Intervention 6: Hand Washing With Soap


Handwashing with Soap

Proper personal hygiene is one of three key strategic elements of sanitation. The other elements are clean water (safe treatment and storage of drinking water) and safe removal of excreta. Research has shown that improved sanitation results in a reduction in diseases, such as intestinal parasites, skin diseases, guinea worm and diarrhoea.

Proper personal hygiene practise refers to hand washing by rubbing both hands with soap (or soap alternatives such as ash, salt or lemon/lime) and rinsing with running water to wash the germs away. The critical times for hand washing are before cooking, before eating, before handling the baby and after using the toilet or disposing of faeces. Proper hand washing can reduce diarrhoea-related deaths by almost 50 per cent and deaths from ARIs among children by 25 per cent.


  • Handwashing should ideally be performed under running water from a regular tap, from a Tippy Tap, or under water poured from a cup, jug or some other kind of vessel.
  • Soap can be any type of proprietary bar soap, powder soap or liquid soap-or home-made soup.
  • Suitable soap subsitutes for hand washing at home include wood ash or other home-made hand cleaning products considered suitable by local health workers
  • In warm climates it is recommended to dry hands by shaking them-air drying
  • In cold climates recommended methods of hand drying are with disposable paper towels, hot air driers or freshly laundered towels

Target Behaviours/Results:

  • Caregiver washes hands with soap before cooking, before eating, before feeding the baby and after toilet and disposal of faeces
  • Household has washing station with running water, soap or soap equivalent


Why is handwashing important? 

Hand washing can greatly reduce the chance of getting infections; mostly infections of the stomach and intestines, but also respiration (breathing) and skin infections. Also, hand washing can reduce the risk of diarrhea by 40%. This makes hand washing the best thing you can do to avoid diarrhea!

Hand washing in a community can help to prevent outbreaks of cholera and different kinds of flu. If childbirth takes place where there is not good hygiene, there is three times more chance that the mother could die. This is true both for births in the clinic or at home.  A clean birth leads to less risk of the mother dying or of the newborn getting an infection. It is very important to wash hands when handling a newborn because they can easily get infections. 

Who is hand washing important for? 

Hand washing with soap is a good hygiene practice for everyone. Frequent hand washing is recommended as hands can quickly become dirty again after washing. Hand washing is very important for the mother, other caregivers and the child. 

What are the benefits of hand washing? 

Besides reducing the risk of diarrhea and infections, washed hands smell nice. A person can feel better when hands are clean. Babies and infants dislike dirty hands. 

Does the water need to be clean?

Clean water is essential for birth attendants and laboring mothers. For situations that are less risky than childbirth, clean water is somewhat less essential. 

How much water is needed? 

Hand washing can be done with small amounts of water by following the four steps: Wet, Soap, Rub and Rinse.

There is no need for taps to be running fully open and they can be closed when the hands are being soaped and rubbed. 

What is a Tippy Tap? 

The Tippy Tap is a homemade device designed to dispense small amounts of water. Two commercially avilable hand washing stations for household use are the Mrembo and the Happy Tap. 

What should be done with the waste water? 

In places where water is hard to get, the waste-water can be collected in a bowl or bucket for watering plants or sprinkling on the ground in the homestead. If it isn’t necessary to re-use the water, it should be properly drained away to avoid accumulation of stagnant water.

We can't afford soap. Are there other alternatives, like ash?  

Wood ash is the most commonly mentioned suitable substitute for soap. An alternative to bar soap is homemade soap solution using ash and sodium bicarbonate; or made by dissolving soap powder or detergent in water. In some places there maybe be a traditional way of making a hand-cleaning product from local plants. In the absence of any of these, vigorous rubbing under flowing water is next best. 

When should mothers and other caregivers wash their hands? 

  • Before handling the newborn
  • Before preparing the family’s food, or complementary food for the child
  • Before eating
  • After going to the toilet
  • After changing a baby’s nappy and/or clothing
  • After disposing of baby and/or infant poop
  • After assisting the infant with toileting 
  • After cleaning the infant’s potty
  • After giving care to an infected or at-risk person
  • After contact with pets of domestic animals
  • After handling raw meat, poultry or fish
  • Mothers should also help their small children wash their hands 

I sometime forget to wash my hands-how can I remember? 

Locating the hand washing facility close to where the hand washing moment takes place can be a powerful reminder. If this is not practical, an alternative is to place an eye-catching visual reminder close to where the hand washing moment takes place. Seeing other people hand washing can also serve as a powerful reminder.

Does it help to keep my finger-nails short?  

Short fingernails are less likely to conceal dirt-hence nails and hands are easier to clean. 

How do other hand washing methods compare with soap and water? 

Washing hands with hot water and soap can be more efficacious than cold water and soap, although the amount and vigour of rubbing will affect results.

 Alcohol-based hand sanitizers (ABHS) don’t require water and hands can be air dried after application.

 Both water and soap and ABHS are effective in producing a significant reduction in bacteria and viruses on the hands, though some bacteria are more stubborn than others. In hospital settings, other specialized hand sanitizing gels or foams are recommended for meeting specific infection control needs. 


7-11 Health Strategy

Next Intervention: Oral Rehydration therapy (ORT)/Zinc