Global Handwashing Day is celebrated on October 15th to promote handwashing with soap. The document provides information about Global Handwashing Day, including its goals of fostering a global culture of handwashing, raising awareness of its benefits, and advocating for policies to promote behavior change. It also discusses the importance and effectiveness of handwashing with soap for preventing diseases, especially diarrhea and pneumonia, the critical times for handwashing, and how handwashing is a highly cost-effective health intervention.
4. What’s
Inside
1 About Global Handwashing Day p. 5
2 Handwashing with Soap: p. 10
The Basics
3 Critical Five: Five Facts Everyone p. 17
Should Know about Handwashing
with Soap
4 Innovative Ideas in Handwashing p. 20
5 Global Handwashing Day: p. 27
Get Involved
6 Frequently Asked Questions p. 40
7 Press Release Template p. 43
8 References and Suggested p. 45
Resources
6. 1 6
About Global
Handwashing Day
The practice of handwashing with soap The challenge is to transform
tops the international hygiene agenda on handwashing with soap from an
October 15, with the celebration of Globalabstract good idea into an automatic
Handwashing Day. Since its inception behavior performed in homes, schools,
in 2008 – which was designated as the and communities worldwide. Turning
International Year of Sanitation by the UNhandwashing with soap before eating
General Assembly – Global Handwashing and after using the toilet into an ingrained
Day has been echoing and reinforcing habit could save more lives than any
the call for improved hygiene practices single vaccine or medical intervention,
worldwide. cutting deaths from diarrhea by almost
half2 and deaths from acute respiratory
The guiding vision of Global Handwashing infections by one-quarter.3 More
Day is a local and global culture of handwashing with soap would make a
handwashing with soap. Although people significant contribution to meeting the
around the world wash their hands with Millennium Development Goal of reducing
water, very few wash their hands with deaths among children under the age of
soap at critical moments (for example, five by two-thirds by 2015.
after using the toilet, while cleaning a
child, and before handling food). Global Handwashing Day will be the
centerpiece of a week of activities that
Handwashing with soap is among will mobilize millions of people across five
the most effective and inexpensive continents to wash their hands with soap.
ways to prevent diarrheal diseases
and pneumonia, which together are
responsible for the majority of child
deaths. Every year, more than 3.5 million
children1 do not live to celebrate their
fifth birthday because of diarrhea and
pneumonia. Yet, despite its lifesaving
potential, handwashing with soap is
seldom practiced and not always easy
to promote.
7. Launched by the
Public-Private
Partnership for
Handwashing with
Soap (PPPHW), the
annual celebration of
Global Handwashing
Day is designed to:
1
Foster and
support a global
and local culture
of handwashing
with soap.
Shine a spotlight Raise awareness
on the state of about the benefits
2 3
handwashing in of handwashing
each country. with soap.
8. 1 8
In the long term,
Global Handwashing
Day can become a
powerful platform
for advocacy aimed
at policy makers and
key stakeholders
and an occasion
for concrete public
commitment to
actions that will spur
behavior change.
9. Global Handwashing Day revolves
around schools and children. Children
suffer disproportionately from diarrheal
During Global
and respiratory diseases and deaths.
But research shows that children – the
Handwashing Day –and
segment of society so often the most
energetic, enthusiastic, and open to
new ideas – can also be part of
the surrounding week –
the solution. Ideally situated at the
intersection of the home, school, and
playgrounds, classrooms,
community, children can be powerful
agents of behavioral change. community centers and
The Public-Private Partnership for
Handwashing with Soap (PPPHW) is a
the public spaces of
coalition of international handwashing
stakeholders. Established in 2001, the
partnership includes the Water and
towns and cities will be
Sanitation Program, UNICEF, USAID, the
World Bank, the Academy for Educational
awash with educational
Development, the Centers for Disease
Control and Prevention, the London
School of Hygiene Tropical Medicine,
and awareness-raising
Johns Hopkins University School of
Public Health, the International Centre for
activity as countries unite
Diarrhoeal Disease Research, Colgate-
Palmolive, Procter Gamble, Unilever,
the USAID/Hygiene Improvement Project,
to change handwashing
and the Water Supply and Sanitation
Collaborative Council.
behavior on a scale never
The goals of the PPPHW are to:
Reduce the incidence of diarrhea and
seen before.
pneumonia in poor communities through
public-private partnerships promoting
handwashing with soap.
Support its partners’ large-scale, national
handwashing interventions and promote
replication of successful approaches.
Share scientific evidence showing
handwashing with soap to be an
exceptionally efficacious and cost-
effective health intervention.
11. Handwashing
with soap is a Handwashing with
life-saving soap is seldom done.
intervention People all over the world wash their
hands with water. The belief that washing
within the
with water alone to remove visible dirt
is sufficient to make hands clean is
commonplace in most countries. But
technological
washing hands with water alone is
significantly less effective than washing
hands with soap in terms of removing
and financial
germs, and handwashing with soap is
seldom practiced. Around the world,
the observed rates of handwashing with
reach of all
soap at critical moments range from zero
percent to 34 percent. Using soap adds
to the time spent washing, breaks down
countries and
the grease and dirt that carry most germs
by facilitating the rubbing and friction that
dislodge them and leaves hands smelling
communities.
pleasant (which creates an incentive for
soap’s use). With proper use, all soaps are
equally effective at rinsing away the germs
But promoting
that cause disease.
it requires
appeals not
Tippy Taps are cans or plastic bottles
that release a small amount of water—
just enough for a clean hand wash—
necessarily to
each time they are tipped.
health, but to
other things
that people Using soap at critical
value, such as moments is the key
to handwashing’s
comfort, social benefits.
status, nurture The critical moments for handwashing
and a wish to
with soap are after using the toilet or
cleaning a child’s bottom and before
handling food.
avoid disgust.4
12. Handwashing with soap
works by interrupting
the transmission of
disease. Hands often
act as vectors that
carry disease-causing
pathogens from person
to person, either through
direct contact or
indirectly via surfaces.
