Water Currents: Global Handwashing Day 2018

Celebrate Global Handwashing Day (GHD) on October 15, 2018. Organized by the Global Handwashing Partnership, this important international advocacy day is dedicated to increasing awareness and understanding about the importance of handwashing with soap (HWS). HWS is one of the most effective and affordable ways to prevent diarrhea and pneumonia––the leading causes of death for children under the age of 5.
The theme of this year’s celebration, “Clean Hands—A Recipe for Health,” emphasizes the key role that handwashing plays in reducing the prevalence of diarrheal disease and increasing overall health. For that reason, USAID and local partners promote improved handwashing behavior—educating the public about the health benefits of regular handwashing with soap; encouraging handwashing behavior change; and improving handwashing infrastructure in schools, health facilities, businesses, and households around the world to help create healthier, more self-reliant communities.  
Hygiene and handwashing behavior change are also highlighted in the 2017 U.S. Government Global Water Strategy and USAID’s Water and Development Plan.
This issue contains contributions from the Global Handwashing Partnership, USAID, and others, as well as the latest studies on handwashing and food hygiene.
Join the #GlobalHandwashingDay conversation @USAIDWater.


Global Handwashing Partnership Resources 
Global Handwashing Partnership (GHP) website – GHP is a coalition of international stakeholders who work explicitly to promote handwashing with soap and recognize hygiene as a pillar of international development and public health. GHP has important resources on its website for promoting GHD.

Norms, Nudges, or Addiction: Understanding Drivers for Handwashing BehaviorGHPUSAID, September 2017. In this webinar, Nga Ngyuen of USAID, Dr. Reshmaan Hussam, Assistant Professor of Business Administration at Harvard Business School, and Dr. Hans Mosler of the University of Zurich and EAWAG present updates on recent research and key implications of two frameworks for handwashing behavior change.

The Forgotten Juncture? Handwashing and Safe Management of Child FecesGHPUSAID; International Water Center; Water and Engineering Center for Development; UNICEF, August 2018. Safe disposal of children’s feces is a critical practice. This webinar discusses the present status and impact of child feces disposal practices and handwashing, shares experiences across regions, and reviews key considerations for practitioners.

USAID Resources
Global Handwashing Day 2018: Clean Hands—A Recipe for HealthGlobal Waters, September 2018. This collection of photos highlights USAID’s support for improved handwashing practices and how the Agency is helping create healthier communities around the world.

Toward a Hygienic Environment for Infants and Young Children: A Review of the LiteratureUSAID Water, Sanitation, and Hygiene Partnerships and Sustainability (WASHPaLS) Project, February 2018. This report discusses the importance of a hygienic environment for infant and child health. It concludes that food hygiene is largely a neglected aspect of WASH, and the few existing intervention studies are weak in quality and not easily generalized.

Nga Nguyen and Reshmaan Hussam on Incentivizing Handwashing Habit FormationGlobal Waters Radio, September 2017. The two handwashing experts in this podcast discuss the role of learning and habit formation in achieving sustainable changes in handwashing habits, and share insights about recent handwashing field studies conducted in India’s rural West Bengal state.

Water Currents: Annual State of Handwashing ResearchUSAID, June 2018. This newsletter features highlights from “The State of Handwashing 2017,” a GHP review of 117 handwashing-related research papers. 

Recent Studies and Reports on Food Hygiene and Handwashing

Country Studies—Africa
Promoting Hygienic Weaning Food Handling Practices Through a Community-Based ProgrammeBMJ Open, August 2018. Researchers engaged village members in this study using an intervention process that provided lessons for future implementation. Culturally adapted performing arts were an important element. The research has potential as a new low-cost and broadly available public health program to reduce infection through weaning food.

State of Hygiene in Southern Africa: Summary of Key FindingsWaterAid, August 2018. This study collected evidence on the status of hygiene practice in southern Africa; the enabling environment and institutional arrangements for hygiene promotion; and key policy and program bottlenecks for the prioritization of hygiene.

Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya.International Journal of Environmental Research and Public Health, September 2018. Three novel caregiver hygiene behavior measures are documented in this paper: hygienic food preparation and storage, handwashing at key times, and provision of a safe play environment for children under 2 years.

Child Care-Giver Food Hygiene Practices in Urban Informal Settlements of Kisumu, KenyaWEDC Conference, July 2018. Researchers found that child care in the selected informal settlement is done by multiple caregivers, suggesting that food hygiene interventions should give attention to all likely child caregivers to reduce diarrheal disease.

Designing a Food Hygiene Intervention for Children 69 Months in an Informal Settlement in Kisumu, KenyaWEDC Conference, July 2018. An intervention comprising education, environmental modification, and motivational messaging targeted four major behaviors in an informal settlement: hygienic storage, handwashing with soap, hygienic feeding, and reheating.

Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens Among Infants 3–9 Months Living in Informal, Peri-Urban Communities in Kisumu, KenyaInternational Journal of Environmental Research and Public Health, January 2018. Observers of oral contact behavior in children and hand hygiene of caregivers concluded that caregiver hand hygiene prior to feeding events and after cleaning a child should be considered as priority interventions.

Food Hygiene Practices and its Associated Factors Among Model and Non-Model Households in Abobo District, Southwestern Ethiopia: Comparative Cross-Sectional StudyPLoS One, April 2018. Good food handling practice is lacking in both “model” and “non-model” households. Health extension workers should play a greater role in educating all households regarding food hygiene practices.

Country Studies—Asia
Prevalence and Association of Escherichia Coli and Diarrheagenic Escherichia Coli in Stored Foods for Young Children and Flies Caught in the Same Households in Rural BangladeshAmerican Journal of Tropical Medicine and Hygiene, April 2018. In rural Bangladesh, flies are a likely route for fecal contamination of stored food. Controlling fly populations may reduce contamination of food stored for young children.

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in NepalAmerican Journal of Tropical Medicine and Hygiene, June 2017. In this study, researchers report on the results of a trial intervention among mothers of young children in rural Nepal to improve five food hygiene behaviors: cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment.

Policy Briefs and Other Resources
Sanitation and Hygiene Applied Research for Equity (SHARE) website – Established in 2010 with funding from the U.K. Department for International Development, the SHARE Consortium works toward achieving universal access to effective, sustainable, and equitable sanitation and hygiene by generating, synthesizing, and translating evidence to improve policy and practice worldwide. SHARE has published and produced more than 20 reports, briefs, and other material on food hygiene.

Safe Start: Formative Research Policy BriefSHARE, March 2018. The authors of this policy brief outline an assessment of food hygiene behaviors in Kisumu, Kenya. The study focused on caregivers of children 6–9 months of age living in urban informal settlements.

Integrating WASH and Food Hygiene: Formative Research BriefSHARE, October 2017. This briefing note provides an overview of the formative research conducted as part of the Integrating WASH and Food Hygiene project in rural Malawi. The brief highlights the methods and findings from the four key stages leading to intervention development and summarizes critical points for behavior change to reduce diarrheal disease.

Behaviour Change for Water, Sanitation and HygieneSHARE, June 2018. The direct observation of infant food preparation and infant feeding helped to inform intervention development in two projects on WASH and infant food hygiene and tailor them to local contexts.

Systems Approaches to Hygiene Behavior Change: Lessons Across WASH, Health, and EducationIRCGHP, May 2018. In this webinar, hygiene and behavior change practitioners discuss using existing systems to improve the scale and sustainability of hygiene promotion efforts.


Water Currents
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USAID Bureau for Economic Growth, Education and Environment (E3) Water Office