This review of 38 studies evaluates the effects of Water, Sanitation, and Hygiene (WASH) programs in schools across low-income countries. While comprehensive interventions (combining water access, sanitation infrastructure, and hygiene education) show promise in reducing diarrheal diseases (up to 56% reduction in water-scarce areas) and soil-transmitted helminth infections, results are inconsistent. Successful outcomes depend on context, such as water availability and program fidelity. Hygiene behaviors, particularly handwashing, improved significantly with nudges like painted pathways and soap provision. School attendance saw mixed results: handwashing programs and menstrual hygiene support reduced absenteeism, but infrastructure-only interventions (e.g., latrines without water/soap) had limited impact. Critical gaps include understudied menstrual hygiene management (MHM) and challenges in maintaining intervention adherence.

The World Health Organization (WHO) developed the Hand Hygiene Self-Assessment Framework (HHSAF) to evaluate hand hygiene resources, promotion, and practices in healthcare facilities as part of its global "Clean Care is Safer Care" initiative. The framework underwent rigorous usability and reliability testing across 26 facilities in 19 countries (usability phase) and 41 facilities in 16 countries (reliability phase). Usability results showed the tool was easy to use (89% agreement) and effective for assessing hand hygiene status. Reliability testing revealed moderate-to-high consistency (0.54–0.86) across its five components, though seven indicators required refinement due to poor reliability. Post-testing modifications improved clarity, ensuring the HHSAF’s alignment with WHO’s evidence-based Multimodal Hand Hygiene Improvement Strategy. The finalized tool aids facilities in identifying gaps, planning interventions, and tracking progress over time.

Despite global efforts under the Millennium Development Goals (MDGs), sanitation-related diseases remain a leading cause of child mortality in low-income regions. While access to toilets and water infrastructure has improved, sustainable health outcomes require a holistic approach addressing interconnected challenges: safe water access, hygiene practices, and complete sanitation systems (from toilets to safe disposal/resource recovery). The post-2015 Sustainable Development Goals (SDGs) emphasize integrated water, sanitation, and hygiene (WaSH) strategies that prioritize sustainability, equity, and behavior change. Key pillars include enabling policies, economic incentives for sanitation services, technology innovation beyond toilets (e.g., fecal sludge management), and understanding drivers of behavior change. Success hinges on addressing gaps in planning, financing, and community engagement to ensure long-term adoption and maintenance of WaSH interventions.

UNICEF's 2023 report on Goal Area 4 underscores the critical need for safe water, sanitation, and hygiene (WASH) services, especially amid escalating climate challenges. Despite progress, over 2.2 billion people lack safe drinking water, and 3.5 billion are without safe sanitation. Children are disproportionately affected, with 739 million exposed to high water scarcity and 436 million living in areas of high water vulnerability. In 2023, UNICEF facilitated access to safe water for nearly 36 million people, including over 1.5 million with disabilities, and provided basic WASH services to over 7,500 schools and 3,000 healthcare facilities. The launch of the Sustainability and Climate Change Action Plan (SCAP) 2023–2030 marks a significant step toward integrating child-focused climate resilience into global frameworks.

Menstrual hygiene management (MHM) remains a critical yet overlooked challenge in resource-poor countries, disproportionately affecting adolescent girls’ health, education, and empowerment. This review synthesizes evidence from sub-Saharan Africa and South Asia, revealing that over 50% of girls miss school monthly due to inadequate MHM resources, such as sanitary products and private WASH facilities. Many rely on unsafe materials like cloths or leaves, correlating with a 65% higher risk of urogenital infections compared to sanitary pad users. School absenteeism is exacerbated by stigma, lack of teacher support, and poor infrastructure (e.g., 54% of Indian girls avoid school during menstruation). Interventions distributing pads or reusable products (e.g., Ghana’s 3-arm trial) reduced absenteeism, though cultural resistance and affordability persist. The review underscores systemic barriers—male-dominated decision-making, economic constraints, and fragmented WASH policies—while advocating for multi-sectoral solutions, including education, product access, and infrastructure upgrades. Future research must address gaps in understanding household decision-making, long-term health impacts, and integration of MHM into global health agendas.

Healthcare-associated infections (HCAIs) are a major global health challenge, but hand hygiene is proven to significantly reduce their spread. Between 2000–2009, 30 European countries were surveyed on national/regional hand hygiene campaigns as part of the WHO’s Clean Care is Safer Care initiative. Thirteen countries had national campaigns (e.g., Belgium’s You Are in Good Hands with 90% hospital participation, France’s Mission Clean Hands with multimedia resources, and the UK’s cleanyourhands campaign involving patient engagement). Three additional countries planned campaigns, while 10 relied on regional efforts. Key strategies included multimodal approaches: training, ABHR accessibility, audits, and public awareness. Successes included tripled ABHR sales in Norway and improved compliance in Spain. However, data on HCAI reduction were sparse, and evaluation methods varied, complicating cross-country comparisons. The report underscores the need for standardized metrics and sustained investment to align with global patient safety goals.

Hygiene, defined as practices preventing infection transmission, is vital for public health, especially highlighted during outbreaks like SARS and avian influenza. Key focuses include handwashing, household cleaning, food safety, and respiratory etiquette. Studies in developing countries show handwashing reduces diarrheal diseases (30–47% risk reduction), while U.S. trials found alcohol-based sanitizers cut gastrointestinal illnesses but not respiratory ones. However, antibacterial products showed no added benefit, and improved handwashing in schools didn’t lower absenteeism. Overzealous hygiene poses risks: skin irritation from harsh agents, potential asthma links to irritants like bleach, and the "hygiene hypothesis" tying excessive cleanliness to allergies. Antibacterial overuse may also drive resistance. Recommendations emphasize handwashing with soap, alcohol sanitizers where water is scarce, avoiding routine antibacterial cleaners, and skin protection with lotions. Respiratory hygiene remains commonsense but unproven.

The Guelph Water Filtration system is a low-tech, low-cost, easy-to-maintain, and robust solution for providing safe drinking water. It outperforms previous technologies, lasting up to 6 years and delivering over 1 liter per hour for low turbidity water. The replaceable ceramic filter components can be produced locally, offering employment opportunities. The system's design reduces clogging, doubles filtration area, and requires less frequent refilling.

The factsheet provides water disinfection guidelines for people invovled in outdoor activities such as hiking, camping, and traveling