Efficient Ways to Extend Hand Washing to all Ugandans

The COVID-19 pandemic has highlighted the importance of having effective and efficient water service delivery. While the issue of hand washing is critical in curbing the spread of the epidemic, it had prior been neglected according to the latest statistics. This blog discusses the importance of the hand washing practice beyond COVID-19, relates the exercise with other public services, and suggests policy implications going forward.

Statistics on hand washing

Although the Uganda Bureau of Statistics (UBOS) household survey of 2017 confirms that seventyseven percent of households have access to a safe water point, washing practices remain low.  According to a New vision article published in 2013, twentyeight percent of Uganda’s population has access to hand washing facilities.

Moreover, there are impressive milestones in access to improved drinking water sources that can be emulated to maintain the current hand washing momentum. UBOS also informs that nighty percent of households are within three kilometers of a drinking water source. Travel time on average remains at twenty-four minutes, and waiting time at water source at twenty-three minutes.

Reason for the low incidence of hand washing

The question is, will hand washing practices improve now that the population is practicing interim preventive handwashing? Will the incidence of the people accessing hand washing facilities increase? In response to the above question, it is essential to understand what brought about the low prevalence in the first case.  One apparent reason is the poor attitude towards the practice. Many citizens have either not been adequately educated on the benefits of hand washing or simply forget to do so.

Another not so apparent reason relates to the numerous uses of water in an average home. Most homes in Uganda are not equipped with piped water or an inbuilt improved or protected water source. The lack of piped water means that a significant portion of the population must travel to collect water, sometimes for more than five kilometers, in the worst case. Both distance and time to the water sources determine how much water is assigned to handwashing. Therefore, homes that must travel long miles for water may be forced to carefully distribute it to all purposes, such as cooking, drinking, and cleaning. Insufficient water could also mean that handwashing gets neglected.

Hand washing
Source: SoftPower

For those that practice hand washing, irregular water flow,especially in the city, has meant that water is stored in unsafe conditions, which leads to contamination. For instance, city toilets have a practice of mixing hand washing water with liquid soap instead of separately. Of concern is that handwashing water provided by street vendors is usually discarded after several washes. While there is an attestation of enough water within the city, with the majority accessing clean water, it comes at a high cost, necessitating its meager or careful use. Therefore, irregular water flow inhibits the maturation of the practice.

How other efficiencies in other services play a role in the handwashing incidence

Retrospectively, the road network and the extent to which it  plays a critical role in water access. The presence of a dense road network suggests that distances to water become shorter and less time is required to access water points. Furthermore, an efficiently maintained road network increases safety and security, availing households with more water as they can travel shorter distances. To this end, more water could also be apportioned to handwashing.

Policy implications

What should be done to keep the impetus of hand washing after COVID-19?

Equip crowded places with hand washing points. Schools, hospitals, markets, and worship centers should continually be served with hand washing points, not just the toilet. The government can also enhance inspection by having them monthly or quarterly.
Sensitization – This drive can be kept through awareness in the media and hand washing champions.
Subsidize sanitizers and piped water. It is essential to ensure equitability in handwashing, among both the poor and the rich. Therefore a subsidy towards hand-sanitizers and handwashing facility manufacturers may improve the uptake, especially among the disadvantaged.
Upgrade and maintain the inter-village road network. As discussed above, road infrastructure is a crucial complementary to hand washing.
Enhance mind change towards hand washing, starting with households and families. While this may be a long-term plan, social workers can innovate ways of penetrating families through educational visits.

In this dispensation, the uptake of handwashing has improved compared to prior times. However, if deliberate steps are not undertaken, we are unlikely to witness a continuation of the upsurge in handwashing. Complimentary services are important in ensuring this campaign, although not discussed in this blog, health services play an equally auxillary role as road services.

Miriam Katunze ,Ph.D Candidate
Lingnan University.