Mental, social, and economic impacts of environmental health services in healthcare facilities in low- and middle-income countries

<p>Environmental health services in healthcare facilities include water, sanitation, hygiene, waste management, and cleaning. This systematic scoping review aimed to identify and synthesize evidence for the mental, social, and economic impacts of environmental health services for patients and workers in low- and middle-income country healthcare facilities. We conducted a systematic literature search in 2023 and updated it in 2025. After title-abstract and full-text screening, we identified 231 studies that measured mental, social, and/or economic impacts of environmental health services in healthcare facilities in low- or middle-income countries. Most of the identified studies (91%; n = 209) described impacts on patients, whereas only 12% (n = 28) described impacts on healthcare workers. The most commonly reported impacts were patient satisfaction (reported by 141 studies), healthcare utilization (28 studies) and patient-perceived quality of care (22 studies). Few studies reported on economic impacts or examined impacts arising from hygiene and waste management services. While most studies (78%; n = 180) used quantitative measures, fewer than half used pretested or validated measurement tools. Findings demonstrate the multitude of mental, social, and economic impacts that arise from environmental health services in healthcare facilities.</p>