When not washed
with soap, hands that
have been in contact
with human or animal
feces, bodily fluids like
nasal excretions, and
contaminated foods
or water can transport
bacteria, viruses and
parasites to unwitting
hosts,5 as shown in the
F-Diagram of disease
transmission and
control, below.
Source: Wagner
and Lanoix.
Primary Secondary
Barriers Fingers
Barriers
Fluids
Feces Food New Host
Flies
Fields/Floors Disease
transmission Route
Barriers to
transmission
2 12
13. 2 13
Handwashing with
soap reduces disease.
Handwashing is a cornerstone of public
Diarrheal disease:
health, and new hygienic behaviors and
Diarrheal Infections are the second most common cause of death
sanitary services were principal drivers of
in children under five. A review of more than 30 studies found that
the sharp drop in deaths from infectious
handwashing with soap cuts the incidence of diarrhea by nearly
disease in affluent countries in the late
half.6 Diarrheal diseases are often described as water-related,
19th century. Along with the isolation and
but more accurately should be known as excreta-related, as
safe disposal of feces and the provision
the pathogens come from fecal matter. These pathogens make
of adequate amounts of clean water,
people ill when they enter the mouth via hands that have been in
handwashing with soap is one of the
contact with feces, contaminated drinking water, unwashed raw
most effective ways to prevent diarrheal
food, unwashed utensils or smears on clothes. Handwashing with
diseases; it is also the cheapest way. In
soap breaks the cycle. The figure on the following page shows
addition, handwashing with soap can limit
the effectiveness of handwashing with soap for reducing diarrhea
the transmission of respiratory disease,
morbidity in comparison to other interventions.
the largest killer of children under five.
And handwashing with soap is also a
formidable ally in efforts to combat a Acute respiratory infections:
host of other illnesses, such as helminths Acute respiratory infections like pneumonia are the leading
(worms), eye infections like trachoma and cause of child deaths. Handwashing reduces the rate of respiratory
skin infections like impetigo. infections in two ways: by removing respiratory pathogens that are
found on hands and surfaces and by removing other pathogens
(in particular, enteric viruses) that have been found to cause not
only diarrhea, but also respiratory symptoms. Evidence suggests
that better hygiene practices – washing hands with soap after
defecation and before eating – could cut the infection rate by
about 25 percent.7 And a recent study in Pakistan found that
handwashing with soap reduced the number of pneumonia-related
infections in children under the age of five by more than
50 percent.8
Intestinal worm and skin and eye infections:
Though not as extensive and robust as the research evidence
for diarrheal disease and respiratory infections, studies have
shown that handwashing with soap reduces the incidence of
skin diseases; eye infections like trachoma; and intestinal worms,
especially ascariasis and trichuriasis. More evidence is needed, but
existing research points to the effectiveness of handwashing
in reducing the incidence of these diseases.
14. Reduction in diarrheal
morbidity [%] per invention type
0% 10% 20% 30% 40%
Hand Washing with Soap 44
Point-of-use
39
Water Treatment
Sanitation 32
Hygiene Education 28
Water Supply 25
Source
Water 11
Treatment
Source: Fewtrell et al. 2005
15. Handwashing with 2 15
soap is cost-effective.
Handwashing with soap is the single-most cost-effective health intervention. Disability-adjusted life years (DALYs) are used to
measure the burden of disease and the effectiveness of health interventions by combining information on years of life lost and
years lived with a disability. Remarkably, handwashing with soap has been shown to be the most effective way to avert DALYs
associated with diarrheal diseases. Handwashing is also orders of magnitude less expensive than immunization; for instance,
one DALY requires investment in measles immunization anywhere from US$250 to US$4,500. This is not to say that immunization
is not essential; it is simply to point out the tremendously inexpensive life-saving opportunities being missed by the widespread
failure to invest in handwashing promotion. Soap is already available in most households in the world; cost is not the chief barrier
to handwashing with soap.
Interventions
against diarrheal
disease
Cholera 1,658 to 8,274
immunizations
Rotavirus 1,402 to 8,357
immunizations
Measles 257 to 4,565
immunization
Oral rehydration 132 to 2,570
therapy
Breastfeeding 527 to 2,001
promotion programs
Latrine construction 270
and promotion
House connection 223
water supply
Hand pump or 94
stand post
As table 1 (cost-effectiveness ratio) to
the right shows, every US$3.35 invested
in handwashing programs yields one Water sector regulation 47
DALY; gaining that same year through and advocacy
latrine promotion would cost US$11.00;
through household water connection,
Latrine promotion 11.15
more than US$200.00. Source: Jamison
et al. 2006.
Hygiene promotion 3.35
(including hand washing)
16. 2 16
Effective promotion Public-private
requires understanding partnerships help
behaviors and take behavior change
motivations for change. efforts to scale.
There is ample evidence that health Partnerships among national and local
considerations rarely motivate people governments, international organizations,
to change their hygiene and sanitation nongovernmental organizations (NGOs),
practices. The conventional way to and multinational, as well, as local soap
promote handwashing – top-down, manufacturers can be extremely effective
health-focused campaigns that raise in promoting handwashing with soap.
the specter of disease and death – have They combine the health objectives of
had little success in changing people’s the public sector, the marketing expertise
behavior, research shows. Formative of the private sector and often the
research – a thorough study of the Different communities value and are community knowledge of NGOs to create
factors that may influence different motivated by different things; there is a more far-reaching and beneficial
people within a community to wash their no “one size fits all” handwashing impact than any of the three could
hands (or not) – is a critical first step in campaign. For instance, formative achieve on its own.
any hygiene promotion campaign. Only research in Kerala, India, suggests
by knowing what people do now, that people want clean hands for
what they value and which benefits of reasons of comfort, to remove smells,
handwashing with soap appeal to them to demonstrate love for children and to
can you design an effective campaign. exercise their social responsibility. In
Ghana, a study found the chief motives
for handwashing to be to nurture, to avoid
disgust and to gain social status. Social
marketing campaigns that are based
on the hopes and desires of the target
population and approach that population
as consumers with a range of behavior
choices have found far more success
than conventional promotion campaigns
based on what experts believe a target
population should do.
