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
Effectiveness of measures taken by governments to support hand hygiene in community settings: a systematic review
Jedidiah S Snyder1, Erika Canda1, Jordan Honeycutt1
1Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, USA.
Introduction:
This systematic review aimed to identify and evaluate the implementation of government measures that support equitable and sustained hand hygiene practices in community settings.
Methods:
We systematically searched 12 databases, including 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 for peer-reviewed and grey literature published through late March 2023. Additional sources were identified through expert consultations and manual reference list checks of related reviews. Studies employing quantitative, qualitative or mixed-methods designs were eligible. Study quality was assessed using the Mixed Method Appraisal Tool. Government measures were categorised according to the Sanitation and Water for All Building Blocks framework: sector policy strategy; institutional arrangements; sector financing; planning, monitoring, review; and capacity development. Hand hygiene outcomes were classified as access, behaviour change or enabling environment and impact as positive, null or not evaluated.
Results:
Thirty-one studies (24 journal articles and 7 grey literature) from 19 countries-mostly middle income (71%)-were included. Most focused on household (58%), schools (19%) or both (13%). A total of 75 government measures were identified, with sector policy strategy and capacity development being the most common (each 31%), followed by institutional arrangements (17%), planning, monitoring, review (13%) and sector financing (8%). Positive impacts were linked to 45 measures across all five Building Blocks in 17 studies.
Conclusion:
This systematic review highlights diverse government measures supporting hand hygiene in community settings, with sector policy strategy and capacity development being the most frequently reported. While many government measures showed positive impacts, gaps remain in financing, implementation and sustainability beyond households and schools. Strengthening governance, increasing investment and expanding research on cost-effectiveness and implementation barriers are essential to improve hygiene initiatives and ensure equitable access.
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....
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:15Handwashing III: During the Procedure and Post-Procedure Steps
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...
01:26Standard 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...