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Only 40% of health care facilities worldwide met basic sanitation standards in 2025, according to a new WHO and UNICEF report released under the UN system. The finding highlights a major gap in the infrastructure needed to provide safe, dignified and effective health care, particularly in poorer and fragile settings.
The report provides the first global estimates for basic sanitation services in health care facilities, adding to international data on water, hygiene, waste management and environmental cleaning.
Only Four in 10 Facilities Meet Basic Sanitation Standards
The latest figures show that just 40% of health care facilities globally had basic sanitation services in 2025. The estimate covers facilities with improved and usable sanitation facilities that meet specific requirements for patients and staff.
Basic sanitation is not simply about having a toilet somewhere inside a medical facility. According to the WHO/UNICEF definition, facilities should have at least one toilet dedicated to staff, at least one sex-separated toilet with menstrual hygiene facilities, and at least one toilet accessible to people with limited mobility.
The figures therefore reveal a significant infrastructure challenge across the global health system.
11% of Health Facilities Have No Sanitation Service
The situation becomes even more concerning when looking at facilities with no sanitation service at all.
The WHO/UNICEF data show that 11% of health care facilities had no sanitation service in 2025, representing facilities serving approximately 936 million people. In these facilities, no improved toilets were available.
In 30 countries with available data, at least one in 10 health care facilities had no sanitation service.
This means that millions of patients, health workers and visitors may still encounter inadequate sanitation conditions when accessing essential medical services.
The Problem Is Worse in Poorer Settings
Sanitation coverage varies significantly between regions and country groups.
The global estimate of 40% compares with just 23% coverage in sub-Saharan Africa and 55% in Central and Southern Asia. In least developed countries, landlocked developing countries and fragile contexts, fewer than one in five health care facilities had basic sanitation services.
These disparities demonstrate how access to basic health infrastructure remains closely connected to economic resources and the resilience of local health systems.
For poorer countries, improving sanitation can require significant investment not only in toilets and water systems but also in maintenance, waste management, staffing and long-term infrastructure planning.
Why Sanitation Matters in Health Care
Sanitation is a fundamental part of safe health care.
Hospitals and clinics bring together people who may already be vulnerable to infections. Poor sanitation can therefore create additional risks for patients and health workers while undermining efforts to maintain clean and safe medical environments.
The WHO/UNICEF monitoring programme describes sanitation services in health care facilities as essential to quality care and directly connected to the health, welfare and dignity of patients and staff.
Accessible toilets are also important for people with disabilities and limited mobility, while appropriate menstrual hygiene facilities are particularly important for women and girls using health services.
Sanitation Is Only One Part of the Challenge
The report examined five major areas of water, sanitation and hygiene infrastructure in health care facilities: water, sanitation, hygiene, health care waste management and environmental cleaning.
The findings show that sanitation is not the only area where improvements are needed.
In 2025, 85% of health care facilities had basic water services, while 72% had basic hygiene services and 71% had basic health care waste management services. Only 59% met the basic standard for environmental cleaning.
The figures illustrate how different components of health infrastructure can progress at different speeds.
Having a Toilet Does Not Always Mean Basic Sanitation
The 40% figure requires an important clarification.
The WHO says the finding that only 40% of facilities had basic sanitation does not mean that the other 60% had no toilets. Globally, 89% of facilities had some form of sanitation and 85% had usable toilets.
The distinction is important because the basic sanitation standard includes specific requirements for accessibility, usability and facilities for different groups.
Therefore, the headline reflects the proportion meeting the full basic-service definition rather than simply the presence or absence of a toilet.
A Major Challenge for Global Health Goals
Access to safe water, sanitation and hygiene is closely connected to broader global health objectives.
Health facilities are expected to provide treatment in environments that protect patients rather than expose them to additional risks. Without adequate sanitation, health systems may struggle to maintain infection prevention standards and provide dignified care.
The latest data also highlight the importance of investment in health infrastructure alongside investments in doctors, nurses, medicines and medical technology.
A modern health system requires more than clinical expertise. It also depends on reliable basic services that allow facilities to function safely.
Governments Face Pressure to Improve Health Infrastructure
The new figures are likely to increase pressure on governments and international development agencies to prioritize WASH infrastructure in health care facilities.
Improving sanitation requires sustained investment rather than one-time construction projects. Toilets and sanitation systems must remain functional, accessible and properly maintained over time.
Countries with limited resources may also need international financial and technical support to close infrastructure gaps.
The WHO/UNICEF data provide a baseline that can help governments identify areas where investment and policy action are most urgently required.
Better Sanitation Could Strengthen Patient Safety
Improving sanitation in health facilities can have benefits beyond comfort and convenience.
Clean, accessible and usable sanitation facilities can contribute to better infection prevention, improved working conditions and greater dignity for patients.
For health workers, adequate sanitation is also an important workplace requirement. Medical professionals should not have to work in facilities that lack basic services necessary for safe daily operations.
The finding that only 40% of the world’s health care facilities met basic sanitation standards in 2025 highlights a major global health infrastructure gap. The WHO/UNICEF report shows that 11% of facilities had no sanitation service at all, while coverage was particularly low in sub-Saharan Africa and fragile or economically disadvantaged settings.
At the same time, the figures should not be interpreted as meaning that 60% of facilities have no toilets. The distinction is that only 40% met the complete definition of a basic sanitation service, while 85% had usable toilets and 89% had some form of sanitation.
The findings underline a simple but critical message: safe health care requires safe health facilities. Expanding access to sanitation, water, hygiene and environmental cleaning will be essential to building stronger and more equitable health systems worldwide.
