have different priorities from an urban specialty clinic. A coastal facility affected by changing water quality may require different technical arrangements from an inland healthcare provider.

Viet Nam's geographical diversity, healthcare delivery arrangements, and differences in available resources make local assessment especially important.

International guidance can provide useful frameworks, but practical implementation needs to reflect the facility's actual circumstances and scope of services.

Applying International Guidance Within Viet Nam's Legal Framework

Improving WASH in healthcare facilities requires attention to applicable Vietnamese legislation, technical regulations, and professional requirements.

The Law on Medical Examination and Treatment, No. 15/2023/QH15, which took effect on January 1, 2024, provides an important legal foundation.

Article 74 addresses infection prevention and control in healthcare facilities. It includes measures relating to infection surveillance, standard and transmission-based precautions, medical equipment, hand hygiene, environmental hygiene, and other infection prevention activities.

The Article also establishes responsibilities concerning the organization of infection prevention activities and the provision of appropriate facilities, equipment, protective arrangements, and hygiene conditions.

Article 75 addresses healthcare waste management and environmental protection, requiring healthcare facilities to comply with the relevant environmental protection legislation.

Ministry of Health Circular No. 16/2018/TT-BYT, dated July 20, 2018, provides further requirements concerning infection prevention and control in healthcare facilities.

At the time of this review, the Circular continued to be recorded as effective. In September 2026, the Ministry of Health released a draft replacement for public consultation.

The proposed changes are relevant to future infection prevention governance, but a draft does not establish binding requirements. Healthcare organizations should continue to follow the instruments currently in force and review any replacement once formally issued and effective.

The Ministry of Health has also issued professional guidance concerning hand hygiene and environmental surface cleaning, including materials approved under Decision No. 3916/QD-BYT, dated August 28, 2017.

These resources should be interpreted alongside applicable current regulations, relevant technical guidance, and the organization's clinical responsibilities.

Water quality is governed by a related but distinct regulatory framework.

Ministry of Health Circular No. 52/2024/TT-BYT, dated December 31, 2024, took effect on July 1, 2025. It introduced QCVN 01-1:2024/BYT, the National Technical Regulation on Domestic Water Quality, together with provisions concerning water quality inspection and monitoring.

The regulation establishes requirements for water used for domestic purposes within its defined scope.

However, compliance with domestic water quality requirements should not automatically be interpreted as demonstrating suitability for specialized clinical procedures or medical equipment.

Such activities may require additional water quality specifications, treatment systems, monitoring, or other safeguards according to the intended use and applicable professional and technical requirements.

Healthcare organizations also need to understand the respective responsibilities of water suppliers, water users, and competent authorities under the relevant legal provisions and service arrangements.

Environmental protection and healthcare waste management involve additional obligations.

The Law on Environmental Protection, No. 72/2020/QH14, and its applicable implementing regulations provide the broader environmental legal framework.

Ministry of Health Circular No. 20/2021/TT-BYT addresses healthcare waste management within healthcare facility premises, including requirements relevant to classification, collection, storage, and management within its regulatory scope.

Healthcare waste management is included in the broader international WASH framework, but its legal, technical, and environmental requirements should not be treated as interchangeable with routine environmental cleaning.

The same principle applies to wastewater and other environmental systems, which may be subject to distinct regulatory and technical requirements.

International guidance can support healthcare facilities in identifying risks and organizing improvement activities. However, WHO/UNICEF JMP indicators and WASH FIT do not automatically become binding Vietnamese regulatory requirements.

Meeting an international monitoring definition should not be presented as proof of full legal compliance, and using an international improvement tool does not replace the need to meet applicable national requirements.

For healthcare organizations, the appropriate approach is to use credible international evidence to support improvement while maintaining a clear distinction between professional guidance, voluntary quality improvement methods, and legally binding obligations.

What Climate & Health Vietnam Can Contribute

For Climate & Health Vietnam (CHVN), climate-resilient WASH is an area where international evidence can be connected with practical questions about healthcare quality, patient safety, governance, and implementation.

The opportunity is not simply to raise awareness that healthcare facilities need water and sanitation. These are already recognized as essential services.

A more useful contribution is to help healthcare professionals understand what different WASH indicators actually measure, where basic service assessments have limitations, and how climate-related risks can be considered within existing quality and operational management arrangements.

This includes explaining why water availability should be distinguished from water quality and clinical suitability, why sanitation accessibility matters, and why environmental cleaning requires attention to implementation rather than documentation alone.

It also involves considering how environmental pressures may affect these services and what organizations can learn from established risk-based improvement approaches.

CHVN can contribute through evidence synthesis, professional education, implementation-oriented discussion, and collaboration with relevant organizations and specialists.

Potential areas of professional learning include the interpretation of international WASH monitoring frameworks, climate-related vulnerabilities in healthcare facilities, the relationship between WASH and infection prevention, and practical approaches to assessment, monitoring, and improvement.

Such discussions may bring together healthcare managers, infection prevention professionals, environmental health specialists, engineering and maintenance personnel, researchers, and other relevant stakeholders.

CHVN's role should remain clearly defined.

Its educational materials should not be presented as official WHO assessments, and references to WASH FIT or JMP indicators should not imply authority to certify healthcare facilities or determine regulatory compliance.

The platform can help make credible evidence more accessible, explain its practical relevance, and encourage informed professional collaboration without overstating the conclusions supported by available information.

