To fight the coronavirus, wash your hands and support clean water access around the world

To fight the coronavirus, wash your hands and support clean water access around the world. by Susan Barnett, USA Today, March 4, 2020.

We can’t build a wall around a germ. But we can wash our hands, and our government can help countries trying to improve their health facilities.

Never has my odd obsession with the lack of access to safe water, toilets and soap around the world become more relevant to the headlines.

Because nowhere is the absence of WASH (water/sanitation/hygiene) more abominable than in hundreds of thousands of health care facilities where infections are supposed to go to die.

With all this hand-wringing about the new coronavirus, two things need to happen.

First, this virus has no cure, no vaccine, no treatment other than resting, hydrating, cough medicine and pain relief. You get sick, you feel crummy. You wait it out and try not to get anyone else sick. But the better option is to not get sick in the first place.

There are only two ways to be on the offensive: Avoid sick people, which makes a big presumption that they and you know they’re sick, and — the single most important thing you can do — wash your hands.

Read the complete article.

New SHARE research on handwashing, food hygiene, position paper on the WASH Benefits and SHINE studies

• Publication – Okello et al. (2019) – Factors perceived to facilitate or hinder handwashing among primary students: A qualitative assessment of the Mikono Safi intervention schools in NW Tanzania
• Policy brief (2019) – Improved health and behaviour through integration of food hygiene and WASH
• Publication – Mumma et al. (2019) – Infant food hygiene and childcare practices in context: Findings from an urban informal settlement in Kenya
• WHO and UNICEF position paper on WASH Benefits and SHINE, 2019
  

Wash’Em – How to design handwashing facilities that change behaviour

How to design handwashing facilities that change behaviour. WASH’Em, August 2019.

In a crisis, humanitarians are often responsible for providing or repairing handwashing infrastructure for the affected population. This creates an opportunity for us to build infrastructure and provide products which encourage people to practice handwashing with soap.

Why are handwashing facilities important?
Did you know that having a handwashing facility makes you 50% more likely to wash your hands? If it is conveniently placed near the toilet or kitchen and has soap and water available, then people are up to 80% more likely to practice handwashing.

There are several reasons why handwashing facilities can have an important effect on behaviour. Imagine you are leaving the toilet. If you see a handwashing facility, this is likely to act as a trigger, reminding you to wash your hands. If you don’t see a handwashing facility you might get distracted with other things and forget to wash hands.

Even if you did want to wash your hands where there was no handwashing facility present, you would probably have to go to a lot more effort to walk to somewhere that has soap and water. In the process you may touch and contaminate lots of other
surfaces.

Often the level of effort required would act as a barrier to regular handwashing.
As humanitarians it is unethical and a waste of resources to do hygiene promotion if handwashing facilities, soap and water are not readily available to the population. In the acute phase of a crisis, handwashing infrastructure and products must be our first priority.

Water Currents: Handwashing Research, January – June 2019

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.

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Overviews
Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017: Special Focus on Inequalities. WHO; UNICEF, 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 Contact. International 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, India. American 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.

Read the complete article.

2018 Handwashing Research Index – Global Handwashing Partnership

2018 Handwashing Research Index. Global Handwashing Partnership, March 2019.

A core goal of our research summaries is to increase the research focus on handwashing. In 2018, we found 155 studies which explore handwashing in connection with diverse programmatic areas in global health and development, varying from urban design to maternal and child health. These entries were selected from peer-reviewed literature published in 2018.

The 2018 Handwashing Research Index has been filtered by tags, to aid navigation. Users may also choose to navigate using Date of Publication, Country Focus and Digital Object Identifiers (DOIs).

Case Studies from Tanzania: Emotional Demonstrations of Handwashing with Soap at Vaccination Centres & Sustaining Open Defecation-Free Status

Case Studies from Tanzania: Emotional Demonstrations of Handwashing with Soap at Vaccination Centres & Sustaining Open Defecation-Free Status. SNV Tanzania, February 2019.

These case studies provide practical information for implementing innovative WASH interventions, and brief discussions on challenges and lessons learned by the SNV Tanzania team and their partners in communities.

