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April 5, 2026PLoS MedicineOpen Access

Cost-effectiveness and benefit-cost analyses of promoting handwashing with soap: A systematic review

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Authors

IRIan RossLondon School of Hygiene & Tropical MedicineDBDavid BathLondon School of Hygiene & Tropical MedicineJWJoseph WellsLondon School of Hygiene & Tropical Medicine

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Implication

Systematic review shows promoting handwashing reduces infections and is cost-effective, suggesting efficient resource allocation.

Key Points

  • This review aims to evaluate the cost-effectiveness and benefit-cost of promoting handwashing with soap across various settings.
  • Conducted a systematic review of studies from 1980 to 2025
  • Included full economic evaluations comparing costs and outcomes of handwashing interventions
  • Searched multiple databases for relevant literature
  • Assessed quality of studies based on established reporting standards
  • Identified 15 studies, with 3 in high-income countries
  • Cost per disability-adjusted life-year averted ranged from US$ 37 to 937
  • Two of three cost-effective estimates met country-specific thresholds
  • Mean benefit-cost ratio was 2.1 with specific adoption levels
  • Few studies addressed long-term handwashing adoption or respiratory infections

Cite This Study

Ross et al. (2026) studied this question.

synapsesocial.com/papers/69d1fd62a79560c99a0a36efhttps://doi.org/10.1371/journal.pmed.1004982
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