2.0 CHAPTER TWO: LITERATURE REVIEW
A recent review by (Curtis and Cairncross, 2003) suggests that hand washing with soap, particularly after contact with faeces (post defecation and after handling a child’s stool), can reduce diarrhoea incidence by 42%-47%, while ongoing work by Rabie et al, (2006) Suggest a 30% reduction in respiratory infections. This remains even in areas that are highly contaminated with faeces. Despite the proven benefits of hand washing, many people do not practice as often as they should, even after using the toilet.
Estimates based upon meta-analysis suggest that improved hand hygiene reduces rates of gastrointestinal illness by 31% and respiratory illness by 21% (Aiello, Coulborn, Perez, & Larson, 2008). Prevention through hand hygiene is therefore a potentially easy, effective, and low-cost defence. However, hand hygiene is often neglected and observational and self-report studies suggest it rarely exceeds 50% in either the community (Guinan, McGuckin, & Sevareid, 2000) or in professional domains (Pittet et al, 2004).

Sijbesmac et al (2009), in their study to determine the value of hygiene promotion found that hygiene promotion can greatly improve the benefits of water and sanitation programmes in developing countries at relatively low cost.
In a study carried out by the Ministry of Finance Planning and Economic Development (MoFPED, 2003), poor Sanitation & Hygiene was identified as one of the five major causes of the high infant mortality rate