Celebrating hand hygiene success around the world

On World Hand Hygiene Day, WHO celebrates the remarkable work in countries around the world using hand hygiene and infection prevention and control (IPC) to create a culture of quality and safety in healthcare facilities. Below we look at some of the different ways countries are implementing and strengthening IPC in their health care facilities.

Local production of alcohol-based handrub in Uganda

Producing alcohol-based handrub locally promotes local engagement, improves hand hygiene compliance and is a great way to ensure reliable supplies for health facilities. In Uganda, a group of IPC/Water, Sanitation and Hygiene (WASH) project officers happen at the Infectious Diseases Institute (IDI) which provides system strengthening and capacity building support to the Ministry of Health, have been helping make this.

A study undertaken in 2018 in the Kabarole district, southwestern Uganda, in collaboration with United States Centers for Disease Control and Prevention (CDC) and International Water and Sanitation Center (IRC), showed just what a challenge limited access to hand hygiene products such as alcohol-based handrub was for health care facilities. From this study, the team were able to determine that production was not only possible locally, but was also enthusiastically welcomed by local health care workers.

A “district approach” to production sees the district health officer assigning a team for local production, securing production facilities close to storage or health care care. Production is based on the recommended WHO formulation for alcohol-based handrubs; Quality is assured by the National Drug Authority, and distribution is through the district supplies distribution cycle. An e-learning curriculum for local production of alcohol-based handrub based on the WHO recommendation has also been developed.

Meanwhile, Saraya, a Japanese company which is part of the WHO Private Organizations for Patient Safety (POPS), is partnering with international organizations and academic institutes to promote local production of alcohol-based handrub in Uganda. In 2010, Saraya started a hand hygiene project in collaboration with UNICEF, which identified poor access to hand hygiene related commodities and led to the establishment of a local company, Saraya Uganda. Currently, Saraya Uganda is working with Kakira Sugar, a local sugar manufacturing company to produce alcohol-based handrub, using ethanol made from sugar cane which is grown on local plantations.

The product was registered as the first alcohol-based handrub produced and sold locally in Uganda and East Africa. Evidence suggests that it is leading to improved hand hygiene and reduced health care associated infections. A study is now being conducted to assess the impact of WHO’s hand hygiene multimodal strategy with use of locally produced alcohol-based hand rubs, in collaboration with the University of Geneva.

Five health workers learning to produce locally made alcohol based handrub.

Integrated hand hygiene activities in Saudi Arabia

In 2009, following the launch of WHO’s SAVE LIVES: Clean Your Hands campaign, Saudi Arabia launched a national hand hygiene programme. Since then, the country has made significant improvements in hand hygiene and infection prevention and control.

In 2019 the Saudi Council of Ministers recognized hand hygiene as the most important intervention to reduce health care-associated infections with the highest possible level of national legislation. This meant mandating the practice of hand hygiene for health practitioners, requiring all healthcare facilities to use WHO’s tools to evaluate compliance, and directing all health sectors to launch and intensify hand hygiene programs in health care facilities.

The Saudi Ministry of Health has a client experience center which aims to improve the health care experience. After-visit surveys regularly conducted by the center include questions on health care workers’ hand hygiene compliance. Feedback is shared with healthcare facilities with an emphasis on responsibility rather than blame.

An extensive network of hand hygiene coordinators has been comprehensively trained and given clear roles and responsibilities including education, monitoring compliance, data validation, and reporting. Each health care facility must have at least one hand hygiene coordinator whether it is a hospital, primary health care center, dental center, or dialysis center. In the first quarter of 2022, Saudi Arabia had more than 2100 registered hand hygiene coordinators.

In addition, the country is running education and awareness campaigns, monitoring compliance, establishing an expert team to implement WHO’s multimodal hand hygiene strategy, and ensuring hand hygiene requirements are integrated into all tools for prevention and control of infections. Saudi Arabia also takes part in World Hand Hygiene Day every year with activities taking place in health care facilities across the country.

Two health workers performing hand hygiene during a training session in Saudi Arabia

A group of health workers in Saudi Arabia celebrating world hand hygiene day.

Hand hygiene and infection prevention and control activities from across the globe

Prevention of health care-associated neonatal sepsis through effective IPC is a priority for Viet Name. In the context of improving the quality of skilled delivery and post-delivery care, the country’s main focus is on the national IPC programme, providing IPC guidance and training, good hand hygiene practices, and observation and attention to the built environment. In a pilot hospital, cases of probable and proved neonatal sepsis decreased by three quarters.

A mother holding her newborn child against her chest.

Continued political and leadership commitment from the Ministry of Health in Chile has resulted in remarkable and sustained national IPC efforts since 1982. Having infection prevention and control measures implemented is mandatory by law for every facility since 2010. In 2020 94.3% of 174 public hospitals reported established IPC programs and between 2000 and 2019, the national IPC program documented an 80% reduction in the rate of health care-associated infections being monitored in the country.

During the COVID-19 pandemic Kazakhstan boosted IPC capacities at a national level through rapidly establishing or strengthening all core components of IPC programmes, including extensive IPC training of front-line health workers and assessment and improvement of practices at the point of care in healthcare facilities. IPC has been included as part of the second direction of the national “Healthy Nation” strategic programme, which will be implemented by the Government during the next five years.

A hand hygiene training in Kazakhstan using an ultraviolet light to show commonly missed areas when performing hand hygiene.

In Bangladesh The COVID-19 crisis became the impetus for developing stronger national and health care facility IPC preparedness to outbreaks. The ‘National Preparedness and Response Plan for COVID-19’, as well as a national guideline on IPC for both public and private health care facilities were introduced, including by training 12 733 doctors, nurses and support staff. This was followed by a rapid scale up of IPC measures including hand hygiene.

The Sultanate of Oman has used its national action plan on antimicrobial resistance (AMR) as the entry point to strengthen infection prevention and control. They launched their National Policy and Action Plan on AMR in May 2016 and the national IPC program is the coordinating body for the implementation of this plan with the other stakeholders through the National AMR committee. The national system for AMR and health care-associated infection surveillance has recently reported that 46-73% of bloodstream infections due to resistant pathogens were acquired in health care. These data triggered action to increase education and expertise in infection prevention and control in health care facilities.

A woman presenting a research poster on hand hygiene in Oman.

Ghana has streamlined national IPC and WASH through linkages to quality-of-care programs and a costed national strategy; This was reflected in strong national efforts such as the creation of a national joint IPC and WASH Taskforce in 2016, producing a national technical guide, and strong leadership and finances invested to support IPC and WASH in health care facilities.

To learn more about this year’s theme and understand how you can get involved this 5th May 2022, visit out campaign webpage for more details!

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