Healthy handwashing habits for life
Through Lifebuoy, we have helped 1 billion people around the world improve their handwashing habits, achieving our 2020 target two years ahead of schedule.* But we’re not stopping there. We will continue to help people improve their handwashing habits to prevent childhood deaths.
Clean water & sanitation for all
Every 23 seconds, a child dies from either pneumonia or diarrhoea worldwide.1 The simple act of handwashing is the single most effective way of stopping child deaths. It can reduce the number of incidences of pneumonia by 23% and diarrhoea by up to 45%.2
However, washing with water alone isn’t enough to clean hands. Handwashing with soap is crucial. Through Goal 6 of the UN Sustainable Development Goals – ensure access to water and sanitation for all – governments around the world have committed to promoting the importance of handwashing with soap, specifically through Indicator 6.2.1: proportion of population using safely managed sanitation services, including a handwashing facility with soap and water. And that’s where we come in – and where we’ve been since 1894.
Making soap & saving lives since 1894
In 1885, William and James Lever created a soap-producing business – Lever Brothers – declaring it their purpose to ‘make cleanliness commonplace’. In 1894, the brothers launched Lifebuoy soap to combat cholera in Victorian England and make health and hygiene accessible to everyone.
Lifebuoy is the world’s number one selling germ protection soap.3 It’s sold in nearly 60 countries and available across Asia, Africa, Latin America and the Middle East, and is the only soap to be accredited by the Royal Society of Public Health, London.
We democratise world-class hygiene by making it available at the price of €0.12 for a bar of soap because we believe that best-in-class hygiene should be a right for everyone, not just for the few who can afford it. Lifebuoy is one of Unilever’s largest Sustainable Living Brands, with a clear purpose of saving lives through handwashing with soap, supporting targets in our Unilever Sustainable Living Plan.
125 years of hygiene
- 1 billion
Since 2010, we have reached 1 billion people (459 million people through on-ground programmes and 587 million through TV reach) through our handwashing programmes*
Soap only works if it’s used effectively and people wash their hands at the critical moments of the day: before eating and after going to the toilet. That’s why we work to improve the handwashing habits of people across Europe, North America, Africa, Asia, Latin America and the Middle East.
To do this, in the early twentieth century, Lever Brothers supplied people with charts to record daily whether they had washed their hands with soap before eating and after using the toilet. Today, we run one of the largest handwashing behaviour change programmes in the world, which follows some similar principles.
Since 2010, we have reached 1 billion people (459 million people through on-ground programmes and 587 million through TV reach)* across Asia, Africa and Latin America through schools, health clinics and community outreach programmes, as well as through TV adverts, with proven results.
TV reach: a new paradigm of behaviour change
While our programmes have focused on reaching children and mothers on-ground, we have long believed that our total combined marketing efforts – including mass scale TV advertising – are contributing to changing handwashing behaviour. To test this we ran a randomised control trial in India, our biggest market, to assess the effectiveness of Lifebuoy TV adverts specifically designed to change handwashing behaviour. We used the same methodology that we use to evaluate our on-ground programmes.
TV acts as a constant “nudge” or reminder to practise handwashing with soap at key occasions to remove germs. The Lifebuoy TV adverts established the problem context, showing the presence of germs and the consequence of falling ill. The adverts also demonstrated the role of Lifebuoy soap, showing that handwashing with soap removes germs and prevents illness. And through using a respected authority figure, such as a doctor, we ensured that the advert attracted viewers’ attention.
The study showed a significant increase in the frequency of handwashing with soap on key occasions (particularly before eating) after people had watched the adverts. This result demonstrates that mass media can promote and impact positive health behaviours at scale.
In March 2019 the study was published by the Journal of Health Communication and we have included TV reach in our Health & Well-being performance figures for 2018 alongside our on-ground programme reach. Through TV reach, we have successfully achieved our Health & Well-being target of reaching over 1 billion people two years ahead of schedule.
First mobile phone technology programme to change handwashing behaviour
Governments worldwide are increasingly adopting mobile technologies to deliver public services in areas related to agriculture, education, health and livelihoods. Mobile technologies are widely adopted in developing countries, with 78% of mobile phone users globally from developing economies.4
In India, for example, where 50% of the population live in otherwise ‘media-dark’ rural areas, the only way to reach these people cost-effectively is through mobile phones.
Lifebuoy has designed and piloted a programme using mobile technology that has been proven to change handwashing behaviour – the first time this had been done using mobiles. Our Lifebuoy Mobile Doctarni service reached women in media-dark rural areas in India, providing mothers with free, easily accessible advice about their child’s health.
The service is based on a missed call mechanism, whereby a mother makes a phone call but hangs up before she is connected. Mobile Doctarni then calls her back, sharing health information adapted to her child or children’s ages.
Pilot results were very strong, with high engagement and behaviour change recorded. The campaign increased handwashing with soap at critical public health occasions by more than one per day, and the frequency of handwashing improved by 50% among participants exposed to the campaign.