18. 1
Washing hands with water alone is not enough!
Washing hands with water alone, a common practice around the
world, is significantly less effective than washing hands with soap.
Proper handwashing requires soap and only a small amount of water.
Using soap works by breaking down the grease and dirt that carry
most germs, facilitating the rubbing and friction that dislodge them
and leaving hands smelling pleasant. The clean smell and feeling that
soap creates are incentives for its use. With proper use, all soaps are
equally effective at rinsing away disease-causing germs.
2
Handwashing with soap can prevent diseases that kill millions
of children every year.
Handwashing with soap is among the most effective ways to prevent
diarrheal diseases and pneumonia, which together are responsible for
the majority of child deaths. Every year, more than 3.5 million children
do not live to celebrate their fifth birthday because of diarrhea and
pneumonia. Handwashing can also prevent skin infections, eye
infections, intestinal worms, SARS and Avian Flu, and benefits the
health of people living with HIV/AIDS. Handwashing is effective in
preventing the spread of disease even in overcrowded, highly
contaminated slum environments, research shows.
3
The critical moments for handwashing with soap are after
using the toilet or cleaning a child and before handling food.
Hands should be washed with soap after using the toilet, after
cleaning a child’s bottom (or any other contact with human excreta,
including that of babies and children) and before any contact with
food. Hands are the principal carriers of disease-causing germs.
It is important to ensure that people have a way to wash their
hands at these critical moments. Simple, low-cost solutions like
Tippy Taps are within the financial and technological reach of even
the poorest communities.
19. 4
Handwashing with soap is the single most cost-effective
health intervention.
Handwashing promotion is cost-effective when compared with
other frequently funded health interventions. A $3.35 investment in
handwashing brings the same health benefits as an $11.00 investment
in latrine construction, a $200.00 investment in household water
supply, and an investment of thousands of dollars in immunization.
Investments in the promotion of handwashing with soap can also
maximize the health benefits of investments in water supply and
sanitation infrastructure and reduce health risks when families do not
have access to basic sanitation and water supply services. Cost is not
typically a barrier to handwashing promotion; almost all households in
the world already have soap – though it is commonly used for laundry,
dishwashing, and bathing rather than for handwashing.
5
Children can be agents of change
When it comes down to sharing good hygiene practices, children – the
segment of society so often the most energetic, enthusiastic and open
to new ideas – can act as agents of change by taking the “handwashing
lessons” learned at school back into their homes and communities.
The active participation and involvement of children – ideally situated
at the intersection of the home, school, and community – can ensure
sustained behavioral change when combined with culturally sensitive
community-based interventions. Global Handwashing Day aims
at motivating children to embrace and share proper handwashing
practices, and place them as “handwashing ambassadors” at the heart
of each country’s national and local initiatives.
21. 4 21
Public-private partnership to
promote handwashing in Ghana
What was new about Background mass media, direct consumer contact and
In Ghana, diarrhea accounts for 25 a district-level program through schools,
the program?
percent of all deaths in children under health centers and communities. The
The Ghana handwashing program made
five and is among the top three reported communication strategy also included a
contamination visible to the ordinary
causes of morbidity. Children under five public relations and advocacy component
Ghanaian for the first time, effectively
typically have three to five episodes that targeted policy makers and opinion
communicating a hygiene message using
of diarrhea and a similar number of leaders and promoted the provision of
commercial marketing techniques.
respiratory infections a year. Nine million handwashing infrastructure in schools and
episodes of disease could be prevented public latrines.
each year by washing hands with soap.
Ghanaians use soap, and they buy a lot
of it. However, the soap is almost all used
for cleaning clothes, washing dishes and
bathing. In a baseline study, 75 percent of
mothers claimed to wash hands with soap
after toilet use, but structured observation
showed that only 3 percent did so, while
32 percent washed their hands with water
only. Mothers who did wash hands with
soap generally did so because it felt
good to remove dirty matter from hands,
it was refreshing, it was a way of caring
for children and it could enhance their
social status.
The Ghana Public-Private Partnership to
Promote Handwashing with soap crafted
a high-impact communication strategy
with the slogan “For Truly Clean Hands,
Always Wash with Soap.” The intensive
phase of the program’s communication
activities was carried out in the period
2004-06. During this phase, the
program used three routes to bring the
handwashing with soap message to the
target audiences – mothers and caregivers
of children under five years and children
in basic school, ages 6-15 years, across
the whole country. The routes included
22. The Communication
PR campaign: A public relations program Lessons
Strategy Achievements
targeted at opinion leaders and strategic A major lesson from the Ghana
Mass media: The program employed
targets delivered continued press and program was that when partners from
state-of-the-art marketing strategies. The
media coverage in support of the aims different backgrounds and sectors are
guiding concept for this phase of work
of the handwashing program. A number not accustomed to working together,
was “your hands are only truly clean
of radio and television discussion establishing common grounds and trust
if washed with soap.” Two radio and
programs and interviews were held takes time and effort.
two TV advertisements suggested that
throughout the country on national media
there was “something on your hands,”
and district-specific FM radio stations. Another important take-home lesson was
suggesting an unknown menace, an
An advocacy brochure that outlined that the public and private sector can
unseen contamination that only soap
the strategy for the initiative was also work together for the public good. When
could remove. Three advertisements
produced and distributed to strategic there is transparency, the strengths of
(two on radio and one on TV) targeted
targets and partners. each are recognized and each member is
mothers and caregivers, while another
advertisement on TV targeted children. treated as an equal in the partnership.
Evaluation results: An evaluation reported
The radio and television commercials
that handwashing with soap rates for
were supported by posters and
mothers after six months of the campaign
billboards sited in all 110 district and
were over 80 percent.
10 regional capitals of the country, and
the distribution of promotional items like
Exposure: Exposure to all campaign
badges, T-shirts, branded poly bags, and
materials was also high, with almost
soap. The radio and TV advertisements
everyone aware of and able to sing the
ran for six months, with particularly
campaign theme song, and with more
intense activity in the first three months of
than 80 percent of children and adults
the campaign.
reporting more handwashing with soap
since the campaign.
