Wash your hands regularly
GLOBAL Handwashing Day (GHD) is a global advocacy day dedicated to increasing awareness about the importance of hand hygiene, especially thorough handwashing with soap, and triggering lasting change from the policy-level to community-driven action. The 2020 GHD theme is ‘Hand Hygiene for All’, a call to action to make hand hygiene a reality for all. This theme aligns with the new Hand Hygiene for All Initiative led by the WHO and UNICEF.
The current COVID-19 pandemic has highlighted the critical role hand hygiene plays in disease transmission. The theme reminds us of the need to take immediate action on hand hygiene across all public and private settings to respond and control the COVID-19 pandemic. Hand hygiene must become everybody’s business. It also reminds us of the need to build on the current momentum to make hand hygiene a mainstay in public health interventions beyond the pandemic and create a culture of hand hygiene. This fact sheet provides an overview on what this year’s theme means for handwashing advocacy and programming.
Hand hygiene impacts health and COVID-19
Handwashing can reduce diarrheal diseases by 30 per cent to 48 per cent. Handwashing can reduce acute respiratory infections by 20 per cent. Handwashing plays an important role in reducing the transmission of outbreakrelated pathogens such as cholera, Ebola, shigellosis, SARS and hepatitis E.
Hand hygiene is protective against healthcare-associated infections and reduces the spread of antimicrobial resistance.
Hand hygiene may contribute to the reduction of Neglected Tropical Diseases.
Handwashing with soap can help reduce the transmission of a range of diseases:
Handwashing is also key in the fight against COVID-19. Handwashing with soap destroys the outer membrane of the virus and thereby inactivates it. One study found that regular handwashing with soap can reduce the likelihood of COVID-19 infection by 36 per cent.
‘Hand Hygiene for All’ in the COVID-19 response
Making hand hygiene available and accessible for all requires a multi-faceted, societywide approach. First, this means an urgent need for improvement in access to sustainable hand hygiene services (handwashing facilities, regular water supply, soap or alcohol-based hand rub (ABHR). Second, behaviour change interventions should address the full range of drivers to support optimal hand hygiene behaviour. And finally, components such as policy, coordination, regulation and financing which underpin hand hygiene services and behaviour change need to be strengthened.
Improving access to hand hygiene facilities, soap and water
For people to be able to practise hand hygiene, they need hand hygiene facilities that are conveniently located and easy to use.
People are more likely to wash their hands if they have soap and water present near the handwashing facility.
The Joint Monitoring Programme (JMP) run by UNICEF and WHO defines a ‘ basic handwashing facility’ as the ‘availability of a handwashing facility on the premises with soap and water.’
This includes ‘fixed’ handwashing facilities such as sinks with taps or buckets with taps or tippy- taps, or ‘mobile’ facilities, such as jugs or basins designated for handwashing. Soap includes a bar soap, liquid soap, powder detergent and soapy water but does not include ash, soil, sand or other handwashing agents.
Hand hygiene access within households
60 per cent of the world’s population has access to a basic handwashing facility.
Many high-income nations have almost universal coverage of basic handwashing facilities, yet in the world’s least developed countries only 28 per cent of people in have access to basic handwashing facilities.
In 42 of the 78 countries which the JMP has data for, less than half of the population have a basic handwashing facility at home.
Currently, there are 17 countries where more than 10 million people lack handwashing facilities.
Only 47 per cent of basic handwashing facilities are ‘fixed’. This is a problem because people are much less likely to keep soap and water at ‘mobile’ handwashing facilities and may therefore wash their hands less frequently.
The availability of soap and water at handwashing facilities varies substantially. In Ethiopia, for example only 0.1 per cent of households had soap and water at the handwashing facility whereas in Iraq 91 per cent of people had these items available.
In some counties, whole districts, or regions may have lower access to handwashing facilities. For example, only 12 per cent of households in the Kuntaur Region of the Gambia have access to basic handwashing facilities while in the West Region 68 per cent of people have such facilities.
We have made limited progress on closing the gap in hygiene access between urban and rural populations, with only 34 per cent of people in rural areas having access to a basic handwashing facility. In rural areas of Sierra
Leone people are 24 per cent less likely to have access to soap and 11 per cent more likely to have insufficient water than those in urban regions.
There are also inequities within populations. For example, in 51 out of 82 countries with disaggregated JMPdata, basic handwashing coverage among the richest wealth quintile was at least twice as high as coverage among the poorest quintile. In Nepal, 95 per cent of people in the richest wealth quintile have a basic handwashing facility, while only 38 per cent of people in the poorest wealth quintile do. Vulnerable groups such as people with disabilities, older people, displaced populations and indigenous populations also typically have reduced hygiene access and may have increased hygiene needs.
In 120 countries, we do not have any reliable information about access to handwashing facilities. The COVID-19 pandemic provides a unique opportunity for actors to track and document infrastructural improvements.