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

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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.

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Authors

Haruna Kashiwase

Consultant, Development Data Group, World Bank

Join the Conversation

M.waqar Qureshi
February 19, 2020

Haruna Kashiwase.

UNICEF estimates that children can reduce their risk of getting diarrhea by more than 40% by handwashing with soap and water. My question is that how you can say that handwashing is sufficient for diarrhea as well as recent coronavirus?

February 19, 2020

Thank you for your comment. Although handwashing with soap is effective in reducing the risk of infection or acquiring infectious diseases, neither WHO or UNICEF say that it is sufficient to prevent the diseases. To improve one’s chances of avoiding infection, other measures should also be employed with handwashing, such as practicing proper respiratory hygiene, maintaining distance from those infected, etc. For more information on these and other measures, please refer to this advice from the World Health Organization:
http://wrld.bg/J4eK50yqATI

You can also find the list of studies on the effectiveness of handwashing to prevent diarrheal and respiratory diseases.
http://wrld.bg/W4zS50yqAYT
http://wrld.bg/onxp50yqB0x

Kenalemang Mpoteli
February 19, 2020

Iam From Lesotho and this is so true

KRESDEN PIMENTO
February 19, 2020

YOU ALL ARE DOING A VERY GOOD JOB. GOD BLESS YOU.

Blessing Madimutsa
February 20, 2020

im from Zimbabwe and we have seen the reality of this story. My mother used to be village worker and we have noticed that access to water and soup is a big challenge now especially with the massive drought and economic decline that recently hit Zimbabwe. Myself and my mother are in Planning process to teach women in the village how to use locally available resources to make detergents especially soup for themselves and teaching them hygienic practices...Thank Haruna for this Article so Helpful

Haruna Kashiwase
February 20, 2020

Thank you very much for sharing your valuable story and experience. I hope your project will be successful.

Haruna Kashiwase
February 20, 2020

You might also take a look at the article on the Global Handwashing Day in Zimbabwe from the UNICEF's site: https://www.unicef.org/zimbabwe/stories/zimbabwe-commemorates-global-ha…

BELEMA NUME TOM_GEORGE
February 20, 2020

Dear Haruna, it very important and wise to sensitize the public about hygiene, especially the advantages of washing hands. I noticed in my community, quite a lot of people are not conscious of washing their hands before eating any food. About 50% of the indigenes from my community believe in the traditional way of eating with their bare hands. Thanks.

Haruna Kashiwase
February 20, 2020

Thank you very much for your comment. It is quite interesting to learn about the situation in your community. The following document explains handwashing practices among indigenous populations: https://globalhandwashing.org/wp-content/uploads/2019/09/GHD-2019-Fact-… (page3).

Maxwel lihanda
April 21, 2020

Am from vihiga Kenya am happy with the training to reduce the spread of covid 19 but in my place we have people who ignore hard washing and others admirer to but we do not have the sanitizer how can we be help? Second question is all kind of alcohol helpful in controlling the spread of covid 19 when using in sanitazation?

Stephen maloba
April 21, 2020

Great to learn where lam as acontry kudos