Hands4health – Hand hygiene, water quality and sanitation in primary health care facilities and schools not connected to functional water supply systems

© TdhDemonstrating the Gravit’eau handwashing station to the director of the health centre of Sirimanso, in the District of Ségou, Mali. 

Description of the Project

Hands4health is a four-year research project (2021-2024) supported by the Swiss Agency for Development and Cooperation (SDC) through the TRANSFORM Programme. The project comprises ten partners, who are led by the University of Applied Sciences and Arts Northwestern Switzerland (FHNW).  The project focuses on the most vulnerable in conflict-affected areas, including remote rural communities and internally displaced people in four countries, and benefits an estimated 97,000 people.

In Mali and Burkina Faso, the project concentrates on the staff working in primary health care facilities, whereas in Nigeria and Palestine, the intervention tackles students in primary schools.   Hands4health adopts a systemic and holistic approach to tackle the challenges related to hand hygiene, sanitation and water quality in the target institutions – schools and HCFs without functional water supply.

The systemic approach encompasses 5 pillars, with a research-into-action mindset: 

  1. Understanding the barriers to change through the development of a Theory of Change; 
  2. Systematising a behaviour change approach based on the Ranas framework; 
  3. Implementing a hardware component;  
  4. Developing an enabling environment for the sustainability and replicability of the approach; 
  5. Implementing an impact evaluation.  

Summary of the hands4health interventions per country (© h4h, 2023)

Project Period: 2021 – 2024

Thematic Focus:
  • Hand Hygiene and WASH 
  • Capacity building 
  • Stakeholder Engagement 
  • Knowledge Brokering and technical know-how. 

Name of Staff involved and functions performed:

Matthias Saladin – Project Coordinator

Bertha Camacho – Knowledge Management Expert 

Rena Salzmann – Junior Technical Officer 

Meleesa Naughton – Water Specialist 

Achievements as of May 2023

Burkina Faso 

24 Gravit’eau systems were constructed and installed. 

23,912 people are estimated to benefit from improved access to basic hand hygiene services. 


24 Gravit’eau systems were constructed and installed. 

5,559 people are estimated to benefit from improved access to basic hand hygiene services.  


20 Gravit’eau stations were installed in the Maisandari Alamderi and Dalori Estate primary schools. 


WASH infrastructure rehabilitation works carried out in 9 schools in the Ramallah, Yatta, Dura and Hebron Directorates, as part of the pilot phase