Innovative approaches to sustain handwashing with soap and open defecation free status in rural communities in Tanzania

By SSH4A Tanzania

In Tanzania, SNV has developed, under the Sustainable Sanitation and Hygiene For All programme, two innovative approaches to sustain handwashing with soap and open defecation free status in rural communities. These are triggering with soap at vaccination centres and Jirani (neighbours) sanitation groups.

The first intervention consists of triggering at vaccination centres as they were found to be ideal places to raise awareness of the importance of washing hands with soap among pregnant women, mothers and other caregivers.

The second intervention is based on having neighbours who monitor the sanitation and hygiene progress of the households closest to their homes and sensitise other neighbours on the importance of building, taking care of, and improving sanitation and handwashing facilities.

The following case studies provide practical information for implementing the interventions, and brief discussions on the remaining challenges and lessons learned by the SNV team and their partners on the ground:

SSH4A Tanzania, 2019. Emotional demonstrations (emo-demos) of handwashing with soap at vaccination centres. Dar es Salaam, Tanzania: SNV Tanzania. 8 p. Download case study

SSH4A Tanzania, 2019. Jirani sanitation groups : sustaining open defecation free status in Tanzania. Dar es Salaam, Tanzania: SNV Tanzania Download case study

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Facilitating handwashing where water is scarce – EAWAG

Facilitating handwashing where water is scarce – EAWAG, October 22, 2018.

Even though the water we’ve used for washing our hands is barely contaminated, it usually disappears down the drain, never to be used again. A newly developed system allows handwashing water to be recycled, thus not only saving water, but also helping to prevent infectious diseases in developing countries.

Every year, according to WHO figures, around four million people die as a result of diarrhoeal diseases or respiratory infections. Particularly in developing countries, these deaths are largely attributable to poor hygiene – the problem would be significantly alleviated by regular handwashing.

But how can this be achieved in places where people lack access to safe water, or piped water is unavailable? This issue is being addressed by a group of environmental engineers led by ETH Professor Eberhard Morgenroth (Head of Process Engineering at Eawag), carrying out research as part of the Blue Diversion AUTARKY project.

They have now developed a grid-free treatment system allowing greywater – relatively clean wastewater from showering, bathing or handwashing – to be repeatedly recycled.

As Morgenroth points out, while commercial systems are already available which enable greywater to be treated on-site for use in toilet flushing, the recycled water does not meet the required quality standards to be used for other purposes.

Read the complete article.

Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya

Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya. Int. J. Environ. Res. Public Health 2018, 15(9), 1994; https://doi.org/10.3390/ijerph15091994

Exposure to fecal pathogens results in both acute and chronic sequalae in young children. Diarrhea causes nearly 20% of all under-five mortality, while even sub-clinical enteric infections may lead to growth shortfalls. Stunting affects nearly 165 million children globally and results in lifelong and intergenerational effects for the world’s poorest populations. 

Caregiver hygiene behaviors, such as those surrounding handwashing and food preparation, play a critical role in exposure to fecal pathogens; standard metrics to assess these behaviors are warranted to provide a means of quantifying the impact these behaviors have on enteric infections and to evaluate the success or failure of interventions and programs.

This paper documents the development of three novel caregiver hygiene behavior measures: hygienic food preparation and storage, handwashing at key times, and provision of a safe play environment for children under two years.

We developed these measures using formative qualitative work, survey creation and deployment theoretically underpinned by the COM-B model of behavior change, and exploratory and confirmatory factor analysis.

The final measure for hygienic food preparation and storage includes 10 items across two factors; the final measure for handwashing at key times includes 15 items across three factors; and the final measure for safe play environment contains 13 items across three factors.

Future researchers may employ these measures to assess caregiver behaviors in other populations, identify specific behavioral dimensions that should be the focus of interventions, and evaluate interventions and programs

Webinar summary: The forgotten juncture? Handwashing and safe management of child feces

On August 22nd, 2018, the Global Handwashing Partnership, in conjunction with USAID, the International Water Center, the Water and Engineering Center for Development, and UNICEF hosted a discussion on the intersection of handwashing and the safe management of child feces. 

Safe disposal of children’s feces is a critical practice, and programs often under-emphasize critical times for handwashing related to infant and child feces. This webinar aimed to:
• Discuss the present status and impact of child feces disposal practices and handwashing,
• Highlight case studies, interventions and evidence,
• Share experiences across regions; and
• Review key considerations for practitioners.

Read the complete article and listen to the webinar.