Healthcare facilities

Functional hand hygiene facilities should be present for all health care workers at all points of care, in areas where PPE is put on or taken off, and where health care waste is handled. In addition, functional hand hygiene facilities should be available for all patients, family members and visitors, and should be available within 5 m of toilets, as well as at the entry/exit of facility, in waiting and dining rooms and other public areas.

Homes, schools, prisons, and certain public spaces

In homes, schools, prisons and frequently visited public spaces − such as markets, shops, places of worship, and train or bus stations – hand hygiene facilities should be available and hand hygiene practices strongly encouraged through visual reminders and, where possible, considered as a requirement before entering buildings. In addition, and according to existing guidance, functioning handwashing facilities with water and soap should be available within 5 m of all toilets, both public and private.

Handwashing facility options

A number of design features should be considered in selecting and/or innovating on existing handwashing facility options. These features include:

• Turning the tap on/off: either a sensor, foot pump, or large handle so the faucet can be turned off with the arm or elbow
• Soap dispenser: for liquid soap either sensor-controlled or large enough to operate with the lower arm; for a bar of soap, the soap dish should be well-draining, so the soap doesn’t get soggy
• Grey water: ensure the grey water is directed to and collected in a covered container if not connected to a piped system
• Drying hands: paper towels or clean cloths and a bin provided; if not possible encourage air drying for several seconds
• Materials: generally, the materials should be easily cleanable and repair/replacement parts can be sourced locally
• Accessible: should be accessible to all users, including those with limited mobility.

A number of handwashing designs have been implemented in households, schools and in public settings (e.g. bus and train stations, at store fronts) in both developed and developing countries (1). In schools, a number of simple, easy to maintain, and durable low-cost designs have been successfully implemented (see the compendium of low-cost handwashing facilities for details (2). It is important that public facilities are regularly maintained and are managed so as to limit theft and vandalism and support proper handwashing technique.

1. Examples include HappyTap in Southeast Asia, Mrembo in East Africa and handwashing stations in San Francisco
2. GIZ & UNICEF. Scaling up group handwashing in schools. Compendium of group washing facilities across the globe. New York; Eschborn; 2016.