Access to basic water, sanitation and hygiene, waste management and environment cleaning (WASH) in healthcare facilities (HCFs) is critical for infection prevention and control. The WHO/UNICEF 2019 global baseline report on WASH in HCFs indicates that 51 and 23% of those in sub-Saharan Africa have basic access to water and sanitation, respectively. Guided by the political ecology of health theory, this research engaged with 13 key informants, 16 healthcare workers and 31 community members on their experiences on the implementation, use and management of WASH in HCFs. Interviews were conducted in one informal settlement and three rural dispensaries in Kisumu, Kenya from May to September 2019. Findings indicate improvement in water access, yet water quality and other WASH service components remain a challenge even in newly constructed maternity facilities, thus impacting local health promotion efforts. Institutional challenges such as limited financial resources and ecological factors like climate variability and disease outbreaks compromised WASH infrastructure and HCF resilience. To achieve Sustainable Development Goal 3, good health and well-being, as well as Sustainable Development Goal 6, clean water and sanitation, the prioritisation of WASH in HCFs is required at all levels, from the local to the global.

在医疗保健机构 (HCF) 中获得基本的水、环境卫生和个人卫生、废物管理和环境清洁 (WASH) 对于感染预防和控制至关重要。世卫组织/联合国儿童基金会 2019 年关于 HCF 中 WASH 的全球基线报告表明，撒哈拉以南非洲地区分别有 51% 和 23% 的人能够获得基本的水和卫生设施。本研究以健康理论的政治生态学为指导，与 13 位关键信息提供者、16 位医护人员和 31 位社区成员就他们在 HCF 中实施、使用和管理 WASH 的经验进行了交流。2019 年 5 月至 9 月在肯尼亚基苏木的一个非正式定居点和三个农村药房进行了采访。然而，即使在新建的妇产设施中，水质和其他 WASH 服务组成部分仍然是一个挑战，从而影响当地的健康促进工作。财政资源有限以及气候变异和疾病爆发等生态因素等制度挑战损害了 WASH 基础设施和 HCF 的复原力。为了实现可持续发展目标 3（良好的健康和福祉）以及可持续发展目标 6（清洁水和卫生设施），从地方到全球的各个层面都需要优先考虑 HCF 中的 WASH。