Global Threats: Hand Hygiene in Africa

Table of Contents

Causes of Bad Hand Hygiene

One of the first factors that affect people’s adherence to the rules of hand hygiene is personal forgetfulness. In Africa, people are rather busy surviving the daily challenges that do not leave free time to think about hand hygiene and its consequences. According to Anderson and Weese (2016), about 40 percent of people forget to wash their hands. Another category of people may resist handwashing practice as unnecessary. This may have resulted from flaws in the upbringing and the lack of education in childhood on the benefits of hand hygiene. This is considered to be one of the most significant intervention areas for advocates of hand hygiene.

Cultural traditions are known for their effect on people’s everyday behavior and practices. Thus, it is known that in Africa many people exercise Islam. Qu ‘ran establishes strong practical guidelines on handwashing, yet some of them can be considered unsanitary, such as cleaning private parts with the bare left hand. In the setting of the limited supply of hand hygiene tools, this practice can potentially result in infections. Access to handwashing tools and supplies is considered the universal problem in African countries. Only about 60% of health institutions have all-time access to clean running water and hand disinfectants. In population, this number may even be less than that, which is a serious issue for adherence.

Exacerbation factors

Among the factors that can potentially worsen the hand hygiene situation or prevent the population from adhering to healthy hygiene habits are religious, personal, community, and environmental issues. As such, religion, as it was already exemplified can be a source of unsafe practices that are relatively hard to deal with. Personal and community non-adherence are the factors that either provide reasons for non-adherence or create an environment where social principles contribute to the absence of handwashing practices. Both of them could be addressed through proper education. Constant lack of supplies is a problem that is difficult to tackle and requires significant structural changes in the country of intervention.

Action plan to improve the issue

As the most appropriate intervention in the settings of African countries, one can choose education and advocacy. Before advising indigenous people on handwashing it is paramount to acquaint oneself with local culture and traditions in order not to overstep invisible bounds and not to demonstrate disrespect. The main idea that needs to be relayed to the population is that most infectious diseases can be prevented by adherence to simple rules of hygiene. Provided there are difficulties with continuous access to hand hygiene supplies, it is paramount to speak of tactics that allow saving hands clean and prevent infections from entering the body hands.

Even healthcare providers are revealed to often disregard the hand hygiene rules, which dictates the need for educative intervention in African hospitals. Similar to the previously discussed setting, inquiries should be made before speaking publicly to hospital staff in order to reveal any language or cultural barriers that can obstruct mutual understanding. Provided common ground and understanding of the benefits of hygiene is achieved, tactics of educating the population can be discussed. In addition, one could also mention recent findings on infection prevention in a hospital setting. As such, the use of alcohol-based sanitizers may become the topic for discussion.

Relief workers are another population that may become a valuable ally in promoting hand hygiene in developing countries of Africa. Therefore, an educational intervention on the best advocative practices in relation to hand hygiene can be considered an effective practice. A topic to discuss might be the adherence to hygiene practices in an environment with a short supply of hygiene materials. One can also promote the idea of cooperation with local hospitals and healthcare institutions to advocate for hand hygiene among the population. Hand hygiene tools and materials are essential for adherence to practices, and relief workers need to be consulted on the ways of receiving them.

Government officials can be rather difficult to meet or consult, yet they are in possession of resources and administrative power to deliver the help to the cause of promoting hand hygiene. The primary area for cooperation is hand hygiene adherence among hospital workers and the general population. The need for financing should be clearly articulated and supported by statistical data on the benefits of adherence to hand hygiene.

A constant supply of hand hygiene materials is paramount for infectious disease prevention. Government officials need to be spoken to about the ways of establishing the production of such supplies in their countries instead of relying on scarce amounts of humanitarian aid from developed countries.

In addition to direct cooperation with the government, one could use the authority and resources of the World Health Organization to establish a multilateral cooperation agreement in relation to hand hygiene. WHO is known for its advocative role in the prevention of hygiene-related infections. It could be beneficial to join forces with WHO to appeal to the government and work together towards the resolution of issues connected to supplies of hygiene materials for hospitals and the general population. Culturally and environmentally acceptable techniques of maintaining the cleanness of hands should also be discussed. All in all, the discussed action plan should serve as an effective measure to promote hand hygiene in developing countries across Africa.


Allegranzi, B., Gayet-Ageron, A., Damani, N., Bengaly, L., McLaws, M. L., Moro, M. L.,… Donaldson, L. (2013). Global implementation of WHO’s multimodal strategy for improvement of hand hygiene: A quasi-experimental study. The Lancet Infectious Diseases, 13(10), 843-851.

Anderson, M. E., & Weese, J. S. (2016). Self-reported hand hygiene perceptions and barriers among companion animal veterinary clinic personnel in Ontario, Canada. The Canadian Veterinary Journal, 57(3), 282.

Contzen, N., & Mosler, H. J. (2015). Identifying the psychological determinants of handwashing: Results from two cross-sectional questionnaire studies in Haiti and Ethiopia. American Journal of Infection Control, 43(8), 826-832.

Freeman, M. C., Stocks, M. E., Cumming, O., Jeandron, A., Higgins, J., Wolf, J.,… Curtis, V. (2014). Systematic review: Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine & International Health, 19(8), 906-916.

Kalata, N. L., Kamange, L., & Muula, A. S. (2013). Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi. Malawi Medical Journal, 25(2), 50-52.

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