ArticlePLOS global public health2021
Trends in handwashing behaviours for COVID-19 prevention: Longitudinal evidence from online surveys in 10 sub-Saharan African countries.
Article in PLOS global public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Influence of government policies on handwashing and vaccine uptake in Kenya, Uganda, and Tanzania to prevent and control COVID-19: a systematic review.Frontiers in public health · 2024Pooled it
- Frontline Healthcare Professionals' Perceptions of the Duty to Care During the COVID-19 Pandemic: A Multi-Method Study in Mozambique.Developing world bioethics · 2026Article
- The Yearlong Effect of COVID-19 on Food Safety: Consumer Practices and Perceptions Using Longitudinal Consumer Surveys and Focus Groups.Foods (Basel, Switzerland) · 2025Article
- Determinants of access to basic handwashing facilities and handwashing with soap in low-income areas of four Kenyan cities.PLOS global public health · 2025Article
- The determinants of handwashing in humanitarian crisis setting during the COVID-19 pandemic: a multi-country analysis.Health promotion international · 2024Article
- Article
- Determinants of Handwashing at Critical Times Among Mothers/Caregivers of Children Under-Five Years Old: Panel Data Evidence From Rural Afghanistan.Environmental health insights · 2024Article
- What predicts people's belief in COVID-19 misinformation? A retrospective study using a nationwide online survey among adults residing in the United States.BMC public health · 2022Article
- Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study.Vaccines · 2022Article
- SARS-CoV-2 seroprevalence and infection rate in Manila, Philippines prior to national vaccination program implementation: a repeated cross-sectional analysis.Tropical medicine and health · 2022Article
- Human Respiratory Infections in Nigeria: Influenza and the Emergence of SARS-CoV-2 Pandemic.Vaccines · 2022Review
- COVID-19 lockdowns: Employment and business disruptions, water access and hygiene practices in Nairobi's informal settlements.Social science & medicine (1982) · 2022Article
- "In our culture, if you quarantine someone, you stigmatize them": Qualitative insights on barriers to observing COVID-19 prevention behaviors in Côte d'Ivoire.PLOS global public health · 2022Article
- Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia.Frontiers in public health · 2022Article
- Hand Hygiene Social Norms Among Healthcare Workers During Early COVID-19: Results of a Global Survey.International journal of public health · 2022Article
- Factors Associated with Handwashing Behaviors During the COVID-19 Pandemic: An Analysis of the Community Health Survey in Korea.SAGE open nursingArticle
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
Handwashing is essential for respiratory virus prevention, but uptake of handwashing in the context of the SARS-CoV-2 pandemic remains under-explored. This study examines trends in and determinants of handwashing practices for COVID-19 prevention in 10 countries in West, East, and Southern Africa. Data are derived from an online global Facebook survey assessing COVID-19 knowledge, attitudes, and practices, fielded in July (Round 1) and November 2020 (Round 2). Adults ≥18 years (N = 29,964) were asked if they practiced handwashing with soap and water in the past week to prevent COVID-19. Design-corrected F-statistics compared knowledge and practice of handwashing, at country and regional levels, between survey rounds. A country-level fixed-effects logistic regression model then identified socio-demographic and ideational correlates of handwashing at Round 2. Most participants were >30 years-old, men, post-secondary educated, and urban residents. Between survey rounds, handwashing prevalence declined significantly across regions and in each country, from a 14% decline (Δ84%-70%) in Tanzania to a 3% decline (Δ92%-89%) in South Africa. Handwashing was higher among participants aged >30 years (Adjusted Odds Ratio [aOR] = 1.25, 95% confidence interval [95%CI]: 1.15-1.35) and with post-secondary education (aOR = 1.62, 95%CI: 1.49-1.77) but lower among men (aOR = 0.71, 95%CI: 0.64-0.78). Ideational factors associated with handwashing included perceived effectiveness of handwashing (aOR = 2.17, 95%CI: 2.00-2.36), knowing someone diagnosed with COVID-19 (aOR = 1.28, 95%CI: 1.18-1.40), and perceived importance of personal action for COVID-19 prevention (aOR = 2.93; 95%CI: 2.60-3.31). Adjusting for socio-demographic and ideational factors, country-level marginal probabilities of handwashing ranged from 67% in Tanzania to 91% in South Africa in Round 2. COVID-19 prevention messages should stress the importance of handwashing, coupled with mask use and physical distancing, for mitigating respiratory disease transmission. Behaviour change communications should be sensitive to resource heterogeneities in African countries, which shape opportunities for sustainable handwashing behaviours.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.