Handwashing with soap (HWWS) may be one of the most cost-effective means of preventing infection in developing countries. However, a recent study [1] from 11 countries found that on average, only 17% of child caretakers wash hands with soap after the toilet. The formative research studies by Valerie Curtis and her team focused on understanding the planned, motivated and habitual factors involved in HWWS. Handwash ‘habits’ were generally not inculcated at an early age. Key ‘motivations’ for handwashing were disgust, nurture, comfort and affiliation. Fear of disease generally did not motivate handwashing, except transiently in the case of epidemics such as cholera. ‘Plans’ involving handwashing included to improve family health and to teach children good manners. Environmental barriers were few as soap was available in almost every household, as was water.

Candidate strategies for promoting HWWS include creating social norms, highlighting disgust of dirty hands and teaching children HWWS as good manners. Dividing the factors that determine health-related behaviour into planned, motivated and habitual categories provides a simple, but comprehensive conceptual model. The habitual aspects of many health-relevant behaviours require further study.

[1] Curtis, V.A., Danquah, L.O. and Aunger, R.V. (2009). Planned, motivated and habitual hygiene behaviour: an eleven country review. Health education research. Published online 13 March 2009. doi:10.1093/her/cyp002 [Open Access article]

Related web sites: Hygiene Central ; Global Public-Private Partnership for Handwashing

Contact: Dr. Valerie Curtis, Director & Reader in Hygiene, The Hygiene Centre, London School of Hygiene & Tropical Medicine, UK, val.curtis@lshtm.ac.uk

Tags: hygiene promotion