Water Currents: Handwashing Research, January - June 2019

The January to June 2019 Handwashing Research Index is the result of a collaboration between the Global Handwashing Partnership and the USAID Water Communications and Knowledge Management Project. The index includes 36 peer-reviewed studies from 2019 that explore handwashing in connection with diverse programmatic areas. It also includes several studies from 2018 that were not included in the 2018 Index due to publication timelines.

This issue of Water Currents features selected studies from the index, as well as links to handwashing-related websites.

Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017: Special Focus on InequalitiesWHOUNICEF, June 2019. In 2017, 22 percent of the global population (1.6 billion people) had handwashing facilities that lacked water or soap, and 18 percent (1.4 billion people) had no handwashing facility at all.

Handwashing with Soap after Potential Faecal Contact: Global, Regional and Country Estimates for Handwashing with Soap after Potential Faecal ContactInternational Journal of Epidemiology, December 2018. Researchers found that many people lack a designated handwashing facility, but even among those with access, handwashing with soap is poorly practiced. People with access to designated handwashing facilities are about twice as likely to wash their hands with soap after potential fecal contact as people who lack a facility.

Community Settings
Child Defecation and Feces Disposal Practices and Determinants among Households after a Combined Household-Level Piped Water and Sanitation Intervention in Rural Odisha, IndiaAmerican Journal of Tropical Medicine and Hygiene, April 2019. A study in rural India found that disposal of child feces into a latrine was uncommon, even among households with access to an improved pour-flush latrine that was used by adults in the household.

Epidemiological Investigation on Hand Hygiene Knowledge and Behaviour: A Cross-Sectional Study on Gender DisparityBMC Public Health, April 2019. The findings of this study can provide information on gender-specific health promotion activities and creative campaigns to achieve sustained improvement in household practices.

BabyGel Pilot: A Pilot Cluster Randomised Trial of the Provision of Alcohol Handgel to Postpartum Mothers to Prevent Neonatal and Young Infant Infection-Related Morbidity in the CommunityPilot and Feasibility Studies, March 2019. Alcohol-based hand rub is widely used in both health and social facilities to prevent infection. This study piloted a cluster randomized trial that provided the hand rub to postpartum mothers to learn whether supplying it for regular perinatal use can prevent newborn sepsis in African rural homes.

'We Have to Clean Ourselves to Ensure that Our Children are Healthy and Beautiful': Findings from a Qualitative Assessment of a Hand Hygiene Poster in Rural UgandaBMC Public Health, January 2019. The World Health Organization’s “5 Moments for Hand Hygiene” poster has been used to reduce hospital-acquired infections, but no similar tool has been developed to prevent community-acquired newborn infections in low-resource settings. This assessment, part of the BabyGel Pilot study, evaluated the acceptability of the ‘”Newborn Moments for Hand Hygiene in the Home” poster.

Effect of Two Complementary Mass-Scale Media Interventions on Handwashing with Soap among MothersJournal of Health Communication, March 2019. Television commercials seen in the home and audio messages delivered via mobile phones produced significant increases in handwashing behavior among mothers. The mobile results show messages sent to mothers can drive behavior change, which is particularly relevant for people that television does not reach.

Educational Settings
Impact of a Hand Hygiene Curriculum and Group Handwashing Station at Two Primary Schools in East AfricaInternational Quarterly of Community Health Education, December 2018. This study evaluated the impact of a school-based handwashing program consisting of two interventions: a hand-hygiene curriculum and group handwashing station. The curriculum increased knowledge, and the handwashing station enabled students to translate their knowledge into action.

A Program to Improve the Hand Hygiene Compliance of Hong Kong Preschoolers with an Insight into their AbsenteeismAmerican Journal of Infection Control, May 2019. Good cooperation between schools and families is found to be important in helping students build positive attitudes and habits, even in performing simple routines like hand hygiene.

Humanitarian Settings
Child's Play: Harnessing Play and Curiosity Motives to Improve Child Handwashing in a Humanitarian Setting. International Journal of Hygiene and Environmental Health, March 2019. Researchers show that distributing soaps with toys embedded inside, in a rapidly deployable intervention, can improve child handwashing behavior in a humanitarian emergency context.

Efficacy of the SuperTowel: An Alternative Hand-Washing Product for Humanitarian EmergenciesAmerican Journal of Tropical Medicine and Hygiene, May 2019. The study’s findings indicate that the SuperTowel is appropriate for use in contexts where soap and water availability is scarce or irregular, and where sanitation and hygiene facilities are not available or are shared.

Other Studies
Safely Managed Hygiene: A Risk-Based Assessment of Handwashing Water QualityEnvironmental Science & Technology, January 2019. Researchers modeled the mechanism of infection due to contaminated handwashing water to inform risk-based guidelines for microbial quality of handwashing water, finding that handwashing with nonpotable water will generally reduce fecal contamination on hands but may be unable to lower the annual probability of infection risks from hand-to-mouth contacts below 1:1,000.

Prevalence and Associated Factors of Intestinal Parasitic Infections among Food Handlers at Prison, East and West Gojjam, EthiopiaAdvances in Medicine, January 2019. A high proportion of intestinal parasitic infection was detected among food handlers working at East and West Gojjam Prison, highlighting the need to train the food handlers on personal hygienic conditions.

Global Handwashing Partnership (GHP) – 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. Its Resources Hubincludes a number of toolkits, manuals, etc.

USAID Water, Sanitation, and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) – WASHPaLS works to improve WASH programming by identifying, researching, and sharing best practices for the delivery of WASH services and sustained behavior change. It published a review on hygienic environments for infants and young children and conducted a webinar on community-led total sanitation.

Globalwaters.org – The USAID Water Team supports this website with the aim of fostering global knowledge and collaboration for sustainable water, sanitation, and hygiene access for all. A search on ”handwashing”  retrieves reports, webinars, podcasts, and other handwashing resources.

Sanitation and Hygiene Applied Research for Equity (SHARE) – SHARE contributes to achieving universal access to effective, sustainable, and equitable sanitation and hygiene by generating evidence to improve policy and practice worldwide. Its resources include policy briefs, research, and reports on behavior changefood hygiene, and other topics.


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