We know that handwashing with soap at critical times has many positive outcomes; therefore, it is also an important tool for achieving equity. However, access to proper handwashing facilities, and exposure to effective handwashing promotion that drives people to use them at critical times, varies widely across the world, contributing to inequities in global health, nutrition, education and economic outcomes.

Socioeconomic gap

There is clear evidence that, around the world, poorer households, those located in rural areas, and those with less education have lower access to functional handwashing stations than wealthier households, those in urban areas, and those with higher education.[i],[ii] [iii] As a result, families and communities that are already more susceptible to death from illnesses caused by poor hygiene are less equipped to protect themselves.

Vulnerable populations

People who are already disadvantaged or vulnerable tend to have disproportionately lower access to good handwashing facilities and effective handwashing promotion programs. As a result, these individuals are less likely to wash their hands at critical times, putting them at a higher risk of developing diarrheal and respiratory infections, which contribute to poorer health, nutrition, education, and economic outcomes. This can perpetuate systems of inequality and vulnerability.

Girls, students with disabilities, students from minority ethnic groups, and children from marginalized and isolated sub-national regions can be disproportionately affected by a lack of access to proper handwashing in schools.[iv]

Girls need access to handwashing stations with soap and water for good menstrual hygiene management. Research shows that where there are good handwashing facilities, girls attend at least six more days of school each year compared to girls at schools without handwashing facilities.

Students with disabilities need accessible handwashing stations and soap, particularly as they are more likely to touch the floors and walls of latrines where fecal matter may be present.



[i] MICS 2009-2013.

[ii] Swapna Kumar, Handwashing behavior in 20 countries: analysis of proxy measures of handwashing in Multiple Indicator Cluster surveys (MICS) and Demographic Health Surveys (DHS), 2009-11, UNC Water and Health Conference, 2013, Chapel Hill, NC.

[iii] Ram P. Handwashing – it’s such an easy thing to do. University of North Carolina Water and Health Conference 2014.

[iv] UNICEF 2011. Equity of Access to WASH in Schools.