Even with undisputable scientific findings linking hand hygiene to low disease patterns, hand hygiene practices remain suboptimal. The United Nations Sustainable Development Goals (SDGs) number three and six reflect how pivotal hand hygiene practices are to attaining general health outcomes.

Organizations and government agencies have been promoting hand washing for decades through provision of soap, building hand washing infrastructure and conducting hand washing trainings. Such efforts have not yielded the much anticipated lasting behavioral changes. Question is, what needs to be done? What different interventions have to be made?

The COVID -19 pandemic has been a compelling revelation of how hand hygiene is core in disease prevention. Public hand washing facilities were set up in hospitals, markets, schools, churches and hand sanitizing was mandatory. This evidently played a role in reducing transmission of the virus.

Truth of the matter is that this is neither a single person’s battle nor a subject that is going to yield immediate results rather a multi-sectorial approach involving three key factors as discussed below;

Access to water, soap and handwashing facilities. Governments should make water and soap affordable to cultivate a hand washing behavior among the population. Well maintained hand washing facilities especially in public areas, schools and hospitals need to be set up and maintained.

Promotion activities including communication, social mobilization, social marketing and advocacy among the masses needs to be heightened and maintained. Previous promotion campaigns have been rather temporary. The hand washing message needs to remain in the eyes and ears of the people to have any substantial behavioral impact.

Enabling environment in form of policies, strategies, budgets, coordination and review. The whole process needs to be done according to plan. A review of what changes need to be made in terms of laws right from local council level has to be done. Village Health Teams (VHTs) and District Health Officers (DHOs) need to be empowered to monitor and enforce these in homesteads, schools and markets.

Calls to Action

  • Use signage and posters. Signs and posters in key areas, such as toilets and kitchens, can remind people to wash their hands at critical times
  • Offer alcohol-based hand rub (hand sanitizer). Placing hand rub dispensers throughout a workplace can also encourage regular hand hygiene practices when soap and water are not available.
  • Train children from School. A hand washing culture needs to be groomed right from young age.

Despite its simplicity, handwashing is a complex issue. If handwashing is to be practiced universally and sustainably across a country, focusing on the handwashing behavior of individuals is not enough. Creating an enabling environment to support the scale-up of handwashing requires a focus on the whole system, including the many actors and their interrelationships, which can enable handwashing to be practiced at homes, schools, workplaces, health care facilities, and other public settings. The focus on local systems for handwashing at the national, regional and community levels is based upon the understanding that “achieving and sustaining any development outcome depends on the contributions of multiple and interconnected actors”

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