Clean Care, Better Health: Why Sanitation Investment Matters in Busia

Last May, a Community Health Promoter (CHP) accompanied a mother and her two-year-old child to a nearby health facility after several days of diarrhea. The mother had delayed seeking care, hoping the child would recover at home, but the symptoms had worsened. Upon arrival, they found the facility's handwashing station dry and the patient toilet out of service. The CHP later described the mother's frustration: she had finally overcome the barriers of distance and transport costs to seek treatment, only to find basic sanitation services unavailable.

The child eventually received medical attention, but the experience left the mother questioning the safety of the facility. "We tell families to come to the health facility when a child is sick," the CHP reflected. "But when there is no water to wash hands or a clean toilet to use, it becomes difficult to assure them that the environment is safe." A visit to a healthcare facility should never expose patients to additional health risks.

The need for improved sanitation is particularly evident in Busia County, where diarrhoeal diseases continue to place a significant burden on the health system. According to the Kenya Health Information System (KHIS), Busia County recorded 30,000 cases of diarrhoeal disease among children under five in 2025, making it one of the leading causes of outpatient visits in this age group. Because diarrhoeal diseases are closely linked to poor water, sanitation, and hygiene conditions, strengthening sanitation in healthcare facilities is a practical and cost-effective way to reduce preventable illnesses and improve patient safety.

While this scenario is not unique to one facility, it highlights a broader challenge facing many healthcare facilities across Busia County. Safe healthcare depends not only on medicines and skilled staff but also on reliable water, sanitation, and hygiene services that protect patients, caregivers, and health workers from preventable infections.

As Busia County continues to invest in improving healthcare services, clean water, functional toilets, handwashing facilities, and proper healthcare waste management must remain essential components of quality healthcare. Poor sanitation increases the risk of healthcare-associated infections and undermines efforts to prevent the spread of disease within healthcare facilities.

When healthcare facilities have reliable water supplies, adequate sanitation infrastructure, and functional handwashing stations, they are better equipped to prevent infections, protect healthcare workers, and provide the quality care that residents of Busia County deserve.

Diarrhoeal diseases remain one of the leading causes of illness and death in Kenya, particularly among children. UNICEF reports that diarrhoea remains one of the major causes of under-five deaths linked to poor water, sanitation, and hygiene conditions in Kenya. Investing in sanitation is therefore not only about cleaner facilities; it is about preventing disease and saving the lives of our children.

Preventing infections and disease outbreaks is far less costly than responding to them. The World Health Organization estimates that unsafe water, sanitation, and hygiene are responsible for 69% of diarrhoea deaths globally. Improving sanitation in healthcare facilities reduces the burden of preventable diseases, lowers treatment costs, and strengthens public confidence in the health system. Every shilling invested in sanitation is an investment in a healthier and more resilient Busia County. Without specific protection, these sanitation funds risk being diverted to less urgent operational costs .

As the County Assembly considers the Financial Year 2025/2026 supplementary budget, members must approve and protect the proposed allocation requested by the Department of Health and Sanitation for sanitation improvements in healthcare facilities. The allocation should also be ring-fenced to safeguard these critical investments from future budget reductions.

Busia County has an opportunity to demonstrate leadership by recognizing sanitation as a health investment rather than a routine expense. By approving and protecting sanitation funding today, county leaders must ensure that every healthcare facility is a place of safety, dignity, and healing. The time to act is now: a modest investment can deliver lasting gains for patients, support frontline healthcare workers, and build healthier communities across Busia County.