Towards a systemic approach to water, sanitation and hygiene in healthcare facilities

English
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Towards a systemic approach to water, sanitation and hygiene in healthcare facilities
Strapline
Learning brief on sustainable WASH in healthcare facilities
Node read time
4 minutes
Resource type
Listing introduction text
How systems approaches drive sustainable improvements in water, sanitation and hygiene in healthcare facilities.
Page introduction
How systems approaches drive sustainable improvements in water, sanitation and hygiene in healthcare facilities.
Member
Location
RIVA Authors
Author role
Primary Author
RIVA author profile link

Afou Bengaly

English
Surname
Bengaly
Member
Job description
Strategic advisor
Listing introduction
Afou Bengaly turns citizen voice into lasting change, connecting communities, governments, and essential services across Africa

Afou Bengaly understands deeply that essential services improve when citizens have the power to demand them. Before she joined Riva, she spent years helping young people and civil society organisations across Africa build that power – to gather evidence, develop their voice and hold governments to account. She brought that conviction with her into the water sector, and it has shaped everything since.

Afou works across policy, advocacy and partnership – helping governments, civil society networks and regional institutions create the conditions for services that last. What she does best is connect levels that rarely talk to each other: taking evidence from community level to policy tables where decisions are made, and turning national commitments into plans that local coalitions can implement. 

Afou trained as a pharmacist and that background has never left her. Every disease she studied traced back to water. Her experience connects directly to Riva's conviction that water and sanitation are not ends in themselves but the foundation for health, education and economic life. It also makes her unusually persuasive in rooms where health ministries and finance departments sit alongside water authorities, because she speaks their language too. Add to that the experience of leading country programmes in Mali and Niger through periods of serious political crisis and you have someone whose range is hard to replicate. She is based in Bamako.

A few highlights

  • Country Director, Riva Mali and Niger (2021–2024) – leading programmes and partnerships through periods of political crisis
  • Ten years of civil society leadership across 12 African countries – including representation at UNEP, UNESCO, ECOSOC, Africa Youth Union and the World Humanitarian Summit
  • 2017 to 2020 Country Coordinator of Watershed, a 5-year strategic programme to strengthen the ability of citizens to hold governments and service providers accountable for the services they deliver 
  • Influenced the design and adoption of Mali's 2026–2035 Sustainability Compact – a landmark national framework for assessing and improving essential service delivery across the country
  • Developed national advocacy strategies for WASH financing in healthcare facilities- Mali and the WASH in Healthcare Facilities National Strategic Plan (2023–2027) with the National Health Department
  • Led the regional learning initiative on sub-national WASH systems strengthening across Benin, Ghana, Guinea and Nigeria – with the Sanitation Learning Hub
  • Member of the National Coalition of Civil Society on WASH in Mali;  Réseau Malien des Femmes Professionnelles de l’Eau et l’Assainissement and Association Villes Propres Mali
  • Working languages: French and English
Profile quote
First name
Afou
External authors
Author role
Primary Author
External author

Lauren D’Mello-Guyett

Name prefix
Dr
External author/speaker first name
Lauren
External author/speaker surname
D’Mello-Guyett
External organisation name
London School of Hygiene & Tropical Medicine
Job description
Assistant professor
Publisher
IRC
Page sections
content
This learning brief demonstrates that sustainable improvements in WASH in healthcare facilities are achieved not through isolated investments, but by strengthening the underlying systems that govern how services are planned, financed, delivered and monitored. Applying a systems approach, linking WASH to health policies, financing mechanisms, workforce capacity, governance structures, and information systems enables countries to move from temporary gains to lasting health outcomes. Drawing on global evidence and country experiences from Ethiopia, Ghana, Nigeria, Bangladesh, Sierra Leone, Mali and others, the brief highlights practical entry points for integrating WASH into core health system functions. It goes beyond existing guidance by translating systems thinking into actionable strategies that can be adapted across contexts and levels of the health system.
Title
Towards a systemic approach to water, sanitation and hygiene in healthcare facilities
Downloadable documents
Year
2026