PROMOTING HANDWASHING

Mobilizing for behavior change

Health experts recommend handwashing with soap as a key action in protecting the public health because it’s a mainstay in infection control. Are we really following their advice?

People worldwide wash their hands with water in the common belief that washing with water alone suffices to clean hands because it removes visible dirt. But rinsing hands with water alone is significantly less effective for removing germs than washing hands with soap. Handwashing with soap is seldom practiced, however.

Research reveals that the observed rates of handwashing with soap at critical times (after using the toilet or cleaning a child’s bottom and before handling food) around the world, in industrialized and developing nations, ranges from zero to 34 percent.

Low rates of handwashing are rarely caused by a lack of soap. Soap is present in the vast majority of households worldwide, but it is commonly used for bathing and laundry, not for handwashing. Lack of water is usually not a problem either, as hands can be effectively washed with little, or recycled water. In studies around the world, one major reason for low rates of handwashing with soap is that this is simply not a habit.

The challenge remains: make handwashing with soap a worldwide habit and social norm. 

How can we succeed?

To successfully promote the practice of handwashing with soap, public and private sector partners are drawing on their comparative strengths, resources, and best practices to create effective, large scale, and sustainable handwashing promotion programs.

By bringing the lessons learned in social and commercial marketing to hygiene programming, the PPPHW aims to catalyze effective, sustainable changes in handwashing behavior on a large scale.

Ministries of Health, Education, Water and non-governmental organizations (NGOs), the private sector, and community-based groups must all use every opportunity to promote handwashing with soap, based on the lessons learned.

Lessons learned

Research shows that handwashing behavior tends to stick once individuals and families have adopted the practice. However, bringing about large-scale handwashing behavior change remains a challenge.

• Knowing is not enough.

Knowing why, how, and when to wash hands is no guarantee that individuals will wash their hands with soap. Many handwashing and hygiene promotion programs rest on the assumption that people will change their behavior once they are informed of the health benefits of handwashing.  Health is rarely the primary reason that individuals choose to change their handwashing or other health-related behavior.

Behavioral research from several developing countries shows that people are often motivated to wash their hands with soap by factors other than health, such as disgust, or a wish to be seen as a good parent, to appear attractive, or to protect and nurture children.

• Messages: Less can be more.

Promoting a change in behavior in hygiene usually tends to cover a wide set of behaviors rather than to focus on a single behavior.  This may ultimately achieve little behavior change. To maximize their results, hygiene promotion programs should focus on promoting the behaviors with the greatest potential health benefit.

• Target specific groups.

The first priority in a behavior change program is to focus on targeting those population groups whose practices have the greatest influence on child health: mothers, caregivers, older siblings and grandmothers, in addition to children themselves. Formative research can provide insights about household caregivers for young children, their actual practices and who might influence them.