Hand washing with soap
Why is handwashing with soap important?
The importance of hand washing with soap was demonstrated in a 2003 systematic review on hand washing and diarrhoea, in which Curtis and Cairncross found that community hand washing interventions reduced the risk of contracting diarrhoea by 47%. Handwashing with soap is also considered to be one of the most cost‐effective ways of reducing the global burden of disease (Bank, W. 2006). Despite the potential for hand hygiene interventions to save millions of lives worldwide, behaviour change is not easy. The team at Hygiene Central are working to provide evidence of what really works to improve hand washing behavior through exploratory reserach and clinical trials in in a range of lower income and middle income settings.
Our key reserach and contributions in this area to date:
The Hygiene Centre is known for its research on how to change and sustain hygiene behaviour related to hand washing. Researchers in the Centre have become expert in developing and testing ways in which hand washing can be successfully promoted on a large scale. The Hygiene Centre is also currently testing the hypothesis that the transmission of acute respiratory infections is also prevented by frequent hand washing.
Staff from the Hygiene Centre were actively involved in setting up the Global Public-Private Partnership to Promote Hand washing With Soap and continue to contribute to provide advice and management for the group. The partnership brings together the skills and resources of the soap industry, national governments, development organisations and the academic world. The non-branded soap and hand washing promotion programmes bring substantial health benefits, particularly to children under 5 years, while satisfying the desire of soap manufacturers to improve their market penetration.
The success of the partnership is already evident. Preliminary results from the Ghana initiative show increases of 13% and 41% in hand washing with soap after defecation and before eating, respectively. The advert below was developed as part of this initiative and won the Best Television Advert of the Year in Ghana.
School-age children can be extremely receptive to the promotion of good habits such as tooth-brushing or hand-washing and can develop positive attitudes towards the use of sanitary facilities. These habits and attitudes have positive health outcomes that continue throughout adult life. For this reason, Hygiene Centre staff members are actively involved in studying the psychology of habit formation, particularly in the context of routine behaviours.
To better understand the unique determinants of children’s behaviour, the Hygiene Centre has been working for some years now on developing a set of tools which are tailored to effective communication with, and information elicitation from, children, especially in developing countries.
The first ‘generation’ of these tools were the brain-child of Myriam Sidibe, a DrPH student in the Hygiene Centre, who studied the hygiene behaviour of school-children in Senegal. Since then, the tools have been refined through use in national surveys conducted in other sub-Saharan African countries, and more recently in Asia.
The Hygiene Centre ‘Tools for Schools’ Toolkit is freely availble to anyone who wishes to use it and is available here.
The Hygiene Centre and SHARE collaborated on the development of this hand washing capaign toolkit. The resources are designed to help local implementers promote hand-washing with soap in households in low income settings. The campaign concept draws on ideas and best practices from different fields including hygiene and health promotion, behavioural sciences and marketing. All the resources are provided free to who ever wishes to use them. You can watch the campaign film below or go to the website for access to the full set of tools and activities.
A few things we are currently working on:
The SuperAmma Campaign
This project was the culmination of years of behavioral science research to inculcate the habit of handwashing with soap. This communication campaign is based on the Evo-Eco theory of behavior change. The website linked to here includes the approach and the materials that worked successfully in Southern India. Or watch the campaign video below to get an idea about how the intervention was delivered.
Full list of publications related to hand washing:
- Cairncross, S., Curtis, .V, Greenland, K. (2012). What can hand hygiene do for the world? Ahead of Global Handwashing Day, the Hygiene Centre has updated estimates of the number of lives that can be saved by handwashing with soap.
- *Biran, A., Schmidt, W.-P., Wright, R., Jones, T., Seshadri, M., Isaac, P., Curtis, V et al. (2009). The effect of a soap promotion and hygiene education campaign on handwashing behaviour in rural India: a cluster randomised trial. Tropical Medicine and International Health 14(10), 1303-1314.
- *Schmidt, Wolf-Peter, Robert Aunger, Yolande Coombes, Peninnah Mukiri Maina, Carol Nkatha Matiko, Adam Biran and Valerie Curtis (2009) ‘Determinants of handwashing practices in Kenya: The role of media exposure, poverty and infrastructure.’ Tropical Medicine and International Health 14: 1534-1541.
