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UNC and P&G to Provide First Analysis of Environmental Health in Malawi Hospitals

May 15, 2016
Institute for Global Health and Infectious Diseases

Millions of Malawians seek medical care in the country’s health care facilities each year. Yet, an analysis of the environmental health status in these facilities has never been performed. This summer, baseline measurements will be collected thanks to a partnership between the University of North Carolina at Chapel Hill and Procter & Gamble (P&G) through the Children’s Safe Drinking Water Program (CSDW).

“Health facilities should not be places to acquire infection due to lack of clean water, hygiene and sanitation; they should be places for cure,” says Innocent Mofolo, associate country director of UNC Project-Malawi. “WaSH should be part of an integrated approach to health and human development. This assessment will help determine WaSH gaps that exist in most of our health facilities and devise strategies to improve the situation.”

The assessment of 45 health facilities in the northern, central and southern regions of Malawi is being funded by a generous donation from P&G. Data collection will begin in August by researchers from the UNC Institute for Global Health and Infectious Diseases and its UNC Project in Malawi and the Water Institute at UNC. Specific objectives include:

  • assessing the hospitals’ environmental health conditions including water, hygiene, sanitation, ventilation and solid waste management;
  • learning patients, medical staff and hospital administrators’ knowledge, practices and attitudes about water and sanitation infrastructure as it relates to disease prevention;
  • quantifying health outcomes associated with inadequate environment conditions, such as maternal and infant morbidity and mortality;
  • and analyzing health care workers, patients and their guardians’ ability to comply with universal infection control standards.

“It is common knowledge that many of the health facilities in Malawi do not consistently have the most basic components of environmental health including clean running water, soap and sanitation facilities for staff, patients and patient guardians,” says Irving Hoffman, U.S. director of UNC Project-Malawi. “As a response to this reality, our goal is to provide a comprehensive report on the current status of the environmental conditions at all levels of health facilities in Malawi. With the expectation that this report will lead to a comprehensive program of corrective actions, we will also collect information from facility staff and patients about their environmental health knowledge and willingness and ability to comply with infection control standards. We will also investigate the most useful health outcomes we can measure that would be affected as a result of improving the environmental health conditions at these facilities.”

Data collection is expected to be completed by September 2016. Researchers from the UNC Water Institute and the UNC Institute for Global Health and Infectious Diseases hope this information will yield not only baseline information about the environmental health conditions at Malawian health care facilities, but also provide insight into hospital acquired infections, disease prevention practices, local government and NGOs involved in WaSH activities, and possible interventions.

“Over the last two years the enormous scale of the failure to provide basic environmental safety in health facilities has become increasingly well-documented. Less well-documented are the practical solutions to the problems and approaches to implement them at scale,” says Jamie Bartram, Director of the Water Institute at UNC. “This project will help fill that gap and accelerate improvement in Malawi and beyond.”

The current project between UNC and P&G continues a longstanding partnership to improve the quality of water in Malawi. Since 2011, the P&G Children’s Safe Drinking Water Program has provided grant support to deliver P&G’s water purification packets to Malawians. Highly contaminated local wells or other open sources are often the only source of drinking water. The P&G water purifier packets transform this water from dangerous to drinkable in only 30 minutes. These water purification packets are distributed through health care clinics, and have been shown to prevent childhood diarrhea and promote retention in health care programs.

“P&G is proud of our long-standing partnership with UNC’s Institute for Global Health and Infectious Diseases that continues to provide clean water along with sanitation and hygiene education to thousands of families in Malawi,” says Allison Tummon Kamphuis, leader of the P&G CSDW program. “Our latest collaboration will identify the gaps and opportunities for better integration of WaSH interventions in Health Care Facilities, which will ultimately prevent the spread of diseases and help save lives.”


About the UNC Institute for Global Health and Infectious Diseases

The mission of UNC’s Institute for Global Health and Infectious Diseases is to harness the full resources of the University and its partners to solve global health problems, reduce the burden of disease, and cultivate the next generation of global health leaders. Learn more at


About The Water Institute at UNC

The Water Institute at UNC provides international academic leadership at the nexus of water, health and development. Through research, the institute tackles knowledge gaps that impede effective action on important WaSH and health issues. The institute responds to the information needs of our partners, acts early on emerging issues, and proactively identifies knowledge gaps. By developing local initiatives and international teaching and learning partnerships, the institute delivers innovative, relevant and highly-accessible training programs that will strengthen the next generation’s capacity with the knowledge and experience to solve water and sanitation challenges. By identifying or developing, synthesizing and distributing relevant and up-to-date information on WaSH, the institute supports effective policy making and decision taking that protects health and improves human development worldwide, as well as predicting and helping to prevent emerging risks. Through networking and developing partnerships, the institute brings together individuals and institutions from diverse disciplines and sectors, enabling them to work together to solve the most critical global issues in water and health. The Water Institute at UNC supports WaSH sector organizations to significantly enhance the impact, sustainability and scalability of their programs. The vision of The Water Institute at UNC is to bring together individuals and institutions from diverse disciplines and sectors and empower them to work together to solve the most critical global issues in water, sanitation, hygiene and health.


About Procter & Gamble

P&G serves consumers around the world with one of the strongest portfolios of trusted, quality, leadership brands, including Always®, Ambi Pur®, Ariel®, Bounty®, Charmin®, Crest®, Dawn®, Downy®, Fairy®, Febreze®, Gain®, Gillette®, Head & Shoulders®, Lenor®, Olay®, Oral-B®, Pampers®, Pantene®, SK-II®, Tide®, Vicks®, and Whisper®. The P&G community includes operations in approximately 70 countries worldwide. Please visit for the latest news and information about P&G and its brands.

The P&G Children’s Safe Drinking Water Program (CSDW) is a non-profit initiative that has provided 10 billion liters of clean drinking water to children and families since 2004. CSDW has partnered with a diverse network of organizations to help distribute water purification packets in more than 75 developing countries. To learn more about the P&G CSDW Program, and see how water purification packets work, please visit

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