Related Experiment Video
Updated: Jan 17, 2026
A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Minimum material requirements for hand hygiene in community settings: a systematic review
Lilly A O'Brien1, Kennedy Files1, Jedidiah S Snyder1
1Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Background:
This systematic review assessed the minimum requirements necessary to create an enabling environment for sustained hand hygiene practices: quantity of water and soap, and number, spacing, location, and design of hand hygiene facilities.
Methods:
We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, PAIS Index, WHO IRIS, UN Digital Library and World Bank eLibrary, and consulted experts. Eligible studies were published through 29 March 2023, observational, in non-healthcare community settings, and reported on at least one of the five categories: (1) quantity of water, (2) quantity of soap, (3) location of hand hygiene materials, (4) number of users or spacing of facilities and (5) considerations for equitable access. Two reviewers independently extracted data from each study and assessed risk of bias using the Mixed Method Appraisal Tool.
Results:
This review identified 37 studies that met inclusion criteria from 27 countries, representing 4 of the 6 WHO regions (Africa, South-East Asia, the Americas and Europe). Household settings were the most represented (59% of studies), followed by institutional or school settings (41%) and public establishments (27%). Of the 37 studies, 12 (32%) assessed the relationship between a material requirement and hand hygiene practices. Despite extensive global research on hand hygiene, we found a lack of evidence linking material requirements with handwashing practices in community settings.
Conclusions:
This review was limited to observational studies, and more data could be derived from experimental studies. Important evidence gaps include the quantity of water and soap needed, the influence of facility location and design on hand hygiene practice, and material needs providing equitable access. Further research is needed to strengthen the evidence base for hand hygiene recommendations and supplement the expert opinion on which many recommendations are currently based.
Prospero Registration Number:
CRD42023429145.
Related Concept Videos
01:23Hand hygiene
Hand washing...
01:18Handwashing I: Introduction and Types of Equipment
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated....
01:19Handwashing II: Pre-procedure and Initial Procedure Steps
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail...
01:15Handwashing III: During the Procedure and Post-Procedure Steps
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...