Impact of hand hygiene in reducing the burden of communicable diseases
The WHO reports that more than 500,000 deaths annually are due to poor hand hygiene; and also 1 million out of 4.1 million of maternal and neonatal deaths, are due to the same. PHOTO | COURTESY
What you need to know:
- Research in Tanzania shows that, prior to the outbreak, 59 percent of Tanzanian households had handwashing facilities that included soap and water. However, only 22.83 percent of these facilities were functional (Shao et al., in Tropical Medicine and Health Journal, 2021).
By Shimbo Pastory and Victoria Lyimo
Thorough hand cleaning is a primary measure of hygiene and remains an effective public health measure to prevent spread of infections in our communities by reducing risks of transmission of infections.
The commemoration of World Hand Hygiene Day this year comes with a critical reminder for societal collective responsibility on the importance of hand hygiene in safeguarding public health and wellbeing against the spread of infections and communicable diseases. Although hand hygiene is a universal concern, the focus this year is on promoting knowledge and capacity-building among healthcare workers on infection prevention and control.
In clinical practice and healthcare setting, hand hygiene is a critical component of infection prevention and control (IPC) aiming at preventing microbial transmission during patient care, thus reducing the burden of healthcare associated infections (HCAIs).
Hand hygiene (HH) was advanced as a procedure by a Hungarian obstetrician named Ignaz Semmelweis in the 19th century, who is honoured today as Father of Hand Hygiene. The Center for Disease and Control (CDC), which was established in 1946, recognised hand hygiene as an important area in healthcare settings and included it in the guidelines for prevention of HCAIs in 1975 and 1985.
Among the advancement of hand hygiene was the use of alcohol hand rub, which began in 1990s, shifting from the use of soap and water only. In 2006, WHO provided new directions of hand hygiene based on fostering and promoting system change, feedback provision for outcomes of effective and efficient hand hygiene (performance feedback), education provision and availing of reminders of hand hygiene in workplaces.
Apart from the WHO hand hygiene guide, each country has local adaptations of hand hygiene guidelines in healthcare. WHO member states are committed to enabling access to quality essential healthcare services which has an Infection Prevention and Control component, including hand hygiene (WHO: Global Strategy on Infection and Prevention Control, 2023).
Hand hygiene has been practised poorly in the regular life of the general public in our countries, a reason why it looked so new during the Covid-19 pandemic.
Research in Tanzania shows that, prior to the outbreak, 59 percent of Tanzanian households had handwashing facilities that included soap and water. However, only 22.83 percent of these facilities were functional (Shao et al., in Tropical Medicine and Health Journal, 2021).
In low- and middle-income countries (LMICs), due to lack of accessible hand washing facilities and poor clean water supply, the habit faded away post-pandemic despite the risks being still higher. Knowledge and practice of handwashing has increased rapidly during and after the Covid-19 due to rigorous IPC training, yet the practice is unparallel (Silago et al., in The East African Science Journal, 2021).
Equally, In Tanzania, Water, Sanitation and Hygiene (WASH) and healthcare waste management (HCWM) services need serious improvement. A good number of rural healthcare facilities under public management lack reliable on-site water sources and a constant supply of running water with soap, or alcohol-based hand rub, and functioning safe toilets for patients (Meshi Eugene et al., Equity in water, sanitation, hygiene, and waste management services in healthcare facilities in Tanzania, in Public Health in Practice Journal, 2022).
Hand hygiene will be a mythical practice to healthcare workers in adherence to IPC standards when the Water, Safety and Hygiene (WASH) minimum requirements for healthcare facilities are still low. With the naturally endowed supply of water in Tanzania, we should have this problem solved for common good.
In 2022, only 4 out of 106 countries which were assessed had met minimum requirement for Infection Prevention and Control (IPC) in place at the national and facility level, with training and education scoring as the weakest components by WHO surveys (WHO-IPC Global Report Executive Summary, 2022, p. V). 14 percent of healthcare facilities globally had limited water supply, meaning that the source that was either located away from the premises or had no water available at the time of the survey (Gete Berihun et al., in PLOS Journal, 2022).
The WHO reports that more than 500,000 deaths annually are due to poor hand hygiene; and also 1 million out of 4.1 million of maternal and neonatal deaths, are due to the same. Poor hand hygiene impact lives and productive workforce irreparably due to economy and social burden of diseases.
There is need for public awareness. With multisectoral implementation among public health specialists and continuous public trainings, even from primary schools, we will see change, especially to high-risk populations in crowded towns, and places with water scarcity. The SDG Target 6.2 which states: “To achieve access to adequate and equitable sanitation and hygiene for all and end open defecation” is our target.
Shimbo Pastory is a journalist and student at Ateneo de Manila University, Manila, Philippines. Victoria Lyimo is a nurse, and holds a master’s in public health (MPH) from the University of Dodoma, Tanzania.
