Drinking water quality and management in healthcare facilities: a nationwide survey from Serbia
1
Institute of Public Health of Serbia, Belgrade, Serbia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Serbia was one of the first countries conducted a comprehensive assessment of the water, sanitation and hygiene (WASH) conditions in healthcare facilities (HCFs) as proposed by the 2019 World Health Assembly resolution. Provision of safe drinking water (DW) to HCFs is essential in providing quality health care and reaching universal health care. This article aims to present the results of a nationwide survey on DW quality and the extent of management of DW services in Serbian HCFs in line with the WHO standards.
METHODS:
A survey was conducted in 320 HCFs (272 primary, 38 secondary and 10 tertiary) randomly selected from the national register out of 1888 HCFs, including rural and urban areas. DW sampling and analysis were conducted according to the international standard methods and national regulations and comprised microbiological parameters, as well as physical and chemical parameters. The assessment of the extent of managing the DW services was performed using the WHO checklist.
RESULTS:
Overall, compliance with the national and international DW quality requirements was in 67% of HCFs, with microbiological and chemical compliance 92% and 70%, respectively. Non-compliance of E. coli and Enterococcus faecalis was found in 10% of rural primary HCFs. Non-compliance for arsenic, nitrite, nitrate, and residual chlorine (≤0.2 mg/L or ≥0.5 mg/L) was 7.02%, 2,6%, 4,2 and 36.5%, respectively. Concerning managing the DW services, only 15% of all investigated HCFs have a hygiene plan for managing the facility water network, which does not address regular monitoring of DW quality (42%), protocols for incidents (21%), and preventive measures against contamination and AMR (96%).
CONCLUSIONS:
This survey clearly indicates the need for the implementation of the WHO recommended risk based the water safety planning approach for securing safe DW and safe management of the internal water distribution network, minimising the risk of water-borne hospital outbreaks.
Serbia was one of the first countries conducted a comprehensive assessment of the water, sanitation and hygiene (WASH) conditions in healthcare facilities (HCFs) as proposed by the 2019 World Health Assembly resolution. Provision of safe drinking water (DW) to HCFs is essential in providing quality health care and reaching universal health care. This article aims to present the results of a nationwide survey on DW quality and the extent of management of DW services in Serbian HCFs in line with the WHO standards.
METHODS:
A survey was conducted in 320 HCFs (272 primary, 38 secondary and 10 tertiary) randomly selected from the national register out of 1888 HCFs, including rural and urban areas. DW sampling and analysis were conducted according to the international standard methods and national regulations and comprised microbiological parameters, as well as physical and chemical parameters. The assessment of the extent of managing the DW services was performed using the WHO checklist.
RESULTS:
Overall, compliance with the national and international DW quality requirements was in 67% of HCFs, with microbiological and chemical compliance 92% and 70%, respectively. Non-compliance of E. coli and Enterococcus faecalis was found in 10% of rural primary HCFs. Non-compliance for arsenic, nitrite, nitrate, and residual chlorine (≤0.2 mg/L or ≥0.5 mg/L) was 7.02%, 2,6%, 4,2 and 36.5%, respectively. Concerning managing the DW services, only 15% of all investigated HCFs have a hygiene plan for managing the facility water network, which does not address regular monitoring of DW quality (42%), protocols for incidents (21%), and preventive measures against contamination and AMR (96%).
CONCLUSIONS:
This survey clearly indicates the need for the implementation of the WHO recommended risk based the water safety planning approach for securing safe DW and safe management of the internal water distribution network, minimising the risk of water-borne hospital outbreaks.
| eISSN: | 2654-1459 |
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