The State of Household Handwashing by Mothers and Associated Risk Factors in Nepal: A Systematic Review

Abstract Approximately 53% of households do not use soap and water for handwashing. Mothers oversee their hygiene and are ideally placed to teach their children about handwashing with soap. This paper aims to determine the rates of household handwashing with soap by mothers in Nepal and explore the factors associated with the uptake of handwashing. A systematic literature search using PubMed/Medline, Embase, PsycINFO, CINAHL, and Grey literature was searched. Eligible articles were extracted and recorded then descriptive analysis was performed. The quality assessment of the article was done using STROBE guidelines. We screened 187 articles from database searching and 16 from additional grey literature. A total of 120 full-textt articles and records were retrieved to evaluate for inclusion in the review. We identified seven articles that met the criteria for inclusion. The included studies contained 32,010 participants from articles. Current handwashing rates by mothers were varied, ranging from 5% to 67%. The potential risk factors for a lack of handwashing were lack of knowledge, lack of handwashing facilities, and absence of regularities. The hygiene advocacy, provision of soap and water, family encouragement and support, the establishment of a handwashing strategy, and mothers’ participation in decision making are key possible solutions.