Access to Health V According to the preliminary findings of the 2023 MSNA 89.6% of Gaza households and 62.6% of West Bank households reported a member of their household having a healthcare need requiring care. In addition, around 1.35 million people across the oPt are affected by public health risks associated with insufficient access to WASH services. Many health care facilities in low resource settings lack basic WASH services, compromising the ability to provide safe care and presenting serious health risks to those seeking treatment. A recent news release from WHO and UNICEF states that 1 in 4 health care facilities lacks basic water services and that working on improving WASH in health care facilities produces a 50% return on investment. Another major challenge in health care facilities is the management of medical waste. Currently medical waste materials are still handled manually and disposed of alongside general domestic waste, creating a great health risk to municipal workers, the public and the environment. In order to understand the status of the WASH services in PRCS’ health care facilities in Gaza and make evidence-based decisions on possible interventions, in 2021 PRCS and NLRC under the Access to Health IV project (AtHIV) performed a comprehensive assessment using the WHO developed WASH FIT tool. This tool captures global indicators for WASH services in health care facilities. Data was collected from 6 PRCS health facilities across Gaza, including two hospitals.

Based on last years' experience with the outcomes of the WASH-assessment in Gaza, PRCS and NLRC agreed to conduct a similar assessment in the West Bank. While waiting for the full assessment report, the consultant submitted a preliminary report for the PRCS hospitals in Hebron and Jerusalem. The report identified a significant gap in terms of access to safe water, sanitation, hygiene and wastewater and medical waste management. This project is therefore designed to continue the work started in Gaza under the AtHIV project, and based on the findings of the recent WASH FIT assessment to also target Hebron Hospital as an initial step in supporting PRCS on improving access to and sustainability of quality WASH services in their Health Care Facilities in the West Bank. The intervention relies on a participatory approach in which Health and WASH community members are the key implementers of the activities to ensure the sustainability of the project. All workers engaged in the health system, from doctors to nurses, midwives and cleaners will have access to up to date information and improved skills around WASH and infection prevention and control practices as part of their regular professional development.

The project will be achieved through the following activities: 
1.	Improving access to safe water through new construction or rehabilitation of current water infrastructure within PRCS Health Care Facilities (HCFs);
2.	Providing access to sanitation infrastructure is provided for patients and staff in PRCS HCFs, including wastewater networks and stormwater drainage systems; 
3.	Rehabilitating/upgrading solid waste infrastructure in PRCS HCFs, incl. collection, treatment & disposal; 
4.	Ensuring that PRCS HCFs have increased capacities to manage their WASH infrastructure, incl. WASH in Emergency preparedness and response; 
5.	Enabling PRCS health staff to implement infection prevention and control (IPC) measures and facilities are provided with essential IPC supplies and equipment. 

The project design endorses all WASH Cluster recommendations in the oPt 2023 humanitarian programme cycle and more specifically the Access to WASH services in institutions component, and it will also contribute to the National WASH Sector Contingency Plan aimed at ensuring effective and timely response to the humanitarian needs of people affected by emergencies or crisis in Gaza and the West Bank. The project will improve access and sustainability of quality WASH and Health services for an average of 500.000 people served annually by PRCS’ four Primary Health Care clinics and two hospitals in Gaza strip, and Hebron hospital and Jerusalem Hospital in the West Bank. Gaza and West Bank