This work contributes to the following UN Sustainable Development Goals
Reaching new mothers
Over 45% of deaths of children under the age of five occur within the first 28 days of a child’s life. Every year, 2.5 million babies die before turning one month old – a significant proportion of them from infections. And around 41%5 of these deaths could be prevented just by helping new mums and midwives change their handwashing behaviour.
Since 2011, we’ve reached more than 20 million mothers across Asia and Africa with hygiene education through community visits and neonatal clinics. Our largest programmes in Indonesia and Vietnam are run in partnership with government, enabling health workers and women’s groups to teach mothers about handwashing with soap.
In Kenya, we have partnered with Amref Health Africa, launching a programme in 2017 in Migori County, one of the areas with the highest level of neonatal mortality in the country. Through community health workers, support groups and health centres, the programme educated new mothers over a period of six months on the importance of handwashing with soap, raising awareness of the risks of transmitting diseases to their newborn via contaminated hands.
New mothers who took part in the programme were more likely to wash their hands with soap than the control group during three occasions: after changing nappies (26% vs 2%), before breastfeeding (42% vs 3%), and after visiting the toilet (39% vs 10%). In addition, 90% of the new mothers reached talked about the programme to their friends, family and neighbours, highlighting a positive ripple effect.
Powerful storytelling through Lifebuoy’s Help A Child Reach 5 campaign
In 2013 Lifebuoy launched the Help a Child Reach 5 campaign. The campaign aims to raise awareness of the importance of handwashing with soap and encouraging people to join us and take an active role.
Our four Help a Child Reach 5 films share a personal, powerful and real perspective on the individual tragedy of losing a child to preventable infections like diarrhoea and pneumonia.
The third and fourth films in the series emphasise the importance of handwashing with soap in the month after birth. They bring to life the aspirations that two expectant mothers, Sangrahi in India and Eunice in Kenya, have for their unborn children. Through this campaign, awareness of Lifebuoy’s lifesaving handwashing message has reached hundreds of millions of people around the world.
Empowering young people to drive change
The Lifebuoy Lifesaver Volunteer Programme harnesses the energy and enthusiasm of teenagers and college students, helping them make a difference in their communities by teaching the importance of handwashing with soap. Through colleges and youth networks, we’ve mobilised more than 150,000 Lifesaver Volunteers to run Lifebuoy’s School of 5 programme in schools.
Now running in five countries, the programme is being scaled up through youth organisations such as the World Association of Girl Guides and Girl Scouts (WAGGGS) and through university students in a volunteer programme launched in 2017. It’s called ‘Heroes for Change’, run in partnership with Amref Health Africa.
Joining the programme was one of the best experiences I have had to date! Although the programme has now ended, I often go back and meet the kids. Two months later, they still remember what we taught them.Student volunteer, Welingkar Institute of Management Development & Research, India
Girl Guide superheroes
Through our partnership with World Association of Girl Guides and Girl Scouts (WAGGGS), 100,000 girl guides and scouts in India became handwashing heroes by promoting this lifesaving habit within their local communities.
Each handwashing hero is trained on the importance of using soap while washing hands before eating and after using the toilet, with materials featuring our School of 5 superhero Sparkle as a Girl Guide. They are also equipped with the necessary skills to share these learnings with others, encouraging the practice of using soap at critical occasions to spread across communities, protecting people from illnesses and infections.
In total, WAGGGS reached more than 3 million children and their families through an adapted version of Lifebuoy’s School of 5.
Ana Maria Mideros, WAGGGS’ World Board Chair, said: “At the World Association of Girl Guides and Girl Scouts, we know that every girl has the power and potential to learn, lead and make a positive change in her community and the wider world. We are hugely proud that our partnership with Lifebuoy is helping young people in India to take action and promote handwashing with soap – both at home and in their wider communities. Working with Lifebuoy, Girl Guides and Scouts are driving change, improving hygiene and changing lives.
This work contributes to the following UN Sustainable Development Goals
Heroes for Change
In Kenya, students are being recruited as agents for social change in the ‘Heroes for Change’ volunteer programme. It’s a social-mobilisation model, leveraging the power of young people, and engaging them through digital social platforms such as WhatsApp, Twitter and Facebook. Led by Unilever in partnership with Amref Health Africa, the UNFPA (UN Population Fund) and Sightsavers, the programme has identified university students as an untapped force for good, as they’re known in their communities for being passionate about creating lasting social impact in these spaces.
In the first phase of the programme, student volunteers from five universities in Kenya were trained and then deployed the behaviour change programmes over a six-month period, to improve health and well-being in their home communities. The training covers health programmes from Unilever brands Lifebuoy, Royco and Pepsodent.
Following the success of Heroes for Change in 2017, the programme is being scaled up in Kenya through the Well Told Stories partnership. Our aim is to create a nationwide network of 100,000 young people.
Celebrating Global Handwashing Day
Each year on 15 October, over 200 million people take part in celebrating Global Handwashing Day (GHD) across more than 100 countries. Our Lifebuoy brand is a founding partner of the Global Handwashing Partnership, which has supported GHD from its outset.6
Lifebuoy’s GHD activities include making an impact through our handwashing programmes. Our celebrity ambassadors play a major role at events and on social media to attract support from government representatives, influencers and the media.
