SynthesisBMJ global health2025
Behavioural factors influencing hand hygiene practices across domestic, institutional and public community settings: a systematic review and qualitative meta-synthesis.
Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost-effectiveness and benefit-cost analyses of promoting handwashing with soap: A systematic review.PLoS medicine · 2026Pooled it
- Article
- Hand hygiene knowledge and practices among patients in selected health facilities of Mukono and Kagadi districts in Uganda: A cross-sectional study.IJID regions · 2026Article
- Behavioral interventions related to plastic waste management in low-and middle-income countries: a systematic review using the behavior change wheel and the theoretical domains framework.Environmental research letters : ERL [Web site] · 2026Review
- Food Safety Practices and Associated Factors Among Street Food Vendors in Urban Areas of Eastern Zone of Sidama Region, Ethiopia: A Community Based Cross Sectional Study.Environmental health insights · 2026Article
- Evaluation of the impact of a targeted hygiene intervention on public hygiene understanding and behaviour.Frontiers in public health · 2026Article
- Evaluating Knowledge, Attitudes and Practices Related to Water, Sanitation and Hygiene (WASH): A Case Study of Durban High Schools in South Africa.International journal of environmental research and public health · 2025Article
- We have the evidence but governments must now build the systems to deliver on hand hygiene.BMJ global health · 2025Article
- Prevalence, Antimicrobial Resistance, and Risk Factors of Enteric Bacterial Infections Among Children Under Five in Nairobi County, Kenya.International journal of microbiology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
introductionThis systematic review sought to understand barriers and enablers to hand hygiene in community settings.
methodsEligible studies addressed hand hygiene in a community setting, included a qualitative component, and were published in English between 1 January 1980 and 29 March 2023. Studies were excluded if in healthcare settings or were animal research. We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, Public Affairs Information Service Index, WHO Institutional Repository for Information Sharing, UN Digital Library and World Bank eLibrary, manually searched relevant systematic reviews' reference lists, and consulted experts. We used MaxQDA software to code papers, using the COM-B (Capability, Opportunity, Motivation and Behaviour) framework to classify barriers and enablers. We used thematic analysis to describe each COM-B subtheme identified, GRADE-CERQual to assess confidence in evidence for thematic findings and the Mixed Method Appraisal Tool (MMAT) to assess risk of study bias.
results80 studies were included; most took place in Africa (31; 39%), South-East Asia (31; 39%) and domestic settings (54; 68%). The mean MMAT score was 4.86 (good quality). Barriers and/or enablers were reported across all COM-B constructs and subconstructs. The most reported barriers aligned with Physical Opportunity (eg, soap availability), Reflective Motivation (eg, hand hygiene not prioritised) and Automatic Motivation (eg, no habit). In contrast, the most reported enablers aligned with Automatic Motivation (ie, habit) and Reflective Motivation (ie, perception of health risk).
conclusionFindings confirm that a lack of necessary resources for hand hygiene hinders practice, even when people are motivated. Results may explain why hand hygiene increases when there are acute health risks (eg, COVID-19), but decreases when risks are perceived to fade. The qualitative methodology used among the studies may have revealed a broader array of barriers and enablers than what might have been found by quantitative, researcher-driven studies, but representativeness may be limited. Evidence was also limited on alcohol-based hand rubs. Findings can inform the design of future hand hygiene initiatives. PROSPERO REGISTRATION NUMBER: CRD42023429145.
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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.