A new WHO/UNICEF report provides, for the first time, global estimates for all five basic WASH services in health care facilities. The two newly measured indicators, sanitation and environmental cleaning, turn out to be the weakest: only 40% of facilities meet basic sanitation standards and 59% meet basic environmental cleaning standards, exposing a gap that earlier editions of the report could not see because it had never been measured before.
Published by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP), the report Progress on water, sanitation, hygiene, environmental cleaning and waste management in health care facilities 2015–2025 covers 237 countries, areas and territories and supersedes all previous JMP progress updates on the topic.
Key figures
→ 40% of health facilities worldwide have basic sanitation services, the weakest of all five indicators measured.
→ 59% have basic environmental cleaning services, the second weakest.
→ 85% have basic water services, up from 76% in 2015.
→ 72% have basic hygiene services, up from 55% in 2015.
→ 71% have basic waste management services, up from 59% in 2015.
→ 936 million people are served by facilities with no sanitation service at all.
→ 1.5 billion people are served by facilities with no environmental cleaning service at all.
Established services show steady gains
The three services JMP has tracked since 2019, water, hygiene and waste management, all show clear improvement.
| Service | 2015 | 2025 | Change |
|---|---|---|---|
| Water | 76% | 85% | +9 points |
| Hygiene | 55% | 72% | +17 points |
| Waste management | 59% | 71% | +12 points |
Share of health facilities with basic service. Source: JMP, 2026.
“Reliable water, accessible sanitation, hand hygiene, effective environmental cleaning and safe waste management must be integrated into health planning, financing and monitoring,” said Bruce Gordon, Unit Head for Water, Sanitation and Health at WHO.
Sanitation and cleaning: a new baseline, and the weakest results
Sanitation and environmental cleaning tell a different story. With data now available for 70 and 54 countries respectively, these are the first global baseline estimates ever produced for either indicator, and neither one can yet be compared against a trend.
| Indicator | Basic service | No service at all | People affected by no service |
|---|---|---|---|
| Sanitation | 40% | 11% | 936 million |
| Environmental cleaning | 59% | 18% | 1.5 billion |
Source: JMP, 2026. Baseline estimates; no prior trend data exists for these indicators.
The report also notes a structural reason sanitation lags behind: reaching “basic” status requires more than a working toilet. It requires a toilet dedicated to staff, a sex-separated toilet with menstrual hygiene facilities, and one accessible toilet for people with limited mobility, all at once. Globally, 89% of facilities have some form of sanitation service, and 85% have usable toilets, but only about half have sex-separated or accessible facilities, which is what pulls the basic-service figure down to 40%.
“Safe, inclusive and dignified WASH services are essential to delivering quality care,” said Evariste Kouassi Komlan, Director of WASH at UNICEF.
Where the gaps are widest
The gaps are sharpest in the poorest and most fragile settings. Across least developed countries, landlocked developing countries and highly and extremely fragile contexts combined, fewer than one in five facilities (19%) have basic sanitation. For environmental cleaning, least developed countries alone are at 24%.
| Region | Sanitation coverage | Environmental cleaning coverage |
|---|---|---|
| Sub-Saharan Africa | 23% (lowest) | 65% (highest) |
| Central and Southern Asia | 55% (highest) | not reported |
| Northern Africa and Western Asia | not reported | 46% (lowest) |
Source: JMP, 2026. Figures show the reported range for each indicator, not a full regional breakdown.
Country-level data show how wide the spread is.
| Countries | Indicator | Coverage |
|---|---|---|
| Kuwait, Qatar, Saudi Arabia, Israel, Singapore | Sanitation | Above 99% (universal) |
| Côte d’Ivoire, Kyrgyzstan, Tajikistan | Sanitation | More than half of facilities with no service at all |
| Nepal, São Tomé and Príncipe | Environmental cleaning | Over 80% of facilities with no service at all |
Source: JMP, 2026.
Data coverage itself remains uneven. The number of countries with estimates for all five services has grown from 29 in the previous update to 39 in 2026, but entire regions, including Australia and New Zealand and most of Latin America and the Caribbean, still lack sufficient data to produce regional estimates for several indicators.
Comparing with earlier coverage
The release lands amid renewed political attention to the issue. In May 2026, the United Nations General Assembly adopted a resolution calling on countries to set national standards, monitor progress regularly and develop costed, financed plans for WASH, waste and electricity services in health facilities, with WHO and UNICEF named as co-coordinators of the global effort.
| Report | Water | Hygiene | Sanitation | Environmental cleaning |
|---|---|---|---|---|
| 2024 (Global Framework for Action) | 22% no service | Not measured | Not measured | Not measured |
| 2025 (Tracker update) | No coverage figure given | Half lacked basic service | Not measured | Not measured |
| 2026 (this report) | 15% no service | 72% basic | 40% basic | 59% basic |
Sources: SWM, 2024 and 2025; JMP, 2026.
The Global Framework for Action, covered in 2024, cited 22% of facilities lacking basic water services; that figure has since improved to 15% with no water service, as coverage rose to 85%. The 2025 tracker update reported that half of facilities lacked basic hygiene services; this report puts hygiene coverage at 72%, with only 8% of facilities having no hygiene service at all. Sanitation and environmental cleaning, by contrast, are entirely new to this report: neither indicator had a global estimate in the 2024 or 2025 pieces, so the 40% and 59% figures are not updates but first measurements, revealing gaps that earlier coverage could only suspect, not quantify.
