By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
On World Hand Hygiene Day, the WHO South-East Asia Region joins global calls for immediate and sustained action to achieve effective hand hygiene at the point of care, primarily in health care facilities. Health care-associated infection (HAI) is a major global health problem, affecting millions of patients every year. Globally, out of every 100 patients in acute care hospitals, seven in developed and 15 in developing countries will acquire at least one HAI. HAIs in adult intensive care units and neonatal infection rates are 2–3 and 3–20 times higher, respectively, in low- and middle-income countries than in high-income countries. Appropriate hand hygiene prevents up to 50% of avoidable HAIs, including those affecting health and care workers. To be effective, hand hygiene should be performed according to the WHO “5 Moments for Hand Hygiene” and using the appropriate technique with readily available products at the point of care.
The Region has in recent years made targeted efforts to strengthen infection prevention and control (IPC) measures, including hand hygiene, in line with Flagship Priorities on achieving universal health coverage, preventing and combating antimicrobial resistance, and accelerating reductions in maternal, neonatal and under-five mortality. Since 2016 all countries have been implementing the Region’s strategy for patient safety, which identifies hand hygiene as a priority intervention. Amid the COVID-19 response, all countries have participated in IPC trainings, as well as a Regional consultation aimed at aligning key interventions with WHO’s new Global Patient Safety Action Plan. Member States from across the Region continue to prioritize the improvement of water, sanitation and hygiene (WASH) in health care facilities (HCFs), especially at the primary level, and are contributing to a Region-wide situational analysis that will inform priority actions. In this International Year of Health and Care Workers, WHO will continue to support countries in the Region to strengthen IPC in HCFs to protect health and care workers from COVID-19 and other HAIs.
Accelerated action is needed amid a new wave of COVID-19 infection and as part of ongoing vaccination campaigns. Globally, health and care workers account for around 6.5% of COVID-19 cases. It is imperative that health facility managers apply the WHO hand hygiene multimodal improvement strategy to protect health and care workers and enable them to get the job done. WHO guidance on IPC principles and procedures for COVID-19 vaccination activities must continue to inform vaccination planning and delivery. All vaccination sites should provide soap, clean water and disposable or clean towels, as well as alcohol-based hand rub products. Visual reminders of the importance of hand hygiene should be prominently displayed, and patients should be encouraged to perform hand hygiene on arrival and when leaving the site. Vaccinators should perform hand hygiene before putting on and removing personal protective equipment, before preparing the vaccine and between each vaccine administration.
This year’s “Seconds save lives” campaign makes several calls to action. First, to health and care workers: Perform hand hygiene at the point of care, when it is needed, according to the WHO “5 Moments for Hand Hygiene” and using the appropriate technique. Second, to IPC practitioners: Combine activities aimed at monitoring hand hygiene practices with direct feedback to health and care workers, provided in the spirit of improvement, at the point of care. Third, to facility managers: Ensure reliable and uninterrupted provision of quality alcohol-based hand rub, supplies of clean water, soap, single-use towels and an adequate number of functioning sinks. And fourth, to policy-makers: Strengthen the enabling environment and ensure vital hand hygiene products and WASH services are accessible across the health system, and for everyone in their community.
We must all do our part. The WHO-supported global Hand Hygiene for All campaign, launched last year, highlights how people from all walks of life can come together to promote hand hygiene in a range of settings, from schools and workplaces, to institutions and places of worship, transport hubs and child-care centres. Whole-of-society efforts to enhance hand hygiene must be strengthened throughout the COVID-19 response, but also beyond it. On World Hand Hygiene Day, WHO reiterates its commitment to support Member States to achieve effective hand hygiene at the point of care, and to continue to enhance the quality and safety of health care services. No one goes to a health care facility to get sick. The future is in our hands.