Hand Hygiene Access and Supplies.

 

Access to proper hand hygiene services, supplies, and facilities

Access to proper hand hygiene services, supplies, and facilities is a critical determinant to improving hand hygiene behavior. Studies published in 2022 examined socio-demographic factors that impact hand hygiene access and explored the effectiveness of various hand hygiene techniques and products. Endalew et al. (2022) analyzed the prevalence and factors associated with limited handwashing facilities – defined as a dedicated location for handwashing where either soap or water are available but not both – among 29 countries in Sub-Saharan Africa using data from Demographic Health Surveys. Based on their model, the prevalence of limited handwashing facilities was 66.16%. A cross-sectional study by Muramatsu-Noguchi etal. (2022) investigated the association between socioeconomic status and the presence of soap at handwashing facilities in Laos. The study found a significant linear relationship between the presence of soap and household wealth and educational attainment. Although the study did not assess people’s perception on the cost of soap in Laos, many studies from other countries have reported people’s perception that soap is too expensive. These studies suggest the need to invest in effective strategies to ensure adequate and affordable hand hygiene infrastructure and supplies to improve and sustain handwashing behavior in different contexts. 

Other studies focused on the effectiveness of handwashing alternatives, such as alcohol-based handrub (Muleba et al., 2022; Vuai et al., 2022). A systematic review by Price et al. (2022) included updated research in support of the World Health Organization(WHO) recommendations on alcohol-based handrub. The review evaluated the impact of volume, application time, rubbing friction, and hand size on microbiological load reduction, hand surface coverage and drying time related to alcohol-based handrub, and ultimately determined there was insufficient evidence to change the current recommendations set out by the WHO regarding the use of alcohol-based handrub. Another study by Selam et al. (2022)evaluated the quality and antimicrobial efficacy of locally manufactured alcohol-based handrubs in Ethiopia, with nearly 33% of tested products not complying with WHO ethanol and hydrogen peroxide limits. This study suggests the need for regular quality monitoring of marketed alcohol-based handrubs, especially given the current wide use of such products during public health emergencies when the risk of transmitting diseases from hands are high.

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