Minimum material requirements for hand hygiene in community settings: a systematic review

Area of Science:

• Public Health
• Environmental Health
• Infectious Disease Prevention

Background:

• Sustained hand hygiene practices are crucial for public health.
• Minimum requirements for enabling environments include water, soap, and facility access.
• Evidence linking material requirements to hand hygiene in community settings is scarce.

Purpose of the Study:

• To systematically review the minimum requirements for sustained hand hygiene practices in community settings.
• To identify evidence gaps regarding water quantity, soap availability, and facility design for hand hygiene.

Main Methods:

• Systematic review of observational studies published through March 29, 2023.
• Searched multiple databases including PubMed, Web of Science, and Scopus.
• Included studies on water quantity, soap quantity, facility location, number/spacing of facilities, and equitable access.

Main Results:

• 37 studies from 27 countries across 4 WHO regions were included.
• Household settings were most represented, followed by schools and public establishments.
• Only 32% of studies assessed the link between material requirements and hand hygiene practices, revealing a significant evidence gap.

Conclusions:

• Observational studies provide limited data; experimental studies are needed.
• Evidence gaps exist for water/soap quantities, facility design influence, and equitable access materials.
• Further research is essential to strengthen hand hygiene recommendations beyond expert opinion.