Washing hands with soap and water reduces cases of diarrhoea by almost 50% – yet on average, around the world only 19% of people wash hands with soap after defecation. This Global Handwashing Day, WaterAid urges governments worldwide to prioritise handwashing promotion, alongside water and sanitation, to save lives.

According to ‘The recipe for success: How policy-makers can integrate water, sanitation and hygiene into action to end malnutrition’, a global report produced by Action Against Hunger, the SHARE Consortium and WaterAid, 43.6% of children under five in Nigeria are stunted and 10% of under five deaths is caused by diarrhoea, linked to poor access to water, sanitation and good hygiene.

On 15 October every year, the important role that handwashing with soap plays in reducing the spread of diseases and preventing poor nutritional and health outcomes is highlighted across the world. The theme of this year’s commemoration ‘Clean hands – a recipe for health’ focusses on the link between handwashing, food and nutrition, creating awareness on the need for handwashing with soap at critical times such as after using the toilet, before cooking, eating, or feeding others.

The simple act of washing hands with soap can save lives, helping to keep food safe, prevent diseases and help children to be able to grow strong and healthy. It contributes to child survival, good nutrition, the ability to successfully attend school, and the economic benefits of greater productivity. Yet globally only one in five people washes their hands after going to the toilet, significantly increasing the risk of contamination and diarrhoeal sickness.

Children with diarrhoea not only eat less but are less able to absorb nutrients from food and research has shown that wasting and severe acute malnutrition can be linked to poor hygiene practices. Food borne illnesses are a major cause of death in developing countries like Nigeria, leading to illnesses which are harmful especially for children, pregnant women and those with compromised immune systems.

Handwashing with soap is estimated to reduce diarrhoeal diseases by between 27% and 48%. Combined with the use of clean drinking water, it could reduce the loss of nutrients and stunting in children under five by up to 15%. It is an important hygienic practice that keeps food safe for consumption and protects from food related diseases. Critical food-related times for handwashing with soap include: before cooking or preparing food, before eating, and before feeding someone, including before breastfeeding. It is important caregivers in schools, hospitals or at home wash their hands at all critical times, modelling and enforcing good handwashing behaviour for children.

In Sub-Saharan Africa, only 15% of the population have access to a basic handwashing facility with soap and clean water at home[1]. Access is even poorer in Nigeria where about 157 million people (13% of the population) do not have access to handwashing facilities. Access is even lower in rural and poor households in Nigeria. In health care centres, basic handwashing facilities are also inadequate and almost one in six hospitals (16%) do not have anywhere at all for washing hands with soap and water – according to a World Health Organization report. This has meant that children continue to contact diarrhoeal diseases, cholera outbreaks persist, women in childbirth continue to die and millions of naira is lost to reduced productivity.

It is clear that governments need to make access to hygiene a top priority and plan, finance and maintain systems accordingly. We recognise the laudable actions by the government in declaring a national state of emergency in the water, sanitation and hygiene (WASH) sector, and the development of programmes to bridge access gaps in line with SDG 6. However, more needs to be done.

To make this happen, WaterAid is utilising the upcoming 2019 elections to advocate to political actors and aspirants to prioritise the provision of clean water, decent toilets and good hygiene. While we are working with citizens and communities to improve their hygiene behaviour and make them understand the power they hold in their hands to prevent diseases by regular handwashing at critical times, we are also educating them on their rights to water and sanitation, and the need to realise the power in their hands to demand for the fulfilment of that right through voting in candidates who show commitment to improving water, sanitation and hygiene (WASH) access.

In addition, we are advocating alongside our partners, Action Against Hunger that the recipe for success in improving nutritional outcomes in Nigeria demands, among other things, that:

· Governments should develop cross-ministerial coordination mechanisms between the WASH and nutrition sector championed at the highest level to support sharing of information and joint planning and implementation of policies.

· Policymakers should prioritise nutrition-sensitive WASH interventions and include specific objectives to improve WASH within nutrition plans and policies. Clear entry points to integrate WASH and nutrition include behaviour change promotion and improvement of provision of WASH in healthcare facilities and schools.

WaterAid Nigeria Country Director, Dr ChiChi Aniagolu-Okoye, said: “Together, handwashing with soap and good food hygiene bring health and economic benefits. Handwashing with soap is essential for health workers, improving quality of care and reducing risk of cross-infection. It also makes children healthier, allowing them to go to school and learn, and helps adults remain healthy to go to work and earn a living or care for their families

“This Global Handwashing Day, WaterAid Nigeria is advocating for improved investment in improving handwashing practice and access to basic handwashing access – and for citizens to join in making this happen by using the power they wield in their hands to vote in the coming elections for leaders who pledge commitment to improving WASH access.”

All stakeholders must realise that progress towards the Sustainable Development Goals 2018 isn’t fast enough: about 60,000 children under five in Nigeria still die each year because of diarrhoea linked to dirty water, poor toilets and poor hygiene. Everyone has a right to water, sanitation and hygiene and our leaders must act to leave no one behind. Everyone has a role to play in achieving healthier communities and a healthier Nigeria.

By Ijeoma Nwachukwu