Determinants of hand hygiene behavior.
Sustaining hand hygiene behavior change requires addressing a range of behavioral determinants. Behavioral determinants are factors that influence behavior. Determinants for hand hygiene behavior include social norms, affiliation, enabling technologies/infrastructure, nurture, disgust, perceived susceptibility and perceived severity of diseases. The Handwashing Handbook groups these determinants into reflexive, habitual factors (such as culture, environmental cues, and nudges) and more reflective, conscious decision-making factors (such as knowledge and emotional motivators). Enabling technologies are a critical determinant for hand hygiene behavior. Undoubtedly, it is not possible to maintain good hand hygiene without the necessary facilities. However, in a study surveying 29 countries in Sub-Saharan Africa, Endalew et al. (2022) determined that 66.16% of handwashing facilities lacked either water or soap. Access to facilities and supplies cannot be neglected, but it is not the o...