Half of Health Care Facilities Worldwide Lack Basic Hand Hygiene Supplies

Half of health care facilities worldwide lack basic hand hygiene supplies such as soap, water, or alcohol-based hand rub, according to a recent report by the World Health Organization (WHO) and UNICEF. 

Globally, one out of eleven healthcare facilities lacked appropriate hygiene supplies at points of care and near toilets in 2021. Approximately 688 million people receive care at facilities with no hygiene services at all.

Recognizing the strong link between hand hygiene and infection prevention, the United Nations launched a global call to action in 2018 to improve water, sanitation, and hygiene access in all health care facilities. In May 2022, the Worth Health Assembly passed a resolution calling for WHO to develop a global infection prevention and control strategy. Hand hygiene – and the availability of hand hygiene supplies in healthcare settings – will almost certainly be at its core.

Lack of Hand Hygiene Supplies Increases Risk of Infection and Death

Hand hygiene has been proven to reduce the risk of infection, including healthcare-associated infections (HAIs), or infections that develop while a person is receiving care for another health condition. An inability to access water, soap, or alcohol-based hand rub inhibits healthcare providers’ ability to clean their hands, increasing the probability that they may inadvertently contribute to the spread of pathogens.

Differing access to hand hygiene supplies contributes to differing HAI rates. In high income countries – where virtually all healthcare facilities have basic hygiene supplies – approximately 7% of patients in acute-care hospitals develop an HAI during hospitalization. In low- and middle-income countries, approximately 15% of hospitalized patients contract an HAI. 

More than half of all cases of healthcare-associated sepsis – a life-threatening response to infection that can lead to tissue damage, organ failure, and death – are “thought to be preventable through basic WASH [water, sanitation and hygiene] services and appropriate IPC (infection prevention control) measures,” according to a report by WHO and UNICEF. 

Access to Supplies Doesn’t Guarantee Adequate Hand Hygiene

Yet the mere availability of hand hygiene supplies doesn’t necessarily lead to improvements in hand hygiene. In the United States (and most other high-income countries), water, soap and alcohol-based hand rub are ubiquitous in clinics and hospitals, and all healthcare providers are taught about hand hygiene and infection control. Hand hygiene compliance in hospitals, clinics, and nursing homes averages only about 50%, despite easy access to hygiene supplies. 

In the United States, on any given day, one in 31 hospital patients have at least one HAI, according to the Centers for Disease Control and Prevention (CDC), and approximately 99,000 people die from HAIs annually. 

Monitoring Necessary to Improve Hand Hygiene

Access to hand hygiene supplies is an essential first step to improving hand hygiene and decreasing infection. However, education, monitoring, and adjustments to practice are also necessary. 

The recent WHO and UNICEF report on hand hygiene and infection control outlines 8 practical steps to improve WASH in healthcare facilities:

  1. Conduct situation analysis and assessment
  2. Set targets and define roadmap
  3. Establish national standards and accountability mechanisms
  4. Improve and maintain infrastructure
  5. Monitor and review data
  6. Develop health workforce
  7. Engage communities
  8. Conduct operational research and share learning

Hospitals and healthcare providers in the United States are currently focusing their efforts on numbers five through eight. Research conducted during the COVID-19 pandemic found that high rates of hand hygiene compliance are possible, “yet difficult to sustain.” 

Electronic hand hygiene systems that include automated monitoring (like the SwipeSense system) can help healthcare facilities track hand hygiene performance over time – and intervene quickly if hand hygiene rates drop. After installing SwipeSense in their hospitals, Novant Health noted improvements in hand hygiene rates and a 50 to 60 percent drop in hospital-acquired infections. 

SwipeSense supports the efforts of the United Nations, WHO, and UNICEF to increase global access to water, soap, and alcohol-based hand rubs. Together, healthcare providers, countries, and communities can promote excellent hand hygiene and protect patient safety.