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Abstract：
A hygienic environment is essential to provide quality patient care and prevent healthcare-acquired infections. Understanding costs is important to budget for service delivery, but costs evidence for environmental health services (EHS) in healthcare facilities (HCFs) is lacking. We present the first systematic review to evaluate the costs of establishing, operating, and maintaining EHS in HCFs in low- and middle-income countries (LMICs). We systematically searched for studies costing water, sanitation, hygiene, cleaning, waste management, personal protective equipment, vector control, laundry, and lighting in LMICs. Our search yielded 36 studies that reported costs for 51 EHS. There were 3 studies that reported costs for water, 3 for sanitation, 4 for hygiene, 13 for waste management, 16 for cleaning, 2 for personal protective equipment, 10 for laundry, and none for lighting or vector control. Quality of evidence was low. Reported costs were rarely representative of the total costs of EHS provision. Unit costs were infrequently reported. This review identifies opportunities to improve costing research through efforts to categorize and disaggregate EHS costs, greater dissemination of existing unpublished data, improvements to indicators to monitor EHS demand and quality necessary to contextualize costs, and development of frameworks to define EHS needs and essential inputs to guide future costing.
摘要：
卫生环境对于提供优质的患者护理和预防医疗保健获得性感染至关重要。了解成本对服务交付的预算很重要，但是缺乏医疗保健设施（HCF）中环境卫生服务（EHS）的成本证据。我们提出了第一个系统的审查，以评估建立的成本，操作,并在低收入和中等收入国家(LMICs)的HCFs中保持EHS。我们系统地搜索了花费水的研究，卫生，卫生,清洁,废物管理，个人防护装备,矢量控制，洗衣房,和LMICs的照明。我们的搜索产生了36项研究，报告了51项EHS的成本。有3项研究报告了水的成本，3卫生，4卫生，13用于废物管理，16用于清洁，2个人防护装备，10用于洗衣，也没有用于照明或矢量控制。证据质量较低。报告的成本很少代表EHS提供的总成本。单位成本很少报告。ThisreviewidentifiesopportunitiestoimprovecostingresearchthrougheffortstocatorizeanddisaggregateEHScosts,扩大现有未公布数据的传播，改进指标，以监测环境成本所需的EHS需求和质量，并制定框架来定义EHS需求和必要的投入，以指导未来的成本计算。
