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Hygiene in Lower Income Countries

Overview of Hygiene in Lower Income Countries

Hygiene refers to acts that can lead to good health and cleanliness, such as frequent handwashing, face washing, and bathing with soap and water. Keeping hands clean is one of the most important ways to prevent the spread of infection and illness. However, in many areas of the world, practicing personal hygiene is difficult due to lack of resources such as clean water and soap. Many diseases (including diarrheal diseases) can be spread when hands, face, and body are not washed appropriately at the key times.

Preventing Disease with Proper Hygiene

Many diseases and conditions can be prevented and/or controlled through proper personal hygiene by:

  • Washing hands with soap and running water (if available):
    • Before, during, and after preparing food
    • Before eating food
    • Before and after caring for someone who is sick
    • Before and after treating a cut or wound
    • After using the toilet
    • After changing diapers or cleaning up a child who has used the toilet
    • After blowing your nose, coughing, or sneezing
    • After touching an animal, animal feed, or animal waste
    • After handling pet food or pet treats
    • After touching garbage
  • Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. If clean, running water is not accessible, as is common in many parts of the world, use soap and available water. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.
  • Cleaning teeth regularly with toothpaste, a toothbrush, and safe water (preferably clean, running water if available).
  • Frequently washing other parts of the body and hair with soap and running water (if available):
    • Trachoma infection can be prevented through increased facial cleanliness using soap and water, and improved sanitation to reduce fly breeding sites.
    • People with lymphatic filariasis can prevent secondary bacterial and fungal infections and decrease the risk of lymphedema progression to elephantiasis by daily washing of the swollen area (usually the limbs) with soap and water, as well as disinfecting wounds with antibacterial or antifungal cream.

For more information on the appropriate steps for handwashing and how handwashing can save lives, visit CDC’s Handwashing: Clean Hands Save Lives and CDC Features: Wash Your Hands.

For more information on Global Water, Sanitation, and Hygiene (WASH-related) diseases, visit CDC’s Healthy Water Global WASH-related diseases.

Hand Sanitizers

Hand sanitizers should primarily be used as an optional follow-up to traditional handwashing with soap and water, except in situations where soap and water are not available. In those instances, use of an alcohol-based product containing at least 60% alcohol 1 is recommended.

When using an alcohol-based hand rub:

Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

Hand sanitizers are not as effective when hands are visibly dirty or greasy.

How do you use hand sanitizers?

  • Apply the product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are dry.


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Why? Read the science behind the recommendations.

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  1. CDC. Guidelines for hand-hygiene in healthcare settings: Recommendation of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force [PDF - 56 pages]. 2002.
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