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Hygiene Challenges and Resources in Lower Income Countries

A number of challenges and barriers to good hygiene exist in lower income countries. The greatest of these challenges is the lack of clean water. Hundreds of millions of people do not have access to improved sources of drinking water 1; worldwide, there are 1.6 million deaths per year attributed to diseases spread through unsafe water, poor sanitation, and lack of hygiene 2.

However, even under circumstances where clean water is not available, evidence indicates that hygiene practices (for example, washing hands) using unsafe water are beneficial to reducing the spread of disease and are better than not washing at all. When access to safe water is poor, the Centers for Disease Control and Prevention (CDC) recommends using unsafe water in the same manner as safe water for hygiene practices, to clean hands before eating, after using the toilet, and at other key times.

In addition to water, another hygiene challenge in lower income countries is access to soap. Even when soap is available, it is typically used for laundry and bathing instead of for handwashing. A number of international programs focus on teaching the importance of using soap to wash hands.

One innovation designed to provide a simple, economical, and effective hand-washing station to communities in lower income countries is the tippy tap [PDF - 2 pages]. These devices use significantly less soap and water than other, traditional means of handwashing. In water-scarce settings, CDC’s Safe Water System (SWS) employs the use of tippy taps for handwashing. The SWS is a systematic intervention to improve water quality and access in lower income countries. This intervention consists of three steps:

  1. Point-of-use treatment, in which contaminated water is treated
  2. Safe water storage, which involves the use of specially designed containers
  3. Behavior change techniques, including activities to increase awareness and encourage good hygiene practices

These types of programs, designed to provide education about and access to safe water, are integral to the improvement of water resources in these areas; however, hygiene challenges remain a significant problem for millions of people living in lower income countries.

  1. World Health Organization and UNICEF. Progress on drinking water and sanitation – Special focus on sanitation. 2008.
  2. United Nations Millennium Project. Health, dignity, and development: What will it take? [PDF - 228 pages] 2005.