Many homes in low- and lower middle-income countries lack basic handwashing facilities

With the current flu season predicted to be especially severe, as well the recent coronavirus outbreak, people are rightfully concerned about their health. From flu shots to face masks, many are taking extra measures to protect themselves from infection. But there is also a simple and effective way to help prevent the spread of infectious diseases—handwashing. Washing your hands with soap and water is an efficient and inexpensive way to help prevent transmission of diseases such as diarrheal and respiratory infections. UNICEF estimates that children can reduce their risk of getting diarrhea by more than 40% by handwashing with soap and water. As a standard hygiene measure to prevent infections including the new coronavirus, WHO advises the general public to practice handwashing with soap and water, and published a guideline on proper handwashing techniques.

Handwashing is now recognized as a top hygiene priority and is monitored as part of Sustainable Development Goal 6 (indicator 6.2). The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) has estimated the population with basic handwashing facilities^[1]—defined as households that have handwashing areas with soap and water. Some people might take these for granted, but there are still many who don’t have basic handwashing facilities at home, especially in low- and lower middle-income countries.  Let’s explore the challenges to maintaining good hand hygiene through a couple of charts:

The most recent data (2017) estimating the availability of handwashing facilities at home are available for 77 countries and are based primarily on household surveys such as Multiple Indicator Cluster Surveys and Demographic and Health Surveys. In these surveys, the enumerator visits the handwashing facility and observes if water and soap are present. In 42 countries (54% of the countries with data), less than half of the population have basic handwashing facilities with soap and water in their homes.  The countries with low access are concentrated in Sub-Saharan Africa. For example, Liberia, Lesotho, Democratic Republic of Congo and Rwanda have especially low level of access (less than 5%). Outside Sub-Saharan Africa, in Haiti, Vanuatu, Bolivia, and Timor-Leste less than 30% of people have basic handwashing facilities where they live. In the countries with the low access, not only installation of handwashing facilities with running water but also behavioral change may need to be promoted. UNICEF points out that soaps are available in low-income countries, but rarely used for handwashing. 

To learn more about the state of handwashing around the world, check out our World Development Indicators feature story. 

Notes on data:

Monitoring and measuring handwashing behavior can be challenging.  Presence of a handwashing station with soap and water does not guarantee that household members consistently wash hands at key times, but JMP states that observation of handwashing materials by surveyors represents a more reliable proxy for handwashing behavior than asking individuals whether they wash their hands.  Also, the data in most high-income countries are not available as it is assumed that basic handwashing facilities are nearly universal. 

Definition of the indicator:

[1] People with basic handwashing facilities including soap and water (% of population): The percentage of people living in households that have a handwashing facility with soap and water available on the premises. Handwashing facilities may be fixed or mobile and include a sink with tap water, buckets with taps, tippy-taps, and jugs or basins designated for handwashing. Soap includes bar soap, liquid soap, powder detergent, and soapy water but does not include ash, soil, sand or other handwashing agents.