behaviour change

Hand washing with soap saves lives.    And yet, millions of lives are being lost because people are not practicing it!  Though hand washing with soap is a simple behaviour, it is a difficult one to promote.

So why aren’t people washing their hands?

It’s not just a matter of awareness – many of us know that we should eat fewer sweets and exercise daily.  And yet the majority of us don’t do this.

It’s not just a matter of being educated– studies find that health care professionals (those that we consider most educated) often don’t wash their hands.

And it’s not a matter of infrastructure, wealth  or convenience – in the UK, a study found that less than a third of men washed their hands with soap after using a public toilet – and plenty of running water  and soap was available!

Awareness, education and easy to use hand washing infrastructure are all important pieces of the answer, especially in rural areas where these components are lacking.

But changing health behaviour is difficult.

Successful hand washing campaigns include:

  • Understanding of the target community to best determine their current knowledge, attitudes and practices.
  • Social marketing surveys and observation to determine the specific social and physical barriers to hand washing with soap.
  • Creating tailor made solutions for communities to overcome these barriers.
  • Tailoring messages within your communities – different members respond to different messaging so having a variety of mediums in your toolkit is important.
  • Focusing on the single message of hand washing with soap rather than a variety of hygiene behaviour.  Conveying two messages in a single communication has been shown to reduce the effectiveness of each by half.
  • Realizing that non health messages and motivations are important.  For example, people often diet to look good rather than for health reasons.
  • Understanding that program success is measured by improved health – not infrastructure targets or number of school visits etc.
  • Follow up is important!  It takes time to establish new habits and support the process to ensure that true behaviour change has occurred..
Bottom line: Hand washing with soap is simple, but working to increase this behaviour requires thoughtful, tailored and creative interventions with sustained follow up.