Direct to consumer contact: Under
the Direct Consumer Contact (DCC)
The Ghana handwashing program for
Programme, an event management firm
the first time made contamination visible
visited two districts per region in six
to the ordinary Ghanaian and was able
regions and conducted 128 high-impact
to communicate a hygiene message in
events in schools to reach 103,313
an innovative manner along the lines of
school children, 2,930 teachers, 926
commercial marketing.
food vendors and 132 events in health
centers and communities for 11,500
mothers. DCC is used as an interpersonal
communication strategy that provides
information on handwashing with soap
in an innovative and interactive, face-to-
face manner. This direct contact allows
consumers to ask questions and converse
about handwashing with soap, which
facilitates behavior change.
23. Lifebuoy Swasthya Chetna 4 23
What was new about the Background
program? The Lifebuoy Swasthya Chetna (“Health
The program used a powerful yet simple Awakening”) program began in 2002
demonstration tool – the glow germ demo as a rural health and hygiene education
kit – to make visible the germs on hands initiative in India. The project was
that look clean, but were not washed designed to spread awareness about the
with soap. importance of washing hands with soap
and to promote general hygiene in rural
villages. The program has reached more
than 100 million people, and its teams
have reached at least 44,000 villages in
rural India. Swasthya Chetna is one of the
world’s largest self-sustained and self-
funded hygiene promotion projects.
Glow germ demo used to establish the Children performing on Swasthya Rally: to let the whole village know
presence of germs and the importance Diwas – Health Day
of using soap to remove them.
Key project activities: Communicating the Key factors to success of
Lifebuoy Swasthya Chetna is a multi- message to children: the program:
phase activity that works toward effecting School children are change initiators Continuous monitoring and evaluation is
handwashing behavior change among the and, in this context, the program works at the core of the program – each year,
rural communities it touches. The central with them to take the messages home program activities are evaluated on both
message of the campaign is: and into their communities. Children are awareness of hygiene moments and
also excellent communicators if they find effective behavior changes. Improvements
Visibly clean is not really clean. the topic or activity fun and involving. can be made to the subsequent year’s
The tools to communicate the central program to make it more effective in
The communication Swasthya Chetna message are adapted achieving its goals.
tasks were to: according to the specific audience, and
Establish the presence of germs schools have proven excellent entry Cost-effectiveness of the program – cost
even on clean-looking hands, using a points into communities. The element of per village is approximately £50 for the
simple but extremely powerful, low-cost Swasthya Chetna that involves children three exposures, including implementation
demonstration tool called the “glow focuses on how to position hygiene as and development of the materials.
germ demo kit.” Developed by Unilever fun and uses stories, games, songs
for use in Swasthya Chetna, it brings to and quizzes. Commitment of the operating company –
the target audience the idea that hands Swasthya Chetna is now central to what
are only truly clean if washed with soap. the brand does in India, and the operating
company (Hindustan Unilever Limited) has
Establish the consequences of these invested more than US$5 million.
hidden germs on hands.
24. 4 24
Children as agents of change:
lessons from UNICEF
What is new about the Background
UNICEF approach? Children have historically had few if any
UNICEF recognizes the potential of roles in school decision making, let alone
children as agents of handwashing in community-based programming in
behavior change by coupling water hygiene and sanitation. UNICEF works
and sanitation improvements in toward making schools healthier and
schools with hygiene education. more attractive to children, especially
The use of environmental health girls, through school-based water,
clubs, drama groups and student sanitation and hygiene programs. Guiding
focus groups creates the conditions this approach is the knowledge that
for children themselves to be agents healthier children are more effective
of change in their schools, families learners, and girls who spend less time
and communities. fetching water have more time for school.
Helping to build separate and decent
sanitation facilities in schools can reduce
dropout rates, especially among girls.
25. Achievements hands with soap before preparing food Key lesson
The following UNICEF country programs or eating and after using the toilet. The UNICEF’s experience in promoting
illustrate the impact children are having students’ work of improving the health handwashing with soap in schools as part
on improving handwashing with of their community goes beyond their of a larger water, sanitation and hygiene
soap behavior: theater productions. They also take effort shows how important it is to involve
charge of the village’s Jum’at Bersih children themselves as active participants
Nigeria. Efforts in Nigeria to change (Clean Friday), a national movement, with real project responsibilities rather
the classroom environment are child- begun in 1994, that encourages hygiene than as passive targets of health
centered, including forming children’s promotion, particularly handwashing messages. Combining handwashing with
hygiene and child rights clubs, training with soap, during meetings on Islam’s soap promotion with hands-on school
teachers in life skills education, involving holy day. The little doctors are becoming improvements also creates in the children
parents and encouraging village leaders, learning to communicate a sense of ownership that makes new
artisans to participate in hygiene and clearly and effectively, solve problems, behaviors more likely to stick.
sanitation projects. One school initiated negotiate and analyze. “People love
an Environmental Health Club, where drama, and parents especially love to
students promote handwashing with see their children perform,” said one of
soap in both the school and the the supervising teachers. “It is far more
community and advocate for secure effective than telling people directly to
household water supplies to continue change the way they do things.”
hygienic behavior at home. With the
help of a teacher, the 12 girls and 18 Malawi. An approach in Malawi honors
boys who make up the club operate and the right of children to participate in a
maintain the facilities and keep track of process of developing and instituting
the borehole’s usage. The club funds its national standards for sanitation
activities by selling plastic buckets and facilities and hygiene promotion in
clay pots fitted with taps. Two years after primary schools. National review teams
the project’s inception, handwashing interviewed children on what they liked
among children increased by 95 percent. and disliked about their sanitation facilities
Teachers reported that students came and hygiene education programs. The
to school clean and had fewer cases of children spoke candidly and perceptively
ringworm and other skin diseases. In of the changes needed, and their insights
addition, school attendance grew are being used to modify the technical
steadily each year, from 320 pupils when designs and approach to health behavior
the program was initiated to 538 in 2001. change. The children proved keen
advocates for better sanitation and
Indonesia. A primary school project child-friendly health education. Comic
called “Dokter kecil,” or little doctors, books based on their feedback have
develops school clubs, consisting of 30 already been designed for grades five
students from grades four to six, that to eight. This approach and the insights
promote hygiene through community derived are being seen more actively
theater and other lively, interactive as having potential applications for
activities. The children put on school programming improvements in nutrition,
plays for their parents and other education, health and other areas.
