Handwashing and Hand Hygiene

UN Photo/Prashanth Vishwanathan

The issue explained

Lack of hand hygiene is dangerous. Many infectious diseases, such as cholera and pneumonia, are often caused by pathogens being transmitted through the air or spread by people’s hands. Faeces left exposed will find its way back into people’s mouths without good hygiene behaviours.

Diseases spread by poor hand hygiene have an enormous impact. High rates of diarrhoeal diseases, and acute respiratory, skin and eye infections are all driven to varying degrees by poor hand hygiene, devastating families and placing avoidable burden on the healthcare system. Children under five years old are particularly vulnerable.

Access to hand hygiene facilities remains stubbornly low. COVID-19 is the latest health emergency to raise awareness of hand hygiene. However, access to hand hygiene facilities, reliable water supply, soap or alcohol-based rub, and knowledge of good hygiene behaviours are still low in many areas.

Billions of people rely on healthcare centres without hand hygiene facilities. Similarly, for vast numbers of people, there is nowhere to clean one’s hands at home, school, work or in public spaces. Combined with a lack of awareness of good hand hygiene behaviours, this means one of the primary barriers to infectious diseases is missing in large proportions of society.

UN Photo/Mackenzie Knowles-Coursin

The way forward

Hand hygiene must be recognized as a fundamental behaviour. The transformative health benefits of improved water and sanitation services can only be fully realized when good hand hygiene behaviours are practised. This simple act is proven to dramatically reduce the spread of deadly diseases.

Governments must prioritize hand hygiene to drive progress across the SDGs. Handwashing with soap or alcohol-based rub plays a critical role in public health, and thereby supports education and economic outcomes. Governments must promote and facilitate hand hygiene across society, and ensure handwashing facilities in every healthcare facility and school. 

Hand hygiene is a service and a behaviour. Governments must establish clear policy relating to the necessary water and sanitation services and facilities, as well as the promotional effort needed to educate communities and sustain good practices. Public spending should aim to stimulate investments from households and the private sector.

Hand hygiene is a relatively simple, highly cost-effective health intervention. It requires:

• A reliable water supply.
• Availability of affordable soap or an alcohol-based rub.
• A sink or similar receptacle that can be safely emptied.
• Information on effective handwashing techniques.

Handwashing should be practised at key moments, such as:

• Before preparing food, eating or feeding someone else.
• After going to the toilet.
• After touching surfaces frequently exposed to potential contamination.

• 3 out of 10 people, 2.3 billion, lack a handwashing facility with water and soap at home, including 670 million who have no access to a handwashing facility at all. (WHO/UNICEF 2021)
   
• 700 children die every day from diseases linked to unsafe water, sanitation and hygiene. (WHO/UNICEF 2021)
   
• 818 million children lack a handwashing facility with water and soap at their school.(WHO/UNICEF 2021)
   
• 462 million children attend schools with no handwashing facilities at all. (WHO/UNICEF 2021)
   
• 1 in 3 healthcare facilities does not have access to hand hygiene where care is provided. Almost 2 billion people depend on health care facilities without basic water services. (WHO/UNICEF, 2020)
   
• It is estimated that half a million people die each year from diarrhoea or acute respiratory infections which could have been prevented with timely and thorough hand hygiene. (WHO/UNICEF 2021)
   
• Timely hand hygiene prevents up to 50 per cent of avoidable infections acquired during health care delivery, including those affecting the health workforce. (WHO/UNICEF 2021)
   
• Over the past five years, half a billion people have gained access to basic hand hygiene facilities – a rate of 300,000 per day. (WHO/UNICEF 2021)
   
• Hygiene promotion is the most cost effective health intervention. (World Bank 2016)