On Global Handwashing Day, the World Health Organization (WHO) and UNICEF unveiled the first global Guidelines on Hand Hygiene in Community Settings. These guidelines aim to assist governments and practitioners in promoting effective hand hygiene practices beyond healthcare facilities, encompassing homes, schools, and public spaces.
Framework for Public Health Improvement
These guidelines frame hand hygiene as a public good and a governmental responsibility. They translate scientific evidence into practical actions that facilitate sustainable access to hygiene services. The initiative is expected to significantly reduce the incidence of diarrhoeal diseases, acute respiratory infections, and other preventable illnesses, thereby strengthening public health measures where people live, work, and study.
Despite the clear health benefits associated with improved hand hygiene, around 1.7 billion people worldwide still lack basic hand hygiene services at home as of 2024. Of these, approximately 611 million do not have any facility for handwashing. To meet the 2030 target for universal hand hygiene access, global progress will need to accelerate significantly—potentially doubling current rates. This is especially urgent in the least-developed countries, where improvements may need to occur at rates up to 11-fold.
Cost-Effectiveness and Policy Recommendations
Hand hygiene is one of the most cost-effective health investments available, reducing diarrhoea incidence by 30% and acute respiratory infections by 17%. The guidelines advocate for a policy framework that prioritizes hand hygiene as a critical component of health systems.
“Clean hands save lives, but results at scale require policy, financing, and accountability,” stated Dr. Ruediger Krech, Director a.i. of the Department of Environment, Climate Change, One Health & Migration at WHO.
According to Cecilia Scharp, Director of the Water Sanitation and Hygiene (WASH) Team at UNICEF, children and young people are disproportionately affected when basic hygiene facilities are inaccessible. She emphasized that the guidelines provide actionable steps to ensure that facilities are available in essential locations such as homes, schools, markets, and transport hubs, allowing every child to thrive with dignity.
The guidelines also outline seven principles for effective implementation, including:
- Prioritizing minimum material needs
- Understanding behavioral drivers and barriers
- Engaging communities
- Ensuring gender responsiveness
- Committing to progressive improvement
- Strengthening health systems
- Monitoring, evaluating, and improving services
Efforts to enhance hand hygiene must evolve from project-based initiatives to government-led systems that ensure the availability of soap, water, and conducive conditions for everyday hygiene practices. Following disease outbreaks, governments often mobilize resources and strengthen health systems, but this momentum frequently wanes once the crisis is resolved. As a result, political attention shifts, and budgets are reduced, undermining long-term resilience.
To break this cycle, the guidelines urge governments to fortify systems that deliver hand hygiene services as part of broader health initiatives. Effective measures include developing policy and legal frameworks, implementing regulations and monitoring systems, and coordinating actions through national institutions with clearly defined responsibilities and adequate resources.
By establishing a solid foundation for hygiene services, governments can ensure that hand hygiene facilities are reliable, accessible, and affordable for all. This approach will also incorporate ongoing behavior change strategies to promote sustained hand hygiene practices across communities.