community members that convey
lessons on the importance of washing
26. Safeguard Pakistan 4 26
School Education
Program empowering
children with hygiene
education:
What’s new about The Safeguard school
this program? program has
The Safeguard School Program two components:
connects with kids in a language that 1. Execution: The objective of the
they understand. This program execution component is to spread and
Partnership with Public Sector Health
leverages the animated character reinforce health and hygiene messages
Organizations to make a difference
Commander Safeguard as the among children across Pakistan in a
Health and hygiene programs are
communication vehicle to make the memorable and engaging manner. A
carried out in collaboration with the
overall hygiene message relevant, typical school program day consists of
PMA, the largest body of doctors across
memorable and engaging for school Safeguard’s team of qualified doctors
Pakistan, and the IDSP, which is working
children. Commander Safeguard visiting schools, where they conduct
to create awareness about infectious
communicates with children in a way hygiene tutorial sessions. In these
disease prevention in Pakistan. These
that is novel and exciting. tutorials, children are taught about
credentialing partners help Safeguard
in recruiting and training doctors and germs and how they are spread through
preparing tutorial material communicated casual contact via a germ visualization
in schools. demo. They are also taught how to
wash their hands properly through
a handwashing demo. This hygiene
Achievements
message is reinforced through a
The Safeguard School Program has
Commander Safeguard animated
empowered more than 5 million school
cartoon. Each student is then given
children between the ages of 6 and 11
take-home educational material so that
years with hygiene education over the
they can continue to learn and monitor
last four years. To date, this program has
their hygiene habits with their families.
covered more than 10,000 schools in 100
Background
cities of Pakistan.
The Safeguard School Program promotes 2. Reseeding component: The objectives
handwashing awareness and brings of the reseeding component are to
about habit change at the grassroots Key lesson ensure that health and hygiene learning
level in Pakistan by becoming an ally in Using a memorable, engaging and
continues long after the Safeguard team
empowering children with health and child-friendly vehicle – Commander
has completed its health tutorial and to
hygiene education. The program has Safeguard – to spread and reinforce
help schools institutionalize this learning
its roots in the Karachi Soap Health health and hygiene messages is far more
through activities like “Health Days.” A
Study (2002) led by the Centers for effective with children than standard
Health Day is the celebration of health and
Disease Control, HOPE, and Procter health lessons.
hygiene organized and led by the schools
Gamble. The study showed that regular Private Sector companies like Procter themselves. Schools have celebrated
handwashing with soap can reduce the Gamble bring unique consumer Health Days in various ways, among
incidence of diarrhea by up to 50 percent. understanding and marketing expertise them drama competitions, debates,
In Pakistan, where every year more than which, if combined with public sector singing competitions, art galleries,
250,000 children die from diarrhea, this health organizations, can lead to new health awareness walks, and community
message of handwashing becomes a innovative ways to influence hand wash cleanliness drives – all organized around
message for survival. behavior change. the theme of health and hygiene.
28. The driving
theme for Global
Handwashing Day
is handwashing in
schools.
Therefore, a key
target audience
is children,
positioned as the Global Handwashing Day planners’ chief
agents of change. task is to introduce the concept and
establish credibility at the global and lo-
cal levels. A solid, scaleable framework
You can join Global needs to be created that can be built on in
future years. Other recognition days have
been established for decades; high-profile
Handwashing recognition cannot (and will not) come
overnight. In order to differentiate Global
Handwashing Day from other big-budget
Day celebrations recognition days, Global Handwashing
Day will have a consistent tone and dis-
tinct visual identity.
on 15 October This document outlines the main areas
to consider when planning your Global
by organizing
Handwashing Day activities.
In addition, attached as Annex 1 is a brief
activities
guide to advocacy in general, which was
prepared for the International Year of
Sanitation. It provides guidance on the
to motivate
general principles of issue-based advocacy.
children to wash
hands with soap.
29. 5 29
Institutional The Goal for Global
arrangements Handwashing Day
and the global
context for Global
Handwashing Day
The Global Handwashing Day call is open by the end of the school week in which To provide a “news hook” for media,
to all countries wishing to participate. Global Handwashing Day is celebrated. Global Handwashing Day will be framed
Each participating country can have one as a joint global effort to get as many
or more “lead” agencies, chosen based To obtain additional materials and keep schools and schoolchildren to wash
on convening capacity, which will take up-to-date on Global Handwashing Day their hands with soap on October 15 as
national responsibility for driving the activities, planners are encouraged to visit possible. This will drive headlines and
Global Handwashing Day on the ground the official Global Handwashing Day web coverage and provide journalists an entry
and leading the coalition of organizations site at: www.globalhandwashingday.org point to talk about Global Handwashing
involved. Day as well as handwashing with soap
A press release will go out at the end more broadly.
Where possible, the national coalition of the school week itself to publicize
should be built on existing structures and the success of the day. The release At the national level, each lead agency,
relevant working groups, such as WASH will include the following information: working with its partners on the ground,
coalitions. Tie-ins with other recognition achievements of Global Handwashing Day will set its own goal, ensuring that the
days and national holidays should be globally, how many countries/schools/ target is a realistic stretch – a number
encouraged. Depending upon its human students were involved; quotes from key sufficiently large to attract attention, but
and financial resources, lead institutions opinion leaders; a summary of events that not one that will be impossible to reach.
will be responsible for launching the took place; and a prediction or pledge for The target should be grounded in the
Global Handwashing Day activities and an even bigger and better day in the year facts about the specific handwashing
carrying out local PR and communications to come. situation in that country.
aligned with the global strategy and visual
identity guidelines. Lead institutions are At the global level, the goal is to have,
also responsible for capturing learnings, year by year, an increasing number
using a template evaluation scorecard of countries participating in Global
provided by and collated centrally, to Handwashing Day. The higher the number
measure the success of the day. The of participating countries, the better the
success of the day should be measured chances of having more children washing
their hands with soap.
