November 23, 2020

By: Lily McCann, FHI 360/Global Handwashing Partnership

On October 1, 2020, the Global Handwashing Partnership launched the Handwashing Thursday Series. The series aims to amplify the launch of the Partnership’s most recent publication: The Handwashing Handbook. The handbook launched on Global Handwashing Day 2020, and it serves as an all-in-one resource for handwashing programming.

The fourth webinar of the series was held on November 19, 2020 with a focus on the fourth chapter of the Handbook: Improving Handwashing in Specific Contexts. This chapter addresses handwashing being integrated into related programs such as health, nutrition, early childhood development, education and equity programming. This webinar included presentations on improving handwashing in specific contexts including healthcare facilities, schools, workplaces, and other public settings.

Considerations for WASH in Schools Programs

The webinar began with a presentation by Ms. Alyson Moskowitz, an education specialist at Sesame Workshop. The presentation covered Sesame Workshop’s experiences implementing WASH programs in schools and identified six crucial elements to running a successful program. In 2015, Sesame Workshop partnered with World Vision to launch the WASH UP! Program, a school-based WASH program that targets children ages six to nine in remote low resource settings. The success of this program has been enabled by the following considerations:

• Identify WASH priorities for the context and audience. The WASH UP! Program consults with experts, advisors, and government officials to determine the needs on the ground.
• Develop content that is engaging and fun. Content should be simple and easy to remember, like songs, chants, or rhymes. For example, Sesame Workshop introduced Raya the Muppet as a Global Health Ambassador to engage kids with handwashing messages.
• Understand the power of children as change agents. It is important to not overlook children’s ability as change agents. They have real capacity to bring these messages home and teach their communities and families about how to stay healthy.
• Include the larger community. A key success of the WASH UP! Program is getting buy-in from the larger community. For example, when buy-in from parents is considered, it not only helps to strengthen the messaging, but it can also lead to more support for school infrastructure improvements.
• Infrastructure is essential. It is necessary that children are not only educated about handwashing practices, but also have the infrastructure to practice these handwashing behaviors. The WASH UP! Program ensures that handwashing facilities are available to address access in schools.
• Logistics matter. Understand school schedules and make sure that the program is being implemented as designed. Schools are an important setting to engrain handwashing as a habit. Incorporating handwashing as part of a child’s routine is important to ensure lasting habits.

Hand Hygiene Improvement Strategies in Health Care

Professor Benedetta Allegranzi, the Infection Prevention and Control (IPC) technical lead at the World Health Organization, began her presentation by sharing WHO’s Hand Hygiene for All document that summarizes the strategies for improving WASH in healthcare facilities using approaches and strategic programs developed by WHO and UNICEF. The document can be found here.

Professor Allegranzi then shared two core guidelines for effective IPC programs. It is strongly recommended that monitoring and evaluation programs are established to serve as a key performance indicator at the national level. Additionally, appropriate hand hygiene materials and equipment should be readily available at the point of care in all health care facilities in all countries. Implementing hand hygiene and achieving the desired behavior change also relies on multimodal strategies or putting in place different types of interventions at the same time. The Five Components of the WHO multimodal hand hygiene improvement strategy include systems change, training and education, evaluation and feedback, reminders in the workplace, and institutional safety climate.

Hand Hygiene in the Workplace and Other Public Settings

The webinar was wrapped up with a joint presentation from Ms. Renee Remijnse and Ms. Anna Königson with Essity. This presentation shared statistics from Essity’s Essentials Initiative Survey.

Ms.   Königson started off by talking about hand hygiene in workplaces. Statistics show that proper hand hygiene is not only good for individual benefits, such as a person’s health and reputation, it’s also good for business. For example, as much as 20% of sick leave can be reduced if the appropriate hand hygiene program is executed. A good hand hygiene program provides access to handwashing stations with running water, uses signage and posters to remind and encourage people to wash their hands, and offers alcohol-based hand rub so employees can disinfect their hands when necessary. Lastly, digitalization of real time data enables hierarchy in quality and levels of hygiene by being able to make sure that there is always soap, hand rub, and towels available.

Ms. Remijnse concluded the presentation with a discussion about hand hygiene in public places. Data shows that people are considering hand hygiene a bigger part of their overall health routine and they would feel safer if public places had more hand hygiene alternatives. According to the Essentials Initiative Survey, the two main reasons people do not wash their hands are a lack of soap or hygienic soap dispensers and having access to proper hand hygiene facilities in public places. For this reason, it is essential not only to provide access to handwashing in terms of facilities, products, and signage to guide citizens, but to also make sure these facilities are accessible to children and elderly populations as well.

Moderated Panel Discussion and Key Takeaways

Mr. Chikumbutso Kamwendo, a Technical Program Coordinator for the WASH UP Program, joined the webinar for a moderated panel discussion. This panel delved deeper into various topics highlighted throughout the presentations and answered audience questions. Overall, the key takeaways from the webinar include:

• Identify handwashing priorities based on the context and audience. Developing content that is specific and engaging to a target audience is critical to ensure handwashing behavior change among different populations.
• Connect handwashing with other related development issues to optimize health and development outcomes. The integrated nature of the Sustainable Development Goals challenges practitioners and policy makers to adopt strategies that will lead to benefits across multiple areas. Integrating handwashing into related health and development initiatives can drive progress across the SDG agenda.

The full webinar recording is available below.

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