Good handwashing has broad-reaching benefits beyond just the prevention of diarrhea and pneumonia. It can positively impact sanitation, education, nutrition, and more.

As such, handwashing can, and should, be integrated into related development projects, policies, and initiatives. Three examples of sector programs where handwashing can be effectively integrated are sanitation, nutrition, and education projects.

Handwashing & Sanitation

Handwashing and sanitation are closely correlated. Increasingly, evidence shows that hygiene is as important as water and sanitation in reducing diarrhea.

Lack of access to sanitation and poor hygiene together contribute to approximately 88% of childhood deaths caused by diarrheal diseases. Governments, non-governmental organizations, and donors want to achieve maximum health benefits from WASH interventions, but this cannot be achieved without investing in all three.

As the global community rallies around the call of toilets for all, it is critically important that this call incorporates handwashing promotion. As one billion people move from open defecation to improved sanitation, handwashing behavior change is essential if the full health benefits of improved sanitation are to be realized.

To learn more about how to integrate handwashing into sanitation programs, see our resources page.

Handwashing & Nutrition

The World Health Organization estimates that 50% of cases of child undernutrition are due to repeated diarrhea and intestinal infections caused by poor sanitation and hygiene conditions or a lack of safe water. Handwashing with soap is a critical determinant for achieving and maintaining good nutrition, and this healthy behavior is important part for preventing micronutrient deficiencies, stunting, wasting, and deaths in children under the age of five. Good nutrition is about more than access to nutritious foods:  it is also about the body’s ability to absorb the nutrients in the food a person consumes, an ability which can be significantly affected by germs carried on a person’s hands. As such, handwashing promotion should be integrated into all good nutrition programs.

Diarrhea and undernutrition can become a vicious cycle.

Children are susceptible to infection by bacteria and viruses in fecal matter (poo) that cause diarrhea. When children get diarrhea, they (a) often eat less food, and (b) have a reduced ability to absorb and benefit from nutrients in the food they do eat, contributing to the development of undernutrition. Consequently when children are undernourished, they become more susceptible to developing diarrhea when they come into contact with bacteria and germs in fecal matter. And thus the cycle is further perpetuated.

Handwashing can break the cycle of diarrhea and undernutrition. Good handwashing with soap behaviors can prevent nearly half of all cases of childhood diarrhea. It is estimated that stunting and the loss of nutrients through diarrhea in children under the age of five can be reduced by up to 15 percent when handwashing is combined with drinking clean water. This gives children a better chance of maintaining good nutrition and growing up to thrive.

To further knowledge and practice in this essential area, the Global Handwashing Partnership co-founded the Clean, Fed & Nurtured Community of Practice, which works to explore and promote the integration of WASH, nutrition, and early childhood development in the 0-3 age range. The Community of Practice is open to others; more information on joining can be found here. We also provide a number of tools for implementers relating to the integration of nutrition and handwashing in our resources section.

Handwashing & Education

Long before children are of school age, inadequate hygiene practices can lead to diarrhea and other infections that contribute to stunting. Stunting is a condition that not only impedes a child’s physical height, but also their cognitive development, setting students back from their peers even before the first day of school.

Once in school, children need to be healthy to attend class and focus on their lessons.

Handwashing with soap is a foundational component of healthy schools. Diarrhea is globally responsible for children missing a cumulative 272 million school days each year, and handwashing with soap—a simple behavior that can be promoted and practiced at school—has been found to help reduce school absenteeism by up to 40-50 percent.

The availability of handwashing stations with soap and water also help girls to hygienically manage their menstruation. When girls decide to stay at home while menstruating due to inadequate hygiene facilities, these absences interrupt their education leading to reduced academic performance, delays in academic and social development, and can impact on their future earning potential.

Schools provide a key venue to promote handwashing. Good hygiene behaviors can be integrated into the school day, such as practicing group handwashing prior to mid-day meals. Students can be agents of change, bringing messages about good handwashing home to their families.

The UNICEF WASH in Schools network is an excellent resource for those interested in this topic. Many field guides, posters, and other materials for those who wish to promote handwashing in schools may also be found here.