30. 5 30
Compiling data Thus, well
and developing in advance
key messages of the day,
the following
will be useful:
This kit provides data and messages for In addition to numbers, it is helpful to Hard data on mortality and
the world as a whole. But journalists, compile stories – stories of how poorly
morbidity from
decision makers and regular people are equipped schools are for handwashing,
most interested in knowing about the for instance, but also hopeful stories diarrhea and pneumonia
specifics in their own country. Thus, an about what is working in your country.
important first step in preparing for Doom and gloom news by itself generally Findings of any handwashing
Global Handwashing Day is to compile doesn’t motivate people to action – they
behavior studies that have
relevant national and, to the degree need to see something concrete that is
possible, state, municipal and local data. already working to inspire them. been done
The kind of data that will help you Findings of any studies of
make your case includes mortality and
handwashing and sanitation
morbidity statistics for children under
five from diarrhea and pneumonia. If any facilities in schools
studies have been done on handwashing
behaviors in your country, the key findings Real-life stories of good
about the prevalence of handwashing
practices in your country
with soap are useful. Also helpful will
be any data on handwashing or other
hygiene programs, infrastructure or Photographs of good and
habits in schools. It is important to draw bad practices in schools
a distinction between handwashing
and elsewhere
with water alone – which is commonly
practiced – and handwashing with soap,
which is, in general, comparatively Pre-taped radio interviews
infrequent. Even a brief observational and quotes
study showing how many people are
washing their hands with soap after using
the toilet will make the topic come to life; Charts and other infographics
it is effective to highlight the handwashing that newspapers can just
behaviors of people from all strata of drop into their stories on
society, not just poor people.
Global Handwashing Day
31. Whom to target Primary targets:
From this data collection will emerge your Over time, the primary targets for Global Journalists
key messages. For instance, you may Handwashing Day will increasingly be are the way to get your Global
find that 60 percent of people wash their members of the general public. However, Handwashing Day story and
hands with water – and think that doing given that the task is to introduce messages out. Providing ready-made
so is sufficient – but only 10 percent wash and reinforce the very idea of Global information they can use will increase
their hands with soap. Thus, your key Handwashing Day, journalists, decision the likelihood that they will write
message may center around the idea that makers, and other opinion leaders are about Global Handwashing Day and
water alone is not enough – you need to important targets. stress the messages that you think are
wash with soap for truly clean hands – most important.
possibly evoking disgust at all the germs
that are found on the hands. You may Political decision makers
find that in a specific school, parents built are key to bringing handwashing behavior
handwashing stations and created a soap change to scale. They should be urged,
fund: one of your messages might be that directly and through their constituencies,
parents, working together, can keep all to take action. Heads of state and
their children healthy. Again, positive “we governments, as well as ministers and
can do it” sorts of messages are more officials with responsibility for education,
motivating than a recap of the death- infrastructure, health, finance, social
and-disease statistics (though these are affairs and foreign affairs, all need to
important to provide context, background be engaged.
and support for your messages).
Education officials and
teachers
are particularly important targets, as
Global Handwashing Day focuses
on schools. Creating ready-made
handwashing materials and activities
that teachers can do with their students
is a good approach.
School children
are important agents of change;
activities on Global Handwashing Day
should be ones that children can also
do at home. An efficient way to reach
out to this audience is by managing
information campaigns in primary and
secondary schools.
32. 5 32
Secondary targets
(over time, some of these
groups may become the focus
of Global Handwashing Day):
The general public Academics
must become more aware of the who research topics relevant to
benefits of handwashing with soap in handwashing with soap, including water
order to foster behavior change at the supply and sanitation topics, should
necessary scale. be encouraged to publish research
findings in popular media, as well
Community and as opinion pieces supporting Global
Handwashing Day.
women’s groups
are essential allies in seeking to
change hygiene practices. Close to the Celebrities
people, they can be a good partner for Global Handwashing Day planners
understanding current handwashing should consider recruiting popular
behaviors and rolling out campaigns. culture celebrities from music, sports,
film and television to help carry Global
Handwashing Day messages. To get
Business people them to agree to do this, these stars
should be encouraged to understand
must be convinced that handwashing
the potential commercial benefits of
with soap is an issue worthy of their
a nation of people using soap instead of
time and attention.
just water to wash their hands.
They should also be encouraged to
lend their marketing expertise to this
public health goal.
Religious leaders
greatly influence public opinion in many
communities and should be encouraged
to help inform their congregations of the
benefits of handwashing with soap.
33. Tailoring your message to the listener:
Not everyone is persuaded by the same line
of reasoning. An important guidepost can
be to search for the “what’s in it for me?”
for different groups. Handwashing with soap
may appeal to the public health community
because it cuts down on diarrheal disease; Politicians
it may appeal to mothers because it is a way Treating diarrhea and pneumonia
consumes a large proportion of the
to show that they care about their families; it health budget; handwashing can cut the
may appeal to children because an admired rates of diarrheal disease by nearly half,
pneumonia by one-quarter.
sports star has been shown doing so; it may
appeal to the Minister of Finance because Handwashing promotion is cost-effective
when compared with other frequently
it is an extremely cost-effective health funded health interventions. A US$3.35
intervention. Making the health argument to investment in handwashing brings
the same health benefits as a US$11
school children or the nurturing argument to investment in latrine construction, a
the Minister of Finance might not be terribly US$200 investment in household water
supply and an investment of thousands
effective in changing behaviors or prioritizing of dollars in immunization.
investment in hygiene promotion. The
Investments in health, education and
following gives examples of arguments that improved water supply are imperiled by
might be effective with different audiences. the lack of handwashing with soap.
