Hand washing with soap and water is asimple way to reduce the spread of disease. It doesntrequire complicated technology, its usually affordable andeven young children can do it. Yet many people dont washtheir hands when they should: before touching food, afterusing the toilet or after cleaning a babys bottom. Campaignsto remind people to wash their hands arent alwayssuccessful, even in places where both soap and water areeasy to find. For health experts, the problem is puzzling.Bacteria, parasites and viruses can easily spread whenpeople dont wash their hands, putting children at risk ofpotentially fatal diarrheal and respiratory infections. TheWorld Bank is committed to ending poverty and givingeveryone an equal chance in life, and promoting healthyhabits can help make this happen. There are so many thingsthat can conspire to keep people poor: bad education and fewjobs usually come to mind first. But poor health can be asdevastating, if not more so, to a persons ability to create,find and utilize opportunities. Illness drains finances andkeeps people out of school and work. For young children, theresults can be deadly: diarrhea is the second leading causeof death in children under the age of 5, and this despitethe fact that its both preventable and treatable. As thesestudies underscore, changing behavior is difficult. The twostudies taken together build on existing evidence showingthat handwashing campaigns must move beyond traditional massmedia into more personalized and intensive programs at thecommunity and institutional level. Further research into howsuch approaches can be deployed on a large scale is needed,as is a better understanding of other environmental factorsand fecaloral transmission pathways that can spreadillnesses. This Evidence to Policy note was jointly producedby the World Bank Group, the Strategic Impact EvaluationFund (SIEF), and the British governments Department forInternational Development.
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