The novel coronavirus (COVID-19) pandemic is creating a humanitarian and economic crisis. Amid the chaos, though, lies a simple preventive practice: handwashing with soap. During times of crisis, we must remember that handwashing with soap is a powerful tool to combat infectious diseases like COVID-19, and it is crucial for us to sustain handwashing practices and innovations once the pandemic has ended. Private-sector engagement, especially through public-private partnerships like the Global Handwashing Partnership, can play a significant role in developing immediate and long-term infectious disease solutions.
A version of this post originally appeared on FHI 360’s R&E Search for Evidence blog.
Evidence on the health and social benefits of handwashing is strong. We know that handwashing can prevent up to 40% of diarrheal diseases, and can lead to fewer school absences and increased economic productivity. However, many people don’t wash their hands at critical times, even when handwashing facilities are available. While research on behavior change has shown examples of approaches that lead to increased rates in handwashing, we’re still seeking to understand why people wash their hands, and how motivation for handwashing can be translated into programs that result in effective behavior change.
In advance of Global Handwashing Day on October 15, USAID and the Global Handwashing Partnership – an international coalition with a Secretariat hosted by FHI 360 – organized a webinar on drivers for handwashing behavior change. The Partnership’s work focuses on promoting handwashing with soap as key to health and development, with an emphasis on connecting practitioners with research findings to inform their work. Our webinar speakers provided two examples of how research is exploring behavior change from cognitive (how we think about and understand handwashing) and automatic (how we can be unconsciously prompted to wash our hands) standpoints. In this blog post, I’ll summarize how the two examples show different ways of understanding human behavior and discuss how the findings help us understand what drives behavior change for handwashing.
Each year on Global Handwashing Day, hundreds of millions of people around the world gather to celebrate the power of handwashing with soap to save lives. This day also provides an opportunity to consider the current status of the hygiene sector and catalyze further action. As we look toward the future of hygiene behavior change, we need to ensure that we are maximizing the broader topic of integrated development and fully considering its relationship to hygiene.
Integrated development, which can be defined in many different ways, is increasingly being discussed within the international development community, and FHI 360 plays an active role in convening this conversation. I recently had the opportunity, on behalf of the Global Public–Private Partnership for Handwashing (PPPHW), to attend an event hosted by FHI 360 titled Does 1+1=3? Proving the Integration Hypothesis, which brought together expert panelists from academia, government, donors and nongovernmental organizations.
I took away many key learnings from this event, but the one that stuck with me most is this: If we hope to move the needle on the most entrenched development challenges, we need to consider the benefits that could be offered by combining services or sectors.
The idea seems so simple. But, for millions of people across the globe, handwashing with soap and clean water is much easier said than done.
In eastern Zambia, where we work, FHI 360 is improving access to clean water and sanitation facilities and encouraging healthy hygiene behaviors as part of the Schools Promoting Learning Achievement through Sanitation and Hygiene (SPLASH) project, funded by the U.S. Agency for International Development (USAID).
The need is great. According to a baseline survey conducted by SPLASH in 2012, only 28 percent of 564 schools surveyed had any type of handwashing facility. To fulfill this unmet need, SPLASH is creating permanent handwashing stations in four districts of Zambia’s Eastern Province (Chadiza, Chipata, Lundazi and Mambwe). Since 2012, SPLASH has constructed 760 toilets and rehabilitated 128 others, and installed 40 hand pumps with 2,500 litre water tanks at schools in Chipata, Lundazi and Mambwe.
Did you know that an everyday item in your home has the potential to save the lives of hundreds of thousands of children each year? Soap, when used at critical times such as after using the bathroom or before preparing food, can reduce the risk of diarrheal disease by nearly half and cut the risk of upper respiratory infections, such as pneumonia, by nearly a quarter. While these illnesses may seem like a normal part of childhood, they cause 1.7 million child deaths each year.
Unlike many solutions to the world’s development challenges, handwashing with soap is simple. It does not require any special skills or equipment, and it is within the economic reach of communities everywhere. In fact, handwashing with soap is the most cost-effective intervention to prevent diarrheal disease. However, making handwashing with soap a habit remains a challenge around the world.
Today, the world celebrates Global Handwashing Day, which is an opportunity to promote and advocate for handwashing with soap. As the Secretariat Coordinator of the Global Public–Private Partnership for Handwashing, FHI 360 plays a unique role in moving this agenda forward by linking clinical knowledge about behavior change and hygiene promotion to practitioners in the field. Increasing knowledge sharing and collaboration is a necessity if we hope to eradicate preventable childhood deaths.
This week, GBCHealth will bring together some of the most prominent private-sector leaders in the world to discuss strategies for tackling pressing global health challenges. This year’s GBCHealth conference will focus on how business can better align its work with the Millennium Development Goals (MDGs). The fourth MDG is to reduce mortality for children under 5 years old. The biggest threats to young children are pneumonia and diarrheal diseases, which are the cause of nearly 2 million deaths a year in children under 5 years old. The good news is that there is a simple way to prevent much of the spread of these two diseases: handwashing. And the private sector has been on the forefront of promoting handwashing in developing countries for more than a decade.
In 2000, I co-founded the Global Public–Private Partnership for Handwashing along with the London School of Hygiene and Tropical Medicine and the World Bank/ Water and Sanitation Program. Today, FHI 360 operates the secretariat for the partnership, and our membership has expanded to include Procter & Gamble, Unilever, Colgate-Palmolive, the University of Buffalo, the World Health Organization, the U.S. Agency for International Development, and the United Nations Children’s Fund. Each member of our partnership contributes financial resources, skills or time.
Diarrhea and respiratory infections are responsible for the majority of all child deaths, taking the lives of millions of children in developing countries every year. Fortunately, one of the most cost-effective solutions is virtually at our fingertips: washing our hands with soap. This simple act can reduce the incidence of diarrhea and respiratory infections among children under 5 by almost 50 percent and 25 percent, respectively.
To promote this life-saving practice around the world, the Global Public–Private Partnership for Handwashing — which includes FHI 360, the U.S. Agency for International Development (USAID) and 10 other public and private organizations — launched Global Handwashing Day. The event has grown from a one-day celebration in a few cities to a worldwide movement that has mobilized significant investment in and political support for handwashing with soap.