Hygiene in Emergencies
In emergency settings, handwashing is critical to preventing the spread of disease and has high potential to reduce the health impact of disasters.
Diarrhea is responsible for 25-40% of child deaths in emergencies.[i] Ensuring proper handwashing with soap in emergency settings can also protect the progress made before an emergency.
Handwashing infrastructure and behavioral programs in emergencies often require different approaches compared to non-emergency contexts. Contexts requiring tailored approaches may include natural disasters, outbreaks and other public health emergencies, as well as conflict or post-conflict settings. The pace, scale, and temporality of emergency settings may render some standard approaches ineffective or unfeasible.[ii] Emergencies that cause flooding or displacement are particularly associated with health outbreaks, and handwashing’s potential to prevent disease can be even more critical when health services are disrupted.[iii]
Research has identified handwashing as a major gap in emergency WASH interventions.[ii] Handwashing with soap must be a key consideration in emergency planning, response, and recovery programs. This includes programs focused on WASH, sheltering, nutrition, education, and others.
Key considerations and recommendations:
- Include handwashing supplies (soap and/or alcohol-based handrub) in emergency kits at household and institutional levels.
- Provide handwashing information and outreach in response efforts and programming.
- Ensure personnel receive training on the critical role of handwashing in emergency settings, and practice and promote good handwashing habits.
- Avoid a ‘one size fits all’ approach. Plans, investments, and programs must include special attention to the needs of vulnerable or marginalized groups, including an understanding of their infrastructural needs.
- Ensure that all sanitation plans include convenient, appropriate handwashing infrastructure, including hygiene facilities at community, school, healthcare facilities, and other relevant settings.
Resources
This page summarizes key resources related to handwashing in emergency settings. For research articles, program evaluations, or non-emergency handwashing guidance, visit our resources page. If you know of resources to add to this page, please contact us.
Standards and Guidelines
| Title | Author, Year | Description |
| Minimum standards in water supply, sanitation and hygiene promotion |
Sphere Project, n.d. | Hygiene promotion and facilities are included in the Sphere humanitarian standards. The standards include key actions, key indicators, and guidance notes including contents for hygiene packs, coordination, and equity. Linked directly to hygiene standards. Handwashing is also included in excreta disposal standards, here. |
| Emergency Hygiene Standard | UNHCR, 2015 | This section of the Emergency Handbook covers indicators, ratios for soap distribution and hygiene promotion, and longer-term standards. The handbook is also available as a mobile app. |
| Hygiene promotion in emergencies | World Health Organization, WEDC, 2011 | This technical note summarizes information, standards, and approaches for hygiene in emergencies in an easy-to-read format. It includes a graphic of handwashing steps and a list of tools and principles for hygiene promotion. |
Manuals and Toolkits
| Title | Author, Year | Description |
| Introduction to Hygiene Promotion: Tools and Approaches | Global WASH Cluster, 2009 | This manual includes session plans, PowerPoint slides, and other adaptable materials for hygiene promotion trainings, as well as background on hygiene promotion. It aims to help facilitators prepare trainings for hygiene promotors, or act as a tool for program staff developing hygiene interventions. |
| Water, Sanitation, and Hygiene for School children in Emergencies | UNICEF, 2011 | This guidebook offers guidance on safe WASH behaviors, including handwashing. It is aimed for people who work in school settings, and includes tools to help teach WASH behaviors to children. Handwashing is addressed in section 6 (page 13). Introductory sections (1-5) provide valuable context and best practices. |
| Compendium of WASH in Schools Facilities in Emergencies |
UNICEF, 2012 | This compendium includes examples of facilities used to provide WASH services, including handwashing facilities in schools during emergency settings. It offers real-life examples, guidelines for planning, and lists of materials. |
| Camp Hygiene Promotion Campaigning in Early-Stage Emergencies | Sustainable Sanitation & Water Management | This factsheet provides guidance on hygiene promotion planning and effective handwashing for the early emergency stage in camps and details the steps and components of a hygiene promotion campaign. |
| WASH in Emergencies Problem Exploration Report: Handwashing | Humanitarian Innovation Fund, 2016 | This report examines the challenge of handwashing in emergencies, explores how to develop universal or adaptable handwashing station infrastructure, and identifies drivers to promote handwashing practice & maintenance of facilities in emergencies. |
Health Emergencies
| Title | Author, Year | Description |
| Cholera and Handwashing Fact Sheet | Global Handwashing Partnership, 2016 | This fact sheet outlines basic evidence about cholera, its transmission, its treatment, and how handwashing and other critical WASH measures can play a role in its prevention. |
| Ebola virus disease: Key questions and answers concerning WASH | World Health Organization, 2014 | This fact sheet answers basic questions about Ebola virus disease. It includes clear recommendations for handwashing practice and for WASH in healthcare facilities. |
| Guideline on hand hygiene in health care in the context of filovirus disease outbreak response | World Health Organization, 2014 | This rapid advice guideline provides a summary of the recommendations for hand hygiene best practices for health workers providing care and/or support to patients with filovirus infection (these viruses include Ebola and Marburg). It includes guidance on the use of alcohol-based handrubs, as well as printable guides on the steps for handwashing and handrub use. |
Other Hygiene Resources
| Title | Author, Year | Description |
| Menstrual hygiene management (MHM) in emergencies toolkit |
International Rescue Committee, 2017 | The toolkit on menstrual hygiene management looks at MHM from a multi-sectoral perspective and aims to give practical, streamlined guidance to humanitarian workers. Handwashing facilities with soap are a vital part of any MHM facilities. The toolkit is available in English, French, and Arabic. Links between handwashing and MHM are covered in section 7 (page 39) and 9 (page 57). |
| Ideas that Work: Preventing violence against women through water & sanitation interventions in early emergency response | Oxfam, 2010 | This document collects case studies of attempts to reduce the risk of WASH-related violence against women, particularly in shelters and camps. It includes case studies with examples of safe, private, and appropriate hygiene facilities for women. |
| Guide to Community Engagement in WASH: A practitioner’s guide, based on lessons from Ebola | Oxfam, 2016 | Community engagement is vital to the success of hygiene promotion in emergency settings. This guide is a compilation of best practices and key lessons earned through Oxfam’s experience of community engagement during the 2014–15 Ebola response in Sierra Leone and Liberia. While not specific to hygiene, it provides guidance for design and implementation of community-centered approaches in WASH. |
Citations
[i] Water, Sanitation, and Hygiene for Schoolchildren in Emergencies: Guidebook for Teachers. UNICEF, 2011.
[ii] Yates T, Allen J, Joseph ML, Lantagne D. Short-term WASH interventions in emergency responses in low- and middle-income countries: Systematic Review Summary 8. 3ie, 2017.
[iii] WASH in Emergencies: Lessons learned and way forward. Engineering for Change, 2014.