Sharing knowledge about hand hygiene saves lives!
On May 5th, the world celebrates World Hand Hygiene Day (WHHD) under the annual campaign “SAVE LIVES – Clean your hands” of the World Health Organisation (WHO). The campaign was first launched in 2009 and aims to accelerate action to prevent infections and antimicrobial resistance (AMR) in health care and build a culture of safety and quality in which hand hygiene improvement is given high priority.
This year’s theme revolves around promoting knowledge and capacity building of health and care workers through innovative and impactful training and education on infection prevention and control (IPC), including hand hygiene. This is important to help stopping the spread of harmful germs in healthcare.
According to the WHO (2024):
- Health care associated infections (HAIs) are among the most frequent adverse events occurring in the context of health service delivery. 136 million cases of health care-associated antibiotic resistant infections occur worldwide every year.
- Hand hygiene saves millions of lives every year when performed at the right times in health care, while across the 34 OECD and EU/EEA countries, investing US$ 1 in improving hand hygiene in health care settings returns about US$ 24.6 in economic returns (i.e. both in health expenditure and productivity gains in the broader economy).
The objectives of WHHD 2024 comprise:
- Strengthening learning approaches to enable implementation of innovative and effective training to empower health and care workers to improve hand hygiene and IPC at point of care with enhanced knowledge, skills and behaviours.
- Promoting access to innovative hand hygiene and IPC training resources for health and care workers.
- Raising awareness about the importance of knowledge and learning on hand hygiene at the right times to prevent a range of infectious diseases.
- Encouraging measurement and evaluation mechanisms to assess the impact of training and education on IPC standards and practices including hand hygiene, including their effect on the prevention of HAIs and AMR.
Hands4health: Improving hand hygiene in health centres in Mali and Burkina Faso
The abovementioned objectives resonate with the hands4health project, which is developing and implementing a holistic approach to water, sanitation and hygiene (WASH) in primary health care facilities (HCFs) in Mali and Burkina Faso that includes a strong component on hand hygiene.
In both countries, the intervention comprises, among others, the installation of Gravit’eau handwashing stations and the implementation of RANAS behaviour change campaigns. The latter are tailored to the needs of the health care facilities and aim to foster safe and frequent hand hygiene behaviour in health care facilities, focusing mostly on health care staff. WASH FIT – an approach to improving water, hygiene and sanitation in health centres – is another integral component of the hands4health project in Mali and Burkina Faso.
Mali
In Mali, the hands4health project implemented 22 Gravit’eau handwashing stations in the 12 primary health care centres that integrate the intervention group. The installation was accompanied by RANAS behaviour change campaigns that reached 83 health care workers (44 males, 39 females), as well as the implementation of the WASH FIT approach.
The RANAS campaigns comprised a variety of activities, including: demonstrating and practicing proper handwashing; highlighting the benefits of handwashing; implementing nudges, prompting and environmental cues; adopting hands-on solutions for common barriers; and celebrating a party with the health care staff, to foster their engagement for a better hygiene. Below, staff from two health care centres of the project share how the RANAS campaigns contributed to an improved hand hygiene within their facilities:
I can say that the campaign has helped us a lot with respect to handwashing with soap. Especially the poster with bacteria on the hand showed us how much we’re at risk if we don’t wash our hands properly with soap. We started to raise awareness among patients, especially women, through the poster. I’ve personally noticed a big change in my health centre.
Technical Director of the Temou community health centre, sanitary circle of Markala
The Ranas campaign has really done us good in terms of hand hygiene. We used to come to the health center and go home without washing our hands very often. Now, we wash our hands every time, especially when we see the nudges posted on the floor. It reminds us every time when we forget. We’ve become aware of the risk we run if we don’t keep our hands clean.
Matron of the Fatinè health centre, sanitary circle of Ségou
Hand hygiene is a fundamental component of the WASH FIT approach, as it plays a key role in the prevention and control of infections. WASH FIT was implemented in all intervention centres in Mali, which included the training of health committees. During the WASH FIT training sessions, participants were trained on handwashing techniques and the use of hydroalcoholic gel as defined by the WHO. The trained committees carried out self-assessments of their centres on all relevant components, including hand hygiene. The installation of Gravit”eau devices in the facilities made a vital contribution to the evaluations by the committees, as the devices were present and functional.
Burkina Faso
In Burkina Faso, the hands4health project implemented 24 Gravit’eau handwashing stations in the 12 primary health care centres that integrate the intervention group. The installation was accompanied by RANAS behaviour change campaigns aimed at health care workers.
The RANAS campaigns comprised a variety of activities, including: demonstrating and practicing proper handwashing; highlighting the benefits of handwashing; implementing nudges, prompting and environmental cues; and celebrating a party with the health care staff, to foster their engagement for a better hygiene.
The intervention also implemented a training on infection prevention and control targeting health agents and handymen, covering important handwashing and cleaning practices in health care facilities.
Health impact evaluation
To understand the effects of the intervention on water- and hygiene-related health determinants and outcomes, a health impact evaluation based on randomised controlled trials is being conducted by the Swiss Tropical and Public Health Institute (Swiss TPH) in both countries.
The evaluation will focus in particular on the proportion of correct hand hygiene measures taken by healthcare staff during the five WHO hand hygiene times (see infographic below), taking into account the hygiene measures of cleansing with hydroalcoholic gel, hand washing with soap and water, and wearing correct gloves. The evaluation also collected data on the presence of E. coli on the hands of healthcare staff through hand-rinse samples and RANAS behavioural factors.
Baseline, mid-term and end-of-project data collection has been completed in both countries, and end-of-project data analysis is underway. The results of the health impact assessment will be communicated in forthcoming research publications, so stay tuned!
More information and resources
If you would like to join the movement and help to save lives by promoting adequate hand hygiene to prevent infections, check out the official website of the World Hand Hygiene Day 2024. Useful resources include:
- Annual 5 May Advocacy Toolkit
- Your 5 moments for hand hygiene (infograph)
- How to handwash (infograph)
- How to handrub (infograph)
- The WHO hand hygiene page, which contains guidelines and evidence, as well as training, implementation and monitoring tools on hand hygiene in health care facilities.
We also invite you to access the latest updates on the hands4health website and to register for our newsletter.
