Global Handwashing Day 2018

Global Handwashing Day is a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives. It is an opportunity to design, test, and replicate creative ways to encourage people to wash their hands with soap at critical times.

In 2018, the Global Handwashing Day theme is ‘Clean hands – A recipe for health’. The theme focuses on the links between handwashing and food, including food hygiene and nutrition. Handwashing is an important part of keeping food safe, preventing diseases, and helping children grow strong.

Handwashing and food hygiene

Handwashing with soap is an important part of food hygiene, a set of hygienic practices that keep food safe and prevent food-related illnesses.

Up to 70 percent of cases of diarrhea may be associated with poor food hygiene. Other important aspects of food hygiene include: keeping utensils and dishes clean, properly storing and reheating food, boiling water and milk where needed, and thoroughly cooking food.

Food-borne illnesses are a major cause of death in low income settings, particularly among children under. Contamination of food can lead to a wide range of illnesses and outbreaks, many of which are particularly dangerous for pregnant women, fetuses, and people with compromised immune systems.1 Hygiene promotion activities have shown improved food hygiene behaviors and reduced contamination in food. One study with mothers in Nepal showed that food hygiene behavior change, including improved handwashing, is feasible through a behavior-centered intervention process.

Critical food-related times for handwashing with soap include: before cooking or preparing food, before eating, and before feeding someone (including breastfeeding). Caregivers should wash their own hands at all critical times, and model or enforce good handwashing behavior for children. Caregivers include parents, siblings, other relatives, school or daycare professionals, and others.

Research indicates that existing routines can be modified to help form new habits. For example, a meal canserve as a ‘trigger’ moment for handwashing.5 Habitual handwashing is more likely when handwashing facilities are established, and time is set aside for handwashing before eating, to help develop a group norm.

Handwashing and nutrition

Hygiene is important for improving nutrition but is not a stand-alone solution. Improving handwashing with soap is considered a nutrition-sensitive intervention. Handwashing prevents diarrheal diseases, which not only contribute to the deaths of many children under five but limit the body’s ability to absorb nutrition from food. The negative effects of undernutrition during the first 1,000 days on physical growth, immune system and brain development may be irreversible.

Promotion of handwashing with soap is estimated to reduce diarrheal diseases by between 27% and 48%. Handwashing with soap and the use of clean drinking water could reduce the loss of nutrients through diarrhea and reduce stunting in children under 5 by up to 15%. The contamination of food items with fecal matter is a known cause of chronic environmental enteric dysfunction (EED), also called environmental enteropathy. EED reduces the intestines’ capacity to absorb nutrients. There is research suggesting that a body experiencing EED cannot absorb nutrients because it is too busy fighting off diseases. Children with diarrhea not only eat less but are less able to absorb nutrients from food. This makes future diarrhea more likely, since undernourished children are more likely to develop diarrhea.

Poor hygiene is also linked to wasting and severe acute malnutrition. Handwashing at critical times can reduce the likelihood of wasting and is particularly important in the first months of life.  However, handwashing without improvement in other water, sanitation, hygiene (WASH) and socio-economic factors is unlikely to be sufficient to protect against acute malnutrition. A randomized control study in Chad showed that providing a basic WASH package was effective in improving recovery rates from severe acute malnutrition, including the duration of time it took to recover and the amount of weight children regained. Evidence does not consistently show additional benefit to the integration of WASH with nutrition, and more research is needed to understand how hygiene promotion relates to nutrition outcomes. Two major studies published in 2018 showed no additional benefit to the integration of WASH with nutrition, compared with nutrition alone.   Despite these results, the biological pathways that link WASH to nutrition remain plausible and handwashing with soap is likely to remain an important part of future interventions.

What you can do

Handwashing has multiple benefits for food hygiene, nutrition, and overall health and well-being. On Global Handwashing Day and every day, here are some ways you can help everyone enjoy the benefits of handwashing with soap:

  • Wash your hands with soap at critical times, especially before eating, cooking, or feeding others.
  • Model good handwashing behavior and remind or help others to always wash their hands before eating.
  • Make handwashing a routine part of your family meals.
  • Establish places to wash your hands in the household, in your community, in schools, workplaces, and in health facilities.
  • Promote effective handwashing behavior change in research, policy, programs, and advocacy.


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