34. 5 34
Journalists Health community Businesses
Many people do not realize that Handwashing with soap is among Marketing soap for handwashing
handwashing with water alone is the most effective ways to prevent (and generating demand) can
not sufficient to make them clean. diarrheal diseases and pneumonia, increase your business.
The information on handwashing which together are responsible for the
benefits and prevalence is an majority of child deaths. Every year, Doing research into the motivations
underreported story. more than 3.5 million children do not for using soap will allow you to create
live to celebrate their fifth birthday the most effective marketing campaigns.
Handwashing with soap could save because of diarrhea and pneumonia.
1 million lives per year. Working with governments, NGOs and
Handwashing can also prevent skin others to promote handwashing can
Key newsmakers (sports stars, infections, eye infections, intestinal improve your corporate image.
business leaders, top politicians or worms, SARS and Avian Flu, and
first ladies, for example) are getting benefits the health of people living with
behind Global Handwashing Day. HIV/AIDS. Handwashing is effective in
Teachers
Diarrhea is responsible for the loss of
preventing the spread of disease even
hundreds of millions of school days
in overcrowded, highly contaminated
every year; handwashing with soap can
slum environments, research shows.
reduce diarrheal disease by nearly half.
Religious leaders The handwashing habits you teach in
Many religious faiths call for washing school will last a lifetime.
and cleanliness before prayer or during
other religious rituals; only hands that You can easily include handwashing
have been washed with soap are with soap in many lessons.
truly clean.
Making handwashing stations is a good
The health of your congregants, activity for school children and can
particularly the children among them, influence their families.
is imperiled by lack of handwashing
with soap.
One million lives could be saved each
year through handwashing with soap.
35. Children Parents Others who don’t
It is cool and fun to wash your hands To nurture your child properly, you must
with soap! wash your hands at critical moments.
currently use soap
to wash their hands
Yucky germs from poop are everywhere, To raise your child properly, you must People are motivated by different
but they are too small to see. Washing teach him or her to handwash with soap messages. Health appeals are less
hands with soap makes the germs at critical moments. effective, in general, than appeals to
go away! disgust, to the wish to be attractive,
The feces of babies and children are to the desire to nurture one’s family
You can be like a teacher in your family full of disease-causing germs; it is not and the wish to be like others who
about handwashing with soap. benign, as many parents think. wash their hands.
Diarrhea is not a normal condition; it is
NGOs an illness that is making your child less
Understanding motivations for and
able to grow, learn and thrive.
barriers to handwashing with soap
is the first step toward promoting
behavior change; you are well Community or
placed to understand what motivates
your constituencies.
traditional leaders
You can make a difference in your
community by organizing handwashing
Diarrheal epidemics can jeopardize
programs for all members and leading
projects and undo years of work;
the charge to set up handwashing
healthy people can better capitalize
stations in homes and schools.
on social and economic interventions.
Your role is critical for the success of
Global Handwashing Day and your
participation will make a difference.
The benefits of handwashing with soap
and other hygiene improvements will only
come if the community works together as
one – if only a few participate the effect
will be small and the community will miss
an opportunity to distinguish itself.
36. 5 36
Suggestions for National Activities
There are many ways
to celebrate Global
Handwashing Day.
The following provides
some suggestions and
global examples of
Global Handwashing Launch event School behavior-
A half-day kickoff to either the day itself or
Day activities. the week of activities, with public figures,
change competitions
Competitions geared at training
an overview of Global Handwashing Day,
students in best handwashing
and planned activities and discussion with
practice, such as:
local experts, authorities, school children
and teachers, and media.
Handwashing song competitions – if you
give children some existing verses to a
Handwashing song, then they are more likely to make
up new verses; it’s hard for them to start
learning event
from scratch
A half- to one-day seminar on
handwashing, with case studies, videos, Playground game competition – create
discussion, and a field visit highlighting half a game involving handwashing and
some of the best and worst examples of ask children to find ways to finish it
action/inaction, best practices, etc., with a Relay races involving handwashing at
focus on schools. handwashing stations
Example: In the rural village of Saran Posters that illustrate key messages about
Maradi, Niger, a primary school elected handwashing
a gender-balanced school government
Essay contests for older children
which included a sanitation and hygiene
minister. The “minister” was responsible Rhyme/poetry contests
for promoting activities and participation Drama/plays
on Global Handwashing Day. The school
used “edu-tainment” tools to get the Dress-up parade (Children can dress up
public’s attention nationwide. In front of as germs, soaps, hands, etc.)
TV crews, several radio channels and
popular local newspapers, they made a
salesperson-type demonstration of the Celebrities and leaders
eight steps for proper handwashing with as handwashing
soap. They then sang a song dedicated
to clean hands and the benefits of champions
handwashing against diseases. Sports stars, singers, actors, former
political leaders, corporate leaders, and
academics can all act as ambassadors for
Media event handwashing behavior change. A picture
An event specifically geared toward the of a much-admired sports star washing
media to launch Global Handwashing Day, his hands with soap can go a long to
with guest speakers, celebrities, officials, motivating children to handwash.
or a field visit to a school with good
Example: In India, cricket star Sachin
practices and infrastructure to support
Tendulkar led a handwashing campaign
them. Example: In Bhutan, a panel
that culminated in millions of children
discussion on Handwashing was held on
across South Asia simultaneously
national television in commemoration of
washing their hands.
Global Handwashing Day.
37. Global Participation in the Radio campaigns
Radio campaigns including soap operas,
Handwashing Day WASH Media Awards short PSA spots, and celebrity interviews
The WASH Media Awards initiative is a
coordination group media contest soliciting print, electronic,
and debates on handwashing and hygiene
Revitalization of an existing group or are a great way to get the handwashing
and broadcast media submissions on
forming a new coordination group message out. Involve school children
water supply, sanitation, and hygiene
responsible for Global Handwashing Day and teachers!
issues from journalists in developing
activities. This might include a group of
countries. The initiative aims to encourage
representatives from different stakeholder
groups (government, NGO, industry,
broader media coverage of those issues. Photo contest
Locally, such a contest might delve further A national photo contest of images of
community) who might gather to plan
into issues of importance in your country people handwashing with soap is another
activities for Global Handwashing Day.
as well as engage the public more on the good awareness-raising technique. Focus
Link in, if possible to WASH campaigns issue of handwashing.. on schools and children.
