Key findings

- Hand washing promotion at child day-care facilities or schools in high income countries probably prevents around 30% of diarrhoea episodes, and may prevent a similar proportion in schools in low- and middle-income countries.

- Among communities in low- and middle-income countries hand washing promotion prevents around 28% of diarrhoea episodes.


Diarrhoea causes many deaths in children below five years of age, mostly in low- and middle-income countries. The organisms causing diarrhoea are transmitted from person to person through food and water contaminated with faeces, or through person-to-person contact. Hand washing after defecation, or after cleaning a baby’s bottom, and before preparing and eating food, can therefore reduce the risk of diarrhoea. Hand washing can be promoted through group or individual training on hygiene education, germ-health awareness, use of posters, leaflets, comic books, songs, and drama.