The SaniPath Exposure Assessment Tool identifies which routes of exposure to fecal contamination pose the greatest public health risk in urban and peri-urban neighborhoods. Developed by Emory University’s Center for Global Safe WASH, it is free, open access, and one of the core decision-making tools used across the PROMISE Consortium.
SaniPath compares exposure for adults and children across up to ten public pathways, including open drains, floodwater, surface and drinking water, produce, street food, soil and public latrines. Field teams collect environmental samples, which are tested for E. coli, along with behavioral surveys on mobile phones. The SaniPath web platform analyzes the data automatically and produces People Plots, summary charts and a draft report with recommendations targeted at the highest-risk pathways.
With limited sanitation budgets, decision-makers need to know where investment will protect the most people. SaniPath has been deployed in ten cities worldwide, and PROMISE partner TREND Group has trained teams in Ghana, Zambia, Senegal, Uganda and Kenya through its Accra training hub. PROMISE partners use the Tool for community-level exposure assessments that inform policy and investment.
Visit www.sanipath.net to explore the Tool:
The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) helps health care facilities find and fix gaps in water, sanitation and hygiene services as part of improving quality of care. Developed by the World Health Organization (WHO) and UNICEF, it covers water, sanitation, hand hygiene, environmental cleaning, health care waste management, and selected aspects of energy, buildings and facility management. First published in 2018, WASH FIT was in use in more than 40 countries by 2022, when a second edition added a stronger focus on climate resilience, gender equality and inclusion, and infection prevention.
WASH FIT is a facility-led, risk-based approach adapted from WHO’s Water Safety Planning. A team of facility staff — managers, nurses, cleaners and those responsible for water and waste — works through a five-step cycle: assemble the team, assess the facility against a set of indicators, identify hazards and prioritize improvements, develop and carry out an improvement plan, and monitor progress. The cycle repeats every 6–12 months, so improvements build step by step over time. A mobile version, WASH FIT Mobile, supports digital monitoring of progress.
Safe water, sanitation and hygiene in health care facilities are essential for preventing infections, slowing antimicrobial resistance and delivering quality care. WASH FIT complements SaniPath: SaniPath measures exposure risks in communities, while WASH FIT drives practical improvements inside health facilities. PROMISE partners are working to embed WASH FIT, alongside SaniPath and ComPASS, in national decision-making to strengthen hygiene and infection prevention and control in health care facilities. Because it brings together facility staff, district health officers, engineers and policymakers, WASH FIT helps turn assessment findings into funded, practical action.
Visit the WASH FIT Portal on the WHO/UNICEF WASH in Health Care Facilities website:
Contact: reach the WASH in Health Care Facilities team
The Community Pathogen Hazard Assessment of Sanitation Systems (ComPASS) shows where, along a community’s sanitation chain, disease-causing pathogens from human waste escape into the environment — and which of those releases pose the greatest public health hazard. It builds on the Community Hazard Flow approach developed by The Water Institute at UNC-Chapel Hill, a PROMISE Consortium partner. ComPASS uses pathogens, rather than simple access indicators, to judge whether sanitation is truly safe.
ComPASS follows human waste through the full sanitation service chain — from toilets and containment (pit latrines, septic tanks, sewers) through emptying, transport, treatment and disposal. Teams survey local sanitation systems, inspect how they are built and managed, and sample sludge, effluent, drains and waterways to measure pathogen release. The results map how much hazard each pathway returns to the community environment, revealing priorities that conventional indicators can miss: UNC’s research found, for example, that liquid effluent and sewer overflows can release far more pathogens than sludge. Planners can then target investments at the points in the chain where risks are highest.
ComPASS completes the PROMISE toolkit. SaniPath measures how people are exposed to fecal contamination, WASH FIT improves services in health care facilities, and ComPASS identifies where pathogen hazards enter the environment in the first place. Used together, they let decision-makers trace risk from source to exposure and choose interventions with the greatest health benefit. PROMISE partners are working to embed ComPASS in national and city sanitation planning so that investment decisions are guided by public health evidence.
To learn more about the research behind ComPASS, visit The Water Institute at UNC:
A multi-country initiative advancing sanitation, hygiene, climate resilience, health security, digital decision systems, and healthy institutions in low- and middle-income countries
Don’t miss our future updates! Get Subscribed Today!
©2026. PROMISE CONSORTIUM. All Rights Reserved.