Hand Hygiene for All: Key Messages

 Key messages

  • One of the most effective ways to prevent infection and reduce the spread of COVID-19 and other communicable diseases is to clean your hands thoroughly with soap and water or alcohol-based hand rub products.
    • Together with other precautions, this simple measure protects us from contracting the virus; and
    • helps stop us from spreading the virus (and many other diseases) to others

 

  • Despite its simplicity, in much of the world hand hygiene is still poorly practiced.
    • 3 billion people / 40% of the global population do not have a place at home to wash their hands with water and soap
    • In Least Developed Countries, 3 out of 4 people lack basic hand hygiene facilities at home

 

  • In the most vulnerable countries, the majority of the population is at immediate risk of COVID-19 due to lack of basic hand hygiene facilities.
    • Population density, poverty and poor living conditions, and overwhelmed hospitals, health facilities, physicians and staff, are key factors in determining a country’s vulnerability to COVID-19 and its ability to effectively respond to an outbreak.
    • The most vulnerable countries include but are not limited to Afghanistan, Burundi, Central African Republic, Chad, Congo DR, Haiti, Somalia and South Sudan.
    • In 60 of the most vulnerable countries, 2 out of 3 people – 1 billion people in total – lack basic handwashing facilities with soap and water at home.
    • 1 in 3 people (half a billion people) in these countries have no hand hygiene facility at home at all.
    • Facilities are also lacking outside the home, in the workplace, marketplaces, transport hubs and other public spaces where people gather.
    • Around half of the population in these highest risk countries are children under 18 years of age.[1]

 

  • This lack of access extends beyond the home, to schools, workplaces and healthcare facilities. Access is also lacking in other public spaces where people gather such as marketplaces and transport hubs. In these settings, hand hygiene is critical to keeping children, teachers, doctors, nurses and other workers safe.
    • Globally, nearly half of all schools do not have handwashing facilities with water and soap. This affects 900 million school-age children.
    • 2 in 5 health care facilities do not have hand hygiene at points of care – putting doctors, nurses and other health workers, as well as patients and their families at risk.
    • With limited or no hand hygiene facilities and improvement programmes, healthcare workers’ compliance with hand hygiene best practices can be as low as 8%.
    • Over 1.5 billion workers in the informal and gig economy and in the agricultural sector have very limited access to hand hygiene stations.
    • In all sectors of the economy, Individuals spend up to one-third of their adult life in the workplace, often in close proximity to colleagues and customers. Hand hygiene is an integral part of any comprehensive workplace risk assessment and control package for COVID-19[2].

 

 

  • The threat to children from poor hand hygiene cannot be overstated.
    • 700 children die every day from diseases caused by inadequate water, sanitation and hygiene. Diarrhoea is still one of the leading killers of children worldwide.
    • While children appear less affected by COVID-19 infections, the pandemic has already had enormous impacts on children’s health, wellbeing and in some cases their safety, well beyond the disease itself, through school closures and other lockdown measures.

Hand hygiene has multiple short- and long-term benefits. In addition to preventing the spread of COVID-19, scaling up hand hygiene in all settings yields vast health and economic benefits for everyone.

    • Could potentially prevent an estimated 165,000 deaths from diarrhoeal diseases each year.[3]
    • 100,000 of these preventable deaths would be in the countries most vulnerable to COVID-19.
    • Appropriate hand hygiene prevents up to 50% avoidable infections acquired during health care delivery including those affecting the health work force.
    • There is evidence that investing in hand hygiene yields huge returns. Research has found that hand hygiene policies generate economic savings on average 15 times the cost of implementation.
    • In addition, improving hand hygiene facilities at the workplace can improve working conditions. This in turn promotes productivity through reduced absenteeism and work-related illness.

Objectives

The UNICEF-WHO Hand Hygiene for All Initiative aims to create a culture of hygiene by:

  1. Reinforcing the importance of hand hygiene to reduce the spread of COVID-19 and other communicable diseases – within the context of the pandemic and beyond – through policies, regulation, innovation, private sector engagement, and behaviour change strategies.
  2. Calling to action international partners, national governments, the public and private sectors and civil society to accelerate progress on hand hygiene at the global, national and community levels.
  3. Mobilizing donors and financers to raise funds for hand hygiene in priority countries, with a focus on protecting the most vulnerable.

WHO and UNICEF are coordinating the initiative, supported by select group of core partners, including but not limited to World Bank, Sanitation and Water for All, International Labour Organization, International Federation of the Red Cross and the Red Crescent Societies (IFRC), London School of Hygiene and Tropical Medicine/Hygiene Hub, United Nations Refugee Agency (UNHCR), Global Handwashing Partnership and WaterAid.

 

Coordination of the initiative will operate through four main functions: evidence and learning, leveraging intersectoral and multi-stakeholder support, increasing investments for hygiene and monitoring progress.

 

We’re calling for a ‘whole of society’ approach to scaling up hand hygiene, including:

  • Placing hygiene at the heart of strategies to protect global health, ensure affordable products and services are available, especially to vulnerable and disadvantaged areas, and enable a culture of hygiene in our communities.
  • As countries implement plans to respond to COVID-19, while also considering options for safe return to work and school, they must scale up, systemize and institutionalize hand hygiene into these systems to reduce the risk of future outbreaks.
  • Improving access to and promotion of hand hygiene practices at the point of care in health care facilities, including long-term care and across the health system.
  • Considering all settings public and private, including households, health care facilities, schools, workplaces, transport hubs, and other public places.
  • Support from the private sector through partnerships, investments and in-kind donations, as well developing innovative hand hygiene solutions.

[1] Data from 2020 JMP estimates. 751 million children age 0-18 (or 718 excluding 18 year-olds) in high or very high risk countries according to the INFORM risk categories. Multiplied by the % with basic handwashing facilities (~68%) = 514 million, or approximately half a billion.

[2] Hand washing is one component of preventive and protective workplace measures according to the hierarchy of controls. See the ILO’s Return to Work Guide and Ten Action Points for more information.

[3] 1 Prüss-Ustün, Annette, et al. “Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low-and middle-income countries.” International journal of hygiene and environmental health 222.5 (2019): 765-777.