The presence of a handwashing facility with soap and water on the premises has been identified as the priority indicator for global monitoring of hygiene by the World Health Organization (WHO) and UNICEF. This ‘global handwashing indicator’ requires a field worker to visit a household and conduct a rapid ‘spot-check’ of the hand washing facility. The field worker records if there is a handwashing facility present and the availability of soap and water at this facility. They may also record if the soap is wet which indicates its recent use.
Benefits of spot checks:
Spot checks provide a proxy measure of behaviour but this is a much better estimate of behaviour than self-reported measures.
Spot checks are a rapid way to collect data (much quicker than a survey).
Spot checks are widely used and therefore allow you to compare your program to other hand washing programs around the globe. It is also used by most national governments.
Spot checks do not require highly skilled workers.
Spot checks can also be used to assess handwashing facilities in schools, health centres, or workplaces.
In most cases, it should be possible for field staff to keep a safe distance (at least 1 metre or according to national guidelines) from household members whilst conducting a spot check.
Limitations of spot checks:
The presence of a handwashing facility with soap and water is only a proxy measure of behaviour. It is important to understand what this indicator can and cannot tell you about behaviour. Spot checks are not a measure of actual behaviour, they can only give you an indication of what behaviour is likely to be. To predict behaviour, assumptions are made. For example, if no handwashing facility is present outside the toilet or there is no soap and water there, then the assumption is that hands are not being regularly washed due to the difficulty and inconvenience of doing so. Of course, even if a handwashing facility with soap and water is present, handwashing is not guaranteed but the proper setup does create the right enabling environment, indicating that the family could easily practice handwashing if they wanted to.
Spot checks require field workers to be able to move around between households so local movement restrictions may hinder this data collection method.
Acceptability for this data collection method may also be low among the community at this time.
Recommendations for use during COVID-19
A local-level risk assessment should be conducted before choosing to do spot checks.
Seek the opinions of community leaders / gate keepers about whether spot checks are likely to be acceptable at this time.
If this method is selected, field staff should maintain a distance of at least 1 metre (or according to national guidelines) from others when conducting these spot checks and follow standard guidance for field level staff at this time. Additionally, if going inside a household is unsafe, spot checks should be restricted to facilities outside. If this is the case, self-report questions could be asked about any facilities inside the home. If spot checks are done inside the household, enumerators should wear a mask, avoid touching anything inside the house, politely decline any offers of food or drink, and spend the minimum time possible inside the house (limited to a few minutes).
If spot-checks are not possible due to safety concerns then consider ways of collecting data on handwashing facilities remotely via self-report (e.g.using telephone calls or text and voice messages). You may also consider asking respondents to send a photograph of their facility, if they have the technology to do so, and to note if you can see soap and water at the facility (it may not always be possible to see this from the photograph).
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