This is consistent with a broader approach to climate-resilient healthcare in which governance, quality improvement, patient safety, and operational implementation are central to building more dependable services.

Beyond Water Access to Safe Care

Water, sanitation, hygiene, and environmental cleaning are sometimes described as supporting services within healthcare facilities. In practice, they are among the conditions that make safe, appropriate, and dignified care possible.

A functioning water connection does not establish that every intended clinical use is safe. A toilet may be available without being accessible to the people who need it. A cleaning procedure may be documented without being consistently implemented.

Climate change makes these distinctions more important because changing environmental conditions can place additional pressure on systems that healthcare organizations rely on every day.

The WHO/UNICEF 2026 report provides a timely reminder that progress should not be assessed solely through installed infrastructure or basic service coverage.

Healthcare organizations also need to understand whether essential services are suitable for their intended uses, reliably available, accessible to the people who depend on them, and effectively managed.

For Viet Nam, this creates an opportunity to strengthen climate resilience through established areas of healthcare management, infection prevention, environmental health, and quality improvement.

The starting point does not need to be a new program or a major infrastructure investment. It can begin with understanding how essential services function in practice, identifying the most relevant vulnerabilities, clarifying responsibilities, and taking proportionate steps to improve reliability and safety.

WHO's Global Water, Sanitation and Hygiene: Annual Report 2025, published on October 5, 2026, reinforces the importance of strengthening systems so that WASH services are not only expanded, but also made safe, equitable, resilient, and sustainable.

For healthcare facilities, this means treating climate resilience as part of the ongoing responsibility to maintain conditions for safe care rather than as an environmental activity disconnected from clinical operations.

Climate-resilient WASH is ultimately about more than providing water, toilets, and cleaning procedures. It is about ensuring that these essential services remain safe, accessible, appropriate, and dependable for the people and healthcare activities that rely on them, even as environmental conditions change.

Selected References and Policy Context

International Guidance and Evidence

World Health Organization and UNICEF. Progress on Water, Sanitation, Hygiene, Environmental Cleaning and Waste Management in Health Care Facilities 2015–2025. WHO/UNICEF Joint Monitoring Programme. August 18, 2026.

World Health Organization and UNICEF. WHO/UNICEF Report Highlights Gaps in Health Facility Sanitation. August 18, 2026.

World Health Organization. WHO Global Water, Sanitation and Hygiene: Annual Report 2025. October 5, 2026.

World Health Organization and UNICEF. WASH FIT: A Practical Guide for Improving Quality of Care Through Water, Sanitation and Hygiene in Health Care Facilities. Second edition. April 25, 2022.

World Health Organization and UNICEF. Implementation of the Water and Sanitation for Health Facility Improvement Tool (WASH FIT): Global Report. February 12, 2025.

World Health Organization and UNICEF. Universal Water, Sanitation, Hygiene, Waste and Electricity Services in All Health Care Facilities to Achieve Quality Care: Global Framework for Action 2024–2030. June 22, 2024.

World Health Organization. Safe, Climate-Resilient and Environmentally Sustainable Health Care Facilities: An Overview. November 3, 2024.

World Health Organization. Global Report on Infection Prevention and Control 2024. November 29, 2024.

World Health Organization Regional Office for Europe. Building Climate Resilient WASH Services in Health-Care Facilities: Guide for Players and Facilitators. February 28, 2024.

Selected Evidence and Experience From Viet Nam

World Health Organization Viet Nam. Viet Nam: Learning Lessons on Climate Resilient and Environmentally Sustainable Health-Care Facilities. December 22, 2023.

Viet Nam Policy and Regulatory Context

National Assembly. Law on Medical Examination and Treatment No. 15/2023/QH15, effective January 1, 2024, particularly Articles 74 and 75 concerning infection prevention and control, healthcare waste management, and environmental protection.

Ministry of Health. Circular No. 16/2018/TT-BYT, dated July 20, 2018, concerning infection prevention and control in healthcare facilities, as applicable at the time of review.

Ministry of Health. Decision No. 3916/QD-BYT, dated August 28, 2017, approving infection prevention and control guidance, including hand hygiene and environmental surface cleaning.

Ministry of Health. Circular No. 52/2024/TT-BYT, dated December 31, 2024, concerning the national technical regulation and provisions for inspection and monitoring of clean water quality for domestic use, effective July 1, 2025.

Ministry of Health. QCVN 01-1:2024/BYT — National Technical Regulation on Domestic Water Quality, issued with Circular No. 52/2024/TT-BYT.

National Assembly. Law on Environmental Protection No. 72/2020/QH14, as amended.

Ministry of Health. Circular No. 20/2021/TT-BYT, dated November 26, 2021, concerning healthcare waste management within healthcare facility premises.

Professional scope: This article is intended for professional education, evidence synthesis, and knowledge sharing. It does not constitute individualized clinical advice, procedure-specific infection prevention instructions, water quality testing or certification, a facility-specific WASH assessment, legal advice, or regulatory, accreditation, or certification criteria. References to WHO, UNICEF, and other international publications do not imply endorsement of Climate & Health Vietnam by those organizations. Healthcare organizations should apply current Vietnamese regulations, relevant technical and professional requirements, and qualified clinical, infection prevention, environmental health, and engineering judgment when assessing and improving WASH services.