- *Judah, Gaby, Robert Aunger, Valerie Curtis, Wolf-Peter Schmidt and Susan Michie (2009) ‘Experimental pre-testing of potential public health interventions: The case of handwashing with soap’. American Journal of Pubic Health 99:S405-S411.
- *Judah, G., Donachie, P., Cobb, E., Schmidt, W., Holland, M., & Curtis, V. (2009). Dirty Hands: bacteria of faecal origin on commuters’ hands. Epidemiology and Infection 138(3), 409-414.
- Schmidt WP, Wloch, C., Biran, A., Curtis, V., & Mangtani, P. (2009). Formative research on the feasibility of hygiene interventions for influenza control in UK primary schools. BMC Public Health, 9, 390-398.
- *Aunger, Robert and Valerie Curtis (2009) ‘Lifebuoy Five Occasions Study’. [Unilever]
- *Curtis, V., & Aunger, R. (2010). Formative Research on handwashing in Bangladeshi households for SHEWA-B. Dhaka: Unicef.
- Curtis, V. (2010). Hygiene. In W. H. MacNeill, J. Bentley & D. Christian (Eds.), The Encyclopedia of World History. Barrington MA: Berkshire Publishing.
- *Aunger, Robert, Schmidt,WP., Ashish Ranpura, Yolande Coombes, Peninnah Mukiri Maina, Carol Nkatha Matiko and Valerie Curtis (2010) ‘Three kinds of psychological determinants for hand-washing behaviour in Kenya.’ Social Science and Medicine 70: 383-391.
- *Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP (2011) The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health 8(1):97-104. Epub Jan 6.
- *Curtis V, Schmidt W, Luby S, Florez R, Touré O, Biran A. (2011) Hygiene: new hopes, new horizons. Lancet Infect Dis. Apr;11(4):312-21.
- *Schmidt, W., & Curtis, V. (2011). Respiratory and Hand Hygiene in an Influenza Pandemic: Scientific Evidence Base Review. London: UK Department of Health.
- *Dodrill L, Schmidt WP, Cobb E, Donachie P, Curtis V, de Barra M. (2011) Male commuters in north and south England: risk factors for the presence of faecal bacteria on hands. BMC Public Health. 12;11:31.
- Biran, A. Enabling Technologies for Handwashing with Soap: A Case Study on the Tippy-Tap in Uganda. (2011June 6).
- Water, sanitation and hygiene for the prevention of diarhoea CAIRNCROSS, S. HUNT, C. BOISSON, S. BOSTOEN, K. CURTIS, V. FUNG, I. SCHMIDT, W-P.; 2010, in International Journal of Epidemiology 2010;39:i193–i205
- Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. CURTIS V and CAIRNCROSS S. The Lancet Infectious Diseases, Vol. 3, May 2003,
- Protecting Children from Diarrhoea and Acute Respiratory Infections: The role of Hand Washing Promotion in Water and Sanitation Programmes. (Currently Unavailable) SCOTT B, CURTIS V, and RABIE T Regional Health Forum, WHO South-East Asia Region, Vol. 7, Number 1, 2003
- Hygiene in the home: relating bugs and behaviour. CURTIS V, BIRAN A, Deverell K, Hughes C, Bellamy K, and Draser B Social Science and Medicine, 2003: 57, pp. 657-672.
- Childhood diarrhea and observed hygiene behavior in Salvador, Brazil. Strina A, CAIRNCROSS S, Barreto ML, Larrea C, Prado MS. American Journal of Epidemiology. 2003 Jun 1; 157(11):1032-8.
- Hand washing with soap – a new way to prevent ARIs? CAIRNCROSS S. Tropical Medicine and International Health. 2003 Aug; 8(8):677-9.
- Is hygiene promotion cost-effective? A case study in Burkina Faso. Borghi J, Guinness L, Ouedraogo J, CURTIS V. Tropical Medicine and International Health. Nov; 7 (11):960-9, 2002.