World Hand Hygiene Day 2024

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5 May is World Hand Hygiene Day

Each year the SAVE LIVES: Clean Your Hands campaign aims to progress the goal of maintaining a global profile on the importance of hand hygiene in health care and to ‘bring people together’ in support of hand hygiene improvement globally.

WHO calls on everyone to be inspired by the global movement to achieve universal health coverage (UHC), i.e. achieving better health and well-being for all people at all ages, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. Infection Prevention and Control, including hand hygiene, is critical to achieve UHC as it is a practical and evidence-based approach with demonstrated impact on quality of care and patient safety across all levels of the health system.

2024 THEME:

Promoting knowledge and capacity building of health and care workers through innovative and impactful training and education, on infection prevention and control, including hand hygiene.

Slogan:

Why is sharing knowledge about hand hygiene still so important? Because it helps stop the spread of harmful germs in healthcare.

Objectives of WHHD 2024

Strengthen learning approaches to enable implementation of innovative and effective training to empower health and care workers to improve hand hygiene and IPC at point of care with enhanced knowledge, skills and behaviours.
Promote access to innovative hand hygiene and IPC training resources for health and care workers.
Raise awareness about the importance of knowledge and learning on hand hygiene at the right times to prevent a range of infectious diseases.
Encourage measurement and evaluation mechanisms to assess the impact of training and education on IPC standards and practices including hand hygiene, including their effect on the prevention of HAI and AMR.

Key facts

In 2022, 57% of the global population (4.6 billion people) used a safely managed sanitation service.
Over 1.5 billion people still do not have basic sanitation services, such as private toilets or latrines.
Of these, 419 million still defecate in the open, for example in street gutters, behind bushes or into open bodies of water.
In 2020, 44% of the household wastewater generated globally was discharged without safe treatment (1).
At least 10% of the world’s population is thought to consume food irrigated by wastewater.
Poor sanitation reduces human well-being, social and economic development due to impacts such as anxiety, risk of sexual assault, and lost opportunities for education and work.
Poor sanitation is linked to transmission of diarrhoeal diseases such as cholera and dysentery, as well as typhoid, intestinal worm infections and polio. It exacerbates stunting and contributes to the spread of antimicrobial resistance.

High-level messaging on the HAI and AMR burden

Health care associated infections (HAIs) are among the most frequent adverse events occurring in the context of health service delivery. On average, around 1 in 10 patients is affected by HAIs; however, the frequency can be much higher in low-/middle-income countries and in high-risk patients such as those in intensive care unit.
According to research published by 2023 Balasubramanian et al., an estimated 136 million cases of health care-associated antibiotic resistant infections occur worldwide every year.
In Europe, the burden of the six most frequent HAIs was calculated to be twice the burden of 32 other infectious diseases all together, in terms of disability and premature mortality.
It was also estimated that 63·5% of cases of infections with antibiotic-resistant bacteria were associated with health care. This has a consequence on global mortality, given that globally, more than 5 million deaths were estimated to be associated with antimicrobial resistance in 2019.
HAI, many of which are caused by multidrug-resistant organisms, harm patients, visitors and health workers and place a significant burden on health systems. In Europe alone, some 9 million HAIs occur every year in acute and long-term care facilities; they lead to 25 million extra hospital days and cost 13-24 billion euros.
Emerging data from several countries show that pandemic disruptions led to an alarming and significant increase of HAIs and AMR.

The role of IPC and hand hygiene

IPC interventions are proven to reduce HAIs and AMR by 35-70% and are cost saving, irrespective of the level of income of a country.
Preventing an infection and its spread can have huge benefits in reducing human suffering and loss of lives and producing economic advantages. High quality water, sanitation and hygiene services, effective IPC programmes, based on the WHO core components, including hand hygiene action, can reduce HAIs by up to 70%.
Research from the OECD found that across 34 OECD and EU/EEA countries, investing US$ 1 in improving hand hygiene in health care settings returns about US$ 24.6 in economic returns (i.e. both in health expenditure and productivity gains in the broader economy).
Hand hygiene and general hygiene provide dignity and are a sign of respect to those who are seeking care. They also facilitate the work of those delivering it.
Accelerating hand hygiene action depends on water, sanitation and hygiene services. Yet globally, half of all health care facilities still lack basic hand hygiene facilities at the point of care. Investing in such services requires awareness and leadership and will result in important economic and health gains.

Country progress and the specific role of education and training in influencing the workforce

Many countries are demonstrating strong engagement and advancements in scaling-up strategies and actions, but overall, the progress is slow, and gains are at risk. From the 2022 Global IPC report, only four out of 106 assessed countries (3.8%) had all minimum requirements for IPC in place at the national level. This is reflected in inadequate implementation of IPC practices at the point of care, with only 15.2% of health care facilities meeting all of the IPC minimum requirements in 2019.
In 2021, during the COVID-19 pandemic, only 20% of countries had an IPC training and education programme fulfilling minimum requirements. In multiple WHO surveys, training and education was the weakest component of IPC programmes around the world.

The 2021-22 WHO global survey on national IPC programmes revealed the following common challenges and gaps in core component #4 – IPC education and training. In all regions:
- The lack of IPC experts and mentors
- The lack of standardized IPC curricula, including within pre-graduate courses (e.g. medicine, nursing, midwifery) and in-service training, and for post-graduate specialization
- Lack of career pathways and development for IPC professionals.

The wider global workforce context should not be overlooked and is relevant to this. Latest WHO data from 2020 states that there are 65.1 million health workers that comprise the global workforce “stock”. When broken down by category the figures look as follows: 29.1 million nurses, 12.7 million medical doctors, 3.7 million pharmacists, 2.5 million dentists, 2.2 million midwives and 14.9 million additional occupations, including cleaners and health care waste workers. This does not account for external contractors. For example, 65 million health workers trained/educated & taking action on hand hygiene can help save lives.”
WHO states that a competent IPC workforce means having a proven ability to use knowledge, skills and personal, social and/or methodological abilities in work or study situations and in professional and personal development.
WHO advises that a competent IPC professional is a health care professional (medical doctor, nurse, or other health-related professional) who has completed a certified postgraduate IPC training course, or a nationally or internationally recognized postgraduate course on IPC, or another core discipline including IPC as a core part of the curriculum as well as IPC practical and clinical training.
The 5 Moments for hand hygiene observation & feedback forms have existed since 2009. Individual observation, including health worker identification, may be undertaken for educational purposes.
To improve understanding of hand hygiene and to contribute to its promotion, the results of an observation should be presented immediately to the health workers who have been observed, wherever possible. This should be done in a way that allows an exchange of views conducive to fostering capacity building, a safety culture and trust among those who have taken part, and facilitating on the job training.
Final results should be sent to all the concerned health workers either collectively or individually as well as to others, for example management or IPC committees according to local decisions. This should occur as soon after the data has been collected as possible to facilitate knowledge building among everyone involved.
In the context of a multimodal improvement strategy, you can’t train health workers to clean their hands and expect a sustainable impact without providing them with performance feedback, an enabling environment, including good water, sanitation and hygiene services, reminders or a supportive culture.