Improving Health through Handwashing Programs: Lessons from COVID-19

2020 National Handwashing Awareness Week, the first week of December, is all the more important this year as handwashing is one of the most basic and effective COVID-19 prevention measures. Although the pandemic has led to improvements, the practice of handwashing remains low globally.

The COVID-19 Hygiene Hub is a free service that provides hygiene programming advice and support to more than 132 organizations across 60 low- and middle-income countries. Hygiene Hub evaluated hundreds of global COVID-19 response actions between April and October of 2020 to identify common challenges, and has released a set of innovative actions to promote improvement in long-term handwashing behavior and hygiene programs.

Most people know that handwashing prevents disease, so hygiene programs must do more than simply provide messages about disease and risk, and must avoid providing too much information. Hygiene promotion activities should directly address behavioral barriers. One effective program positioned handwashing as an altruistic way to protect others.

Although the pandemic has led to improvements, the practice of handwashing remains low globally.

Hygiene Hub recognizes that handwashing programs are more likely to be effective if they address factors that affect hand hygiene, such as access to soap and water, availability of handwashing facilities, and dirtiness of the environment. Some 40% of the world’s population lacks access to soap and water at home, so provision of these is a critical priority.

COVID-19 has disproportionately affected vulnerable populations who may not have access to mass communications and social media. Many organizations are working to build local support networks to engage with key community stakeholders and local health volunteers to effectively reach these groups.

The unprecedented scope of this pandemic has placed enormous pressure on governments and organizations to act urgently, which has sometimes led to compromising on systematic program design. However, Hygiene Hub observed that the most effective programs maintain a systematic process that allows for program adaptation as more is learned through feedback. Although measuring handwashing behavior has become even more challenging during the pandemic, Hygiene Hub recommends developing a monitoring and evaluation strategy using multiple data collection methods in order to understand the impact of the program.

To address and respond to a global pandemic, collaboration is critical for sharing information and minimizing duplication of efforts. In addition to government coordination, the COVID-19 pandemic has seen hygiene organizations collaborate with colleagues in other sectors such as mental health, nutrition, and education, as well as private sector companies. The World Health Organization and UNICEF are championing efforts to promote more effective cross-learning between organizations and governments with their Hygiene for All initiative to effect long-term sustainable change.