Your safety is in your clean hands

Project description

Title: Your safety is in your clean hands
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Uzbekistan
Lead executing agency: Ministry of Health; Ministry of Education
Overall term: 2010 to 2012


Uzbekistan faces a high incidence of influenza and other viral infections. Children are especially susceptible, and they contribute to the rapid spread of infectious diseases in the densely populated environment of kindergartens, schools and family networks.

It has been proven that hand washing with soap is the single most effective intervention for preventing infectious diseases, as it interrupts their transmission from one infected person to another. Studies suggest that washing one’s hands with soap after using the toilet, before preparing food and before eating can reduce the incidence of diarrhoea by up to 47% and bring a reduction of up to 30% in respiratory infections.

This pre-school health project was an important entry point for public health education and health promotion.


Children of pre-school age observe the rules of personal hygiene and know about their importance in preventing diseases.


The project was implemented in 20 family polyclinics and in 20 kindergartens in Tashkent, in close collaboration with both the Ministry of Education and the Ministry of Health. This two-track approach ensured that the activities would benefit all children, whether they attended kindergartens or were raised at home.

Training was provided to visiting nurses from the polyclinics and to kindergarten staff, to help them educate children and their parents about the importance of personal hygiene for the prevention of infectious diseases. Parents were encouraged to make sure their children brush their teeth and wash their hands with soap. In the pre-schools, these activities were practised on a daily basis under the supervision of a kindergarten teacher. In the pilot institutions, the project also improved sanitary and hygienic conditions, in order to support the implementation of these activities.

The project was supported by the German Pandemic Preparedness Initiative of GIZ, working on behalf of BMZ.


A training curriculum was developed for visiting nurses at polyclinics and kindergarten staff, enabling them to educate children and their parents on the importance of personal hygiene for the prevention of infectious diseases. For their teaching activities they now use the children’s book, Water Droplet, which was specially developed for this project. The book uses colourful pictures and stories appropriate to the age group to explain to children the importance of personal hygiene. They learn to practise the healthy behaviour themselves, just like Water Droplet in the book. Before lunch, the children now line up in the bathroom and wash their hands with soap. After the meal they brush their teeth. All activities are supervised by the pre-school teachers. Before the start of the project, only 15% of the children in the pilot pre-schools used to wash their hands after going to the toilet. Three months after the implementation of the approach, 100% of the children were observed washing their hands. An observational study conducted in the homes of children who had previously received training by visiting nurses showed a similar increase. Moreover, in each of the two groups more than 85% of the children now brush their teeth every day, mornings and evenings.

The appeal of the approach, as well as its low cost, became apparent shortly after implementation. In each of the 20 pilot kindergartens two groups were selected for the project activities. However, the teachers of the other groups liked the approach so much that they collected money from the parents’ association to buy toothbrushes, toothpaste and soap for their pupils as well. Thus, the approach reached all the children in pilot kindergartens, and has since been replicated by other kindergartens in Tashkent.

In addition to conveying important life skills and creating a health-promoting environment at the pre-schools, the project has also had a positive and sustainable impact at the policy level. It brought together representatives of the health and education sectors and strengthened inter-sectoral collaboration. It was possible to establish the approach sustainably in both sectors. The Water Droplet component of the programme – a training manual for instructors and medical staff of pre-school for the promotion of healthy lifestyle and the teaching of hygiene rules – has been integrated into the national programme for pre-school education. Since September 2012, its use has been compulsory for all pre-school education. The manual “Enhancement of Training Techniques for the Rules of Personal Hygiene” has been integrated in the state system of vocational education for nurses. Thus, all newly trained personnel possess the knowledge, tools and skills they need to apply the approach in their workplace.