To mark Global Handwashing Day in 2018, Lifebuoy embarked on its most high-profile campaign yet. We urged people across the world to share their High 5s on social media, using hashtag #high5forhandwashing. In Ethiopia, for example, Lifebuoy partnered with the Ministry of Health and national television and telecom networks. We spread our handwashing message, reaching over 38 million people with SMS messaging alone. In Indonesia, over 600 Unilever employees visited 19 schools and received over 1.6 million handwashing pledges. And a limited edition Lifebuoy pack supported local hygiene causes.
Double impact: promoting handwashing and immunisation together
Gavi, the Vaccine Alliance, and Lifebuoy launched an innovative partnership in 2017 to protect children under five from illnesses and premature death. By promoting handwashing with soap and immunisation together – two of the most critical and cost-effective child survival interventions – the partnership aims to improve and save many young lives in India.
The partnership leverages our expertise in behaviour change and marketing capability as well as our financial support. It also draws on Gavi’s health system strengthening investments and Vaccine Alliance networks to deliver behaviour change interventions and promote the benefits of vaccination and handwashing with soap.
The programme, Safal Shuruaat (‘Successful Beginning’) aims to tap into parents’ desire to raise successful children, keeping them infection-free for the best start in life. It uses a host of resources – such as a 21-day handwashing challenge and an immunisation calendar – to increase awareness of the importance of handwashing with soap and vaccines, improve handwashing practices and increase demand for immunisation. In its first year, the programme reached 41,000 households and their surrounding communities.
“Diarrhoea and pneumonia are two of the most devastating preventable illnesses which claim the lives of millions of children worldwide,” said Dr Seth Berkley, Gavi CEO. “Integrated interventions that begin at birth, including clean water and vaccines, can protect against these diseases. The Gavi and Unilever Lifebuoy partnership is a great example of the public and private sectors working together to help prevent millions of unnecessary deaths and save lives of the most vulnerable children.”
This work contributes to the following UN Sustainable Development Goals
Tackling blindness through hygiene
Hand and face washing can prevent and control the world’s leading cause of preventable blindness: trachoma. Globally, 158 million people are at risk and the disease is endemic in some of the poorest areas of the world, including countries in Africa and Asia.
We have partnered with international NGO Sightsavers, and have adapted our schools handwashing programme to include face washing in order to address this issue. By the end of 2017, our Super School of 5 programme with Sightsavers in Kenya reached more than 200,000 children and we’ve trained 580 teachers in 116 schools to champion the programme. The programme has also expanded to Ethiopia and Zambia.
An evaluation of the Super School of 5 programme in Kenya showed a significant increase and sustained adoption of observed hand and face washing behaviours, compared to control schools. Supported by other activities and county government, there has been an average 30% reduction in the prevalence of trachoma.
A new era of partnerships
We’re working to create transformational change at scale around Water, Sanitation and Hygiene (WASH), but we can’t do this alone. That’s why we’re working in partnership with a number of organisations to create the change needed to address global health challenges.
Lifebuoy’s partnerships have grown in scale, innovation and thought leadership, and form the backbone of our handwashing behaviour change programmes. These partnerships with governments and NGOs enable us to have a greater impact and reach those most in need, playing a key role in contributing to the SDGs.
As well as the partnership programmes already mentioned, in 2017, we teamed up with Oxfam to create a customised handwashing programme to reach mothers in an emergency setting after the Nepal earthquake. Results from a structured observation study showed significant increases in handwashing with soap before eating and preparing food (18% and 17% respectively). The programme also proved to significantly impact habits after using the toilet, with 45% more mothers observed washing their hands with soap.7
* The evidence that TV drives handwashing behaviour change comes from a proof of principles study in India.
2 Cairncross, Sandy; Hunt, Caroline; Boisson, Sophie; Bostoen, Kristof; Curtis, Val; Fung, Isacc CH; and Schmidt, Wolf-Peter. Water, sanitation and hygiene for the prevention of diarrhoea – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845874/, International Journal of Epidemiology, 2010 39: i193-i205.
3 Nielsen through its Scantrack and Retail Index Services for the Skin Cleansing Category (Bar, Liquid Soap, Shower): Anti-Bacterial/Health Brands Volume Sales latest 12 months, updated November 2018.
5 Rhee, V; Mullany, LC; Khatry, SK; Katz, J; LeClerq, SC; Darmstadt, GL; Tielsch, JM. Maternal and birth attendant hand washing and neonatal mortality in southern Nepal. Archives of Pediatrics & Adolescent Medicine 2008;162(7):603-608.
6 Previously known as the Public-Private Partnership for Handwashing with Soap.
7 Lifebuoy and Unilever’s Chief Sustainability Office partnership with Oxfam, collaborating on a handwashing with soap behaviour change programme for communities affected by flood, earthquake or other type of emergency. The programme was piloted in Nepal following the earthquake in 2015.