Advancing Hand Hygiene in Central American Schools

Key points

CDC worked with partners to improve hand hygiene in primary schools in Belize, Guatemala, and El Salvador as part of efforts to reduce the spread of COVID-19 in Central America. Learning about and practicing hand hygiene in primary education settings is critical to preventing the spread of infectious diseases in schools.

An adult sits across from a young student and points to a poster that reads "Know When to Wash Your Hands at School.

Background

Learning about and practicing hand hygiene in primary education settings is critical to preventing the spread of infectious diseases in schools. Hand hygiene behavior, particularly handwashing with soap, is especially important at moments like after using the toilet and before eating.

Challenge

An adult sits across from a young student and points to a poster that reads "Know When to Wash Your Hands at School."
A nurse in Belize teaches key times to wash hands.

Teachers don’t always have the tools they need to teach their students about hand hygiene. Schools in low-resource settings often lack hygiene materials. This can make it difficult for educators to implement handwashing lessons and for students to regularly practice handwashing.

Intervention

CDC's Waterborne Disease Prevention Branch provided technical assistance to support water, sanitation, and hygiene (WASH) activities in Belize, El Salvador, and Guatemala. CDC collaborated with implementing partners from research institutions, CDC country offices, and ministries of health and education.

In 2022, field staff conducted baseline assessments to understand hand hygiene needs in 12 schools. These assessments found gaps in:

  • Students' hand hygiene knowledge and practice.
  • Inconsistent hand hygiene lessons in school curriculums.
  • Shortages of supplies for hand hygiene practice.

To overcome these challenges, CDC and partners developed a series of hand hygiene promotion programs based on needs for each setting. Activities included:

  • Providing schools with guidance for organizing hygiene festivals.
  • Creating ideas for lesson plans.
  • Setting up behavioral nudges like handwashing signs and painted footsteps leading to sinks.
  • Donating hand hygiene supplies.

Handwashing festivals and health fairs

In Guatemala and El Salvador, partners worked with teachers and administrators to develop materials for handwashing festivals and health fairs. The materials were designed to allow creativity among teachers and students by creating games, songs, and parades to share hygiene messages within their schools and communities.

Children at our school learned the process of washing their hands and, most importantly, they continued practicing it. Students and the entire educational community understood the importance of protecting against bacteria and viruses.
-School administrator in El Salvador
Digital flyers with text in Spanish inviting community members to wash their hands
Schools created invitations for community members.

A gentle nudge to wash hands

In Belize, behavioral "nudges" were placed near handwashing stations to encourage students to practice handwashing at key times. These visual cues included:

  • Footsteps leading students to handwashing stations.
  • Colorful handwashing messages above sinks.
  • Arrows pointing to soap dispensers.
  • Handwashing reminders inside stalls and above urinals.

Soap was provided to participating schools during the intervention period to supplement existing supplies.

Students are not used to practice handwashing regularly. Now that these stickers are there, it helps them with visual reminders to wash their hands.
-School administrator in Belize
Stepping stones are painted with green and yellow pairs of feet and lead up to a handwashing station.
Footpath installed as a handwashing nudge.

Results

Final data on the impact of the interventions are being collected. Partners have already observed improvements in students' hand hygiene knowledge.

Regular hand hygiene supplies and local strategies boost health in areas lacking access to such resources, as shown by these projects.

CDC continues to collaborate with domestic and global partners to improve access to WASH services and infrastructure around the world.

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Content Source:
Global Health Center