Home Reports State of The World’s Hand Hygiene 2021

Investing $1 per person per year in hand hygiene could save hundreds of thousands of lives


The 2021 State of The World’s Hand Hygiene report launched on Global Handwashing Day by WHO and UNICEF, highlights that an annual cost to governments of promoting handwashing with soap at home comes to just 2.5 per cent of the average government health expenditure in these countries — making it a highly cost-effective investment, providing outsized health benefits for relatively little cost.

This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.

State of The World’s Hand Hygiene 2021

The State of the World’s Hand Hygiene report draws on a recent study by WHO and UNICEF that estimated that achieving hand hygiene for all households by 2030 in 46 of the least-developed countries of the world would cost a total of US$11 billion. This is equivalent to 25 US dollar cents per capita per year on promotion efforts, and 66 US dollar cents per capita per year on handwashing facilities. Promotion costs, usually borne by governments, would be equivalent to 2.5% of median government health expenditure in the 46 least developed countries. The costs of facilities, most often borne by households, would equal 25 dollars per year for each unserved household. The study also highlights that with an additional 20 cents per person one-to-one hygiene promotion would be possible, shown to be highly effective.

The costs of achieving hand hygiene can be estimated by examining the many possible interventions to support it, grouped under facilities to practice hand hygiene on the one hand and the promotion of behaviours required on the other. There are both capital, one-off costs and recurring maintenance costs associated with hand hygiene.

The report brings together dispersed data sets on hand hygiene access and underlying national policies and investments to highlight lagging progress; and calls member states and supporting agencies to action, offering numerous inspiring examples of change.  

Hand hygiene, one of the first lines of defence against the spread of infectious diseases, remains out of reach for billions of people who still lack hand hygiene facilities at home, school, or health care facilities.

Globally, 3 in 10 people, or 2.3 billion, lack a handwashing facility with water and soap at home; 818 million children lack a handwashing facility with soap and water at school in 2020, and health workers in 1 in 3 healthcare facilities lack hand hygiene facilities at the points at which they provide care — placing them all at preventable risk of disease even at the best of times. Almost 2 billion people depend on health care facilities that don’t even have basic water services.

5 key actions

To speed up progress, governments should prioritize 5 key actions:

  • Good governance through leadership, effective coordination and regulation, including clear policies on handwashing services and behaviours in all settings.
  • Smart public finance to ensure maximum impact and stimulate investments from households and the private sector.
  • Assessment of current capacity with respect to their hand hygiene policy and strategies, identification of gaps and development of capacity-building strategies based on the rigorous application of best practice.
  • Governments should address the need for consistent data on hand hygiene in order to inform decision-making and make investments strategic.
  • Governments and supporting agencies should encourage innovation, particularly on the part of the private sector, in order to roll out hand hygiene in all settings.

Download: State of the world’s hand hygiene


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