– national alliances of governments,
parliamentarians, NGOs, media,
religious leaders, community groups, Soap wrapper prize Corporate sponsorship
schools, private sector actors, and other Leveraging resources by approaching
Having a local soap company insert
stakeholders that are active in many local soap companies as well as hotels,
winning tickets that can be redeemed
countries. WASH campaigns aim to restaurants, and other firms to sponsor
for a prize on Global Handwashing
raise the commitment of political and Global Handwashing Day activities.
Day. Build anticipation toward Global
social leaders to achieving hygiene Handwashing Day with handwashing
and sanitation goals and effecting the questions and answers on the soap Postage stamp
necessary behavioral changes through wrappers. Prizes should be geared to Investigating the possibilities of a special
various information and communication hygiene hardware for schools. national Global Handwashing Day
channels, using traditional and mass postage stamp.
media, hygiene promotion in schools,
training and building local capacity Stickers Example: The Nepal Post Office and
Hand-shaped, water-drop-shaped, Nepal Philatelic Society developed
in communications, and improving
or soap-bar-shaped stickers could stamps and commemorative covers with
networking and research.
be provided to school children, who handwashing with soap promotional
could then place them near toilets and messages. For 15 days, the postal
office stamped all the incoming and
Handwashing station handwashing stations, but also other
places where people congregate, like bus outgoing national and international letters
design competition stops, reminding people to wash hands with a promotional message of Global
Competitions to design and construct with soap. Handwashing Day.
affordable, useable handwashing stations
could be held. There could be separate
categories – for technical high school Text Messages
students, for engineers and engineering Using text messages/sms as a way of
firms, for art and design students, for conveying health messages can be an
teachers, etc. students, for engineers effective way to reach wider audiences.
and engineering firms, for art and design Example: The Government of Nepal/
students, for teachers, etc. Nepal Telecom sent a SMS message,
“wash hands with soap and be healthy,”
to the mobile users of five rural districts of
Nepal, on Global Handwashing Day.
38. Annex 1:
How to advocate
(adapted from the
International Year
of Sanitation
advocacy kit)
What is Key steps and elements for
planning advocacy activities
advocacy? Effective advocacy work
needs good planning. These
seven questions can guide
The word advocacy has its you in the development of
origins in law, but its modern your advocacy plan.
meaning is the process of
managing information and 1. Identifying the
knowledge strategically to
change or influence policies
issues: What do we
and practices that affect the want to change?
Many people wash their hands with water,
lives of people (particularly but comparatively few wash their hands
the disadvantaged). with soap. Our aim is to motivate people
to automatically wash their hands with
soap at critical moments – after using the
toilet, after cleaning up a child who has
defecated and before handling food.
2. Analysis: What do
we already know and
what knowledge can
we use?
To ensure credibility among your target
groups, you ought to be well informed and
familiar with more than just the key facts.
For country and local activities, you will
need specific information on your region
and the special problems of people there.
Local data will be most persuasive to local
media and politicians.
39. 5 39
3. Setting objectives: 5. Identifying allies: sound bites, slogans or short claims
are best: “Clean hands save lives” is
What are our specific Whom can we work a good example. Turn dry facts and
advocacy objectives, with? statistics into easy-to-remember, clear
key messages and lively stories.
and how can we make Start by gathering information on
potential partners. For handwashing,
them SMART? existing handwashing partnerships and 7. Monitoring
As for any project or program WASH coalitions are a logical place to
objectives, advocacy objectives start. Remember to reach out to less
evaluation: How
should be SMART: conventional groups. Approach a wide can we measure
range of partners with an outline of
Specific (What exactly do we want activities and events to discuss and
the impact of our
to happen?) agree upon their involvement and activities?
support. Discuss their participation by Monitoring and evaluating advocacy
Measurable (Will we know when we’ve focusing on their self-interest – as well work requires clear yardsticks with
achieved it?) as supporting a good cause, many which to measure success. It is almost
activities can increase their visibility in impossible to monitor or evaluate
Achievable (Is it possible to achieve the community or the general public. progress with vague objectives.
given our resources and time?) For example, when approaching actors
in the private sector, check out their Define indicators for success (or proxy
Relevant (Is it relevant to all stakeholders Corporate Social Responsibility Strategy. indicators) for all objectives during the
and the real problem?) planning phase and incorporate them
Time-bound (By when do we want it
6. Developing the in your advocacy plan. Indicators
should be drawn up for inputs,
to happen?) messages, choosing outputs, outcomes and, as much as
approaches and possible, impact.
4. Identifying the selecting the tools: If no hard, quantitative data are available
targets: Whom do we How can we best to measure the impact, record whatever
want to influence? reach our targets?
evidence – such as clippings – is
available as systematically as possible.
Whom are we addressing: community
No end of tools can be used for good Presenting a reasoned argument for the
residents, municipal authorities, NGOs,
advocacy work: press kits, newsletters, likely or plausible impact, based on what
local or national politicians, the corporate
TV, radio and the press, drama and has been achieved to date, is often all
sector, journalists?
theater, artists and celebrities, the that can be done.
Internet, lobbying, project visits,
Your research and analysis on your
petitions, posters, leaflets, and more. Find out what impact your efforts have
advocacy issue will have shown its
You will usually combine several tools, had to plan for follow-up action: What
specific local characteristics and the
but you need first to look at a large elements contributed to your success
power relationships around that issue,
variety of options to find the tools with or failure? How many people did you
helping you determine who has the
the potentially biggest impact on your reach? Inform your partners about this.
power to effect the change you wish
target groups. Thanking the planning committee and
to take place. The better you know and
your partners can lay ground for
define your targets, the better you will
To develop clear messages, transform future collaboration.
be able to select the most appropriate
your data and information into messages
advocacy tools and approaches to
that your targets can relate to. Here,
reach and influence them.
