The importance of basic hygiene

The need for improved hygiene is universal. Proper hand hygiene, including both handwashing and hand sanitizing, is ranked as one of the most effective and affordable public health interventions, and yet global progress on good hygiene practices is severely lacking.5

Globally, 2.4 billion people live without basic sanitation services (flush latrine or pit latrine) in developing countries, and only 27% of the world population have adequate handwashing facilities at home, according to UNICEF.6 People that lack handwashing facilities are therefore potentially even more vulnerable to crises such as COVID-19 and are also often left behind many public health interventions, such as access to adequate healthcare and education on good hygiene practices.

The Essity survey shows that lack of access to clean or safe toilets and washrooms is still an issue, with significant differences between countries.

Community empowerment – building toilets for improved health

Nearly 892 million of the total world’s population still practice open defecation.7 In September 2019, the Government of Nepal declared the country open defecation free. Continuing the people’s momentum, the government announced a national campaign focusing on sustaining a country free from open defecation, addressing long-term behavioral changes and transformation of social norms.

The national campaign arrived in Sunaina Devi’s village, promising to be transformational. Devi lives in Majhi, a village of 104 impoverished people in Nepal’s Terai region. Working these fields is how Devi, and the majority of her neighbors, earn their living. Among their hardships has been the absence of sanitation.

Poor sanitation lead to health issues

“Previously, people did not have toilets and they did not see the necessity of having a proper place to defecate,” says Raju Prajad Sah, the Chief Administrative Officer of the rural municipality of Kalikamai, where the village of Majhi is located. He describes how open defecation has been an age-old and accepted practice.

The pond across the road where the villagers raised fish and watered animals often became contaminated. Sah recalls that outbreaks of diarrhea were common in Majhi with open defecation and a lack of handwashing compromising health and well-being. “Especially vulnerable were the young, the old, and anyone compromised by factors from disability to mental illness, or even just the misfortune of living alone,” he explains.

Empowering communities to construct their own toilets

After three intense months of discussing the health benefits of using a toilet, every household in Majhi decided to construct its own toilet. “Now they are all using toilets and obviously the difference is that there will be the reduction of diseases and the living standard will be, I think, uplifted,” says Sah.

Devi leads the way through her house and out the back to show her new latrine. “I built it myself by taking a loan. I have not paid it back but I will within one year by cutting rice paddies,” she says.

Woman holding a metal bowl (photo)

Improved sanitation in Nepal has raised living standards for people all around the country, like Sunaina Devi from Majhi village.

Education on menstrual health and hygiene in Mexican schools

It is key to develop adequate spaces for health, WASH (Water, Sanitation and Hygiene) and menstrual hygiene in schools. One example how this can be done is through a collaboration between UNICEF in Mexico and Essity.

Children hugging each other (photo)

Following the initiative, the National Institute of Physical Educative Infrastructure (INIFED), which is responsible for issuing standards and technical specifications, as well as managing resources for the educational infrastructure, including WASH services in schools – established of a federal-level strategyfocused on WASH in schools. This was framed within the 2030 Agenda, integrating aspects of behavior change, improvement of infrastructure and strengthening of the environment conducive to the articulation of public policies and sectoral programs. Moreover, in this collaboration Essity and UNICEF developed educational Manuals on Menstrual Health and Hygiene, aimed at primary and secondary school teachers, parents and children of those educational levels. These manuals were launched together with the Ministry of Education, underlining the importance of menstrual health.

SDG Target 6.2 (icon)

SDG Target 6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.

SDG Target 3 (icon )

SDG Target 3: Ensure healthy lives and promote well-being for all at all ages.

Access to handwashing facilities and hygiene product.

Universal access to handwashing facilities with soap and water is already part of the Sustainable Development Agenda. We can do more. The COVID-19 pandemic underlines the importance of what is most needed to save lives today and in the future. As this pandemic has shown, together we can succeed, says the WHO report Hand Hygiene for All.8

Around 1/3 of respondents don’t wash their hands more often during the COVID-19 pandemic because of lacking facilities or hygiene products.
(Essity Survey)

The Essity survey shows that a lack of soap or hygienic soap dispensers and no or inadequate access to handwashing facilities in public spaces (e.g. restaurants and shops) are the top reasons why people do not wash their hands more often since the outbreak of the pandemic. No or inadequate access to proper handwashing facilities at work or school and hot/jet air dryers instead of paper towels also play a part. Only 41% say they wash their hands often enough.

Early start to nurture kids’ lifelong hand hygiene habits

The Ella’s Handwashing Adventure app is designed to make handwashing a little more fun for kids – to promote good hygiene practices from an early age.

Teaching good hygiene can be a challenge, but is critical in reducing the spread of colds, flu and viruses. COVID-19 has proven that hand hygiene has never been more important.

To nurture kids’ lifelong hygiene habits, Essity has advanced the knowledge in day care centers providing toolkits since 2007 and the ‘Ella’s Hand Washing School` package was launched already in 2013. The package includes a Handwashing Adventure app for smartphones and tablets, pedagogical material as well as activities to help make handwashing a little more fun. The app has already been downloaded more than 70,000 times globally and is being used in pre-schools and kindergartens around the world.

As shown in the previous Hygiene and Health Report, preschools that have gone through hygiene programs show improved absence rates of between 7-13%9 – leading to fewer doctors visits and prescriptions for antibiotics, as well as less work days missed by parents.10 The Ella’s Handwashing Adventure app is therefore a valuable tool to teach young children the importance of hand hygiene that creates shared value throughout society.

Boy playing with mobile phone (photo)

Ella’s Handwashing Adventure app is designed to nurture good hygiene habits from a young age.

5 WHO & UNICEF (2017). Progress on household drinking water, sanitation and hygiene I 2000-2017. Visit source

6 Global Citizen (2020). Period Poverty: Everything You Need to Know. Visit source

7 Heaslip, V, et al. (2019) Health and social impacts of open defecation on women: a systematic review.

8 WHO & UNICEF (2020). Hand Hygiene for all. Visit source

9 Västra Götalandsregionen, HYFS Final report 2006-2012, 2014.

10 Essity & WSSCC (2018). Personal Well-being – Key to Public Progress. The Hygiene and Health Report 2018-2019. Visit source