The issue of handwashing is not a modern story of recent decades. However, in the lack of appropriate concern and significant promotion it was on shade for centuries. With the rise of health and health related organizations, professionals and media technologies, hand washing has at least gained a global concern at recent. Public health experts recommend handwashing with soap as a key action in protecting the public health because it’s a mainstay in infection and disease control. Handwashing is linked to achievement of 2015 millennium development goal 4 of reducing under-five child mortality. Because handwashing can prevent the transmission of a variety of pathogens, it is considered to be more effective than any single vaccine.
Handwashing with soap is the single most cost-effective intervention to prevention and control of diarrhoeal related morbidities and mortalities. Yet, tragically, more than 5,000 children every day or 1.7 million every year around the world die from diarrhoeal causes before the age of five. According to the report by UNICEF, 2008, diarrhoea is the second most cause of death in children accounting for 18% of all under five deaths. In Nepal alone, each year 10,500 children under five years of age continue to die of diarrhoeal diseases. Studies reveal that effective practices of handwashing at critical times including before meals or food handling and after the use of toilet, can reduce such diarrhoeal incidence among under-five children by almost 50%. Further, handwashing with soap can reduce the incidence rates of Acute Respiratory Tract Infections (ARIs) by around 23%. Pneumonia, a major form of ARI is another leading cause of childhood mortality claiming the lives of an estimated 1.8 million children each year. Diarrhoea and pneumonia, together account for almost 3.5 million childhood deaths annually in developing countries. It is estimated that wide practice of handwashing with soaps and intensively monitored trials at monitored household and school levels could prevent one million of these deaths. The simple act of washing hands with soap can cut diarrhea risk by almost half, and respiratory tract infection by a third.
Apart from diarrhoea and pneumonia, handwashing can also be a significant measure in controlling pandemic outbreaks of other respiratory infections. Several studies carried out during the 2006 outbreak of severe acute respiratory syndrome (SARS) suggest that washing hands more than 10 times a day can cut the spread of the respiratory viruses by 55 percent. Handwashing is also the foundation in averting many skin infections, worm infestations and eye infections. A study has also shown that handwashing with soap by birth attendants and mothers significantly increased new born survival rates by up to 44%. This makes handwashing a better option for disease prevention than any single vaccine. However this is just a missed opportunity for public health as we are still not in a state to habituate public towards effective handwashing.
Despite of its life saving potential, the rates of handwashing around the globe are still minimal. The observed rates of handwashing with soap at critical moments such as before handling food and after using the toilet range from zero to only 34%. Such lower rates are rarely caused by a lack of soap as almost every household in the world, regardless of economic status, have soap but is used commonly for bathing and laundry. Handwashing with soap at key times, however, is not widely practiced. Though industry has succeeded in getting soap into almost every home, it has not consistently promoted good hygiene or handwashing to accompany their products. In studies around the world, the main reason given why rates of handwashing with soap are so low is that it is simply not a habit. The underlying reasons not only limit to the low awareness level of the public but also to their reluctance and ignorance in using soaps for handwashing despite their better knowledge in this regard. Regardless of nationwide and global efforts in promoting handwashing with soap, it is infrequently practiced and thus behaviour change in this regard is not so straightforward unless the benefits of handwashing are well recognized and internalized by the general public.
Further, efforts at promoting effective hygiene have been piecemeal and ineffective. Current efforts in the nation to promote good hygiene, including handwashing, have not been sufficient to engender mass behavior change. Many public health programs include improved hygiene among their objectives such as in diarrhoeal disease control program, a school health education program that includes hygiene, a water supply and sanitation program that invests in raising hygiene awareness, and sporadic local-level hygiene education or the advertisement of soap itself that incorporates the message of handwashing. However, all these efforts share the weakness of treating hygiene as a side issue, rather than a central one. Hand washing has only been taken as an ingredient of any other public health programs and in lack of concrete approach towards promotion of handwashing and effective behaviour change programs, the public health is at full gear to suffer.
At the present context, the nation is demanding for a specific public health measures to drive into action to contribute significantly towards improvement of public health through successful handwashing. It is necessary to build alliances between the public and the private sectors and mobilize the necessary resources and expertise in promoting hygiene and handwashing. High-impact communications outreach is to be employed to promote handwashing to a mass audience. In a noisy world of competing messages aimed at people from all directions, only the most effective, best-designed campaigns will lead to behavior change.
If the 2015 millennium development targets for reduction in child mortality are to be met, handwashing practices must be improved along with access to safe water and sanitation. This requires Ministries of Health, Education, and Physical Planning in addition to Water and Sanitation Division, Non-Governmental Organizations (NGOs) and community-based groups, to utilize every opportunity to promote handwashing with soap. However, these global efforts to encourage effective handwashing can’t become a success without individual efforts translate into action. Hence, behaviour change efforts targeting every individual, especially children should be the prime focus of all public health programs that incorporate handwashing. Otherwise, the immense global and national approaches with massive expenses to promote handwashing would be in vain without individual compliance to accustom them in handwashing with soap.
