Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Background: According to the WHO, WB estimation, there are over 1 billion people living with some form of disability in the world.² Out of which, 284 million people have vision impairment, 360 million people have hearing and speech impairment, ten percent of them living in developing countries.³ According to the National Statistical Office’s 2018 data there are 105,730 people with disabilities in the country which is 3.2% of the total population.⁴ In Mongolia, 28% of the disabled population in the working age are employed while 43% of the population aged 6-18 are illiterate. People with vision, hearing and intellectual disabilities have the same right to access health, education, employment, social welfare and protection services as others, but due to the lack of access to facilities and public transport, they cannot fully access social services. Also, the legal framework that provides equal opportunities for social contacts is not enough. There is virtually no comprehensive study on access of social service and environmental accessibility for the disabled people in the country. Therefore, there is a need to study in detail of social services and environmental accessibility of the people with visual and hearing impairment and adapt their demands into policy and develop policy recommendations and to further improve legal regulations. Purpose: Main objective of the study is to assess social service delivery and environmental accessability of the people with visual and hearing impairment Methods: The direct-observation, household based survey and document review, methods have been used for this study. Direct observation method has been applied for 100 public constructions. Total of 100 disabled people, out of 50 people with visual impairment and 50 people with hearing impairment has been covered for the public transportation accessibility assessment questionnaire survey. Information and communication accessibility studies carried out among 100 organizational websites and 31 broadcasting internet television including Univision and Sky media.
Household survey covered 148 people with visual and hearing impairments to assess social service accessibility. Results: The public construction’s environmental accessibility for the people with vision impairment was assessed at 48.8 percent: 36.8% for the people with poor vision impairment and very bad for blind people at only 16.5%. The public transportation accessibility assessed as not accessible (3.43 odds) for people with vision impairment and as moderate accepable for blind people (2.87 odds). Information and communication accessibility through website assessed at 25% for people with vision impairment which shows not sufficiently accessible for blind people (32%). Total accessibility of information regarding to the organizational website assessed at 34.8% which shows moderately accessible. Services of the Univision, Sky media internet TV (IPTV) wasn’t accessible for people with vision impairment. Regarding to the people with hearing impairment, public construction environmental accessibility assessed at 31.7%, 48.5% for people with moderate hearing impairment which is average accessibility and 21% people with severe hearing problem. The public transport accessibility assessed in high discrepancy (3.51 odds ratio) which means there is an in-sufficient access. Information and communication accessibility for people with hearing impairment assessed at 5% which shows very bad accessibility.
Health service coverage is 64% for the people with vision impairment while 36% for the people of hearing impairment. Education service coverage for vision impairment people is 36% and 18% to people with hearing impairment. Regarding to the accessibility to social service, the coverage is 33% for people with vision impairment and 31% for the people with hearing impairment. Employment rate among people with vision disability resulted in 19% and 24 % for the people with hearing imapirment. Conclusion The public constructions accessibility for people with vision and hearing impairment (37.7%), public transport accessibility (2.90 odds ratio), information accessibility (34.8%) assessed at “moderately accessible”. Assessment result of below 50% considered as “insufficient” for education service -27%, employment service-21.5%, social welfare services -32%. There is a need for special laws and regulations concerning to social services and environment accessibility.