Qualitative assessment of the water and sanitation for health facility improvement tool (WASH FIT) implementation in Zimbabwe

Inadequate water, sanitation, and hygiene (WASH) services in healthcare facilities (HCFs) put patients and HCF staff at risk of healthcare-associated infections. To facilitate continuous improvements of WASH services in Zimbabwe, the Water and Sanitation for Health Facility Improvement Tool (WASH FIT) program was implemented in 100 HCFs from August 2021 to May 2023. A qualitative study was conducted to describe the experiences and perceptions of WASH FIT implementation by HCF staff and government officers in four provinces of Zimbabwe through in-depth interviews. The findings revealed that WASH FIT has been recognized as a practical methodology, which can contribute to increasing WASH service availability, patient and staff satisfaction, and health service utilization. Constraints on financial resources, supplies, and personnel time and skills were noted as key implementation challenges. This study also highlighted that training might not have been adequate for HCF staff to fully internalize the methodology and five steps of WASH FIT. By mobilizing continuous and adequate financial resources and conducting adequate training for HCF teams, HCFs may further enhance the ownership and sustainability of WASH FIT implementation.