The importance of hand hygiene and the availability of enabling resources in the control of infections cannot be overemphasized. Results from a 2022 study conducted by UNICEF indicated limited access to hand hygiene facilities and commodities within healthcare facilities in Uganda.

In 2018 with funding from the Centres for Diseases Control (CDC), IDI collaborated with the Kabarole District Local Government and the International Water and Sanitation Centre (IRC-WASH) in a study to investigate the feasibility and impact of local production of Alcohol Based Hand Rub through a district-led model. A local production unit for Alcohol Based Hand Sanitisers was set up, supplying over 30 government health facilities within the district. Mid- and end-term evaluations demonstrated improved hand hygiene compliance among health care workers. The district-led model employed was recommended as a cost-effective way to provide access to Alcohol Based Hand Sanitisers in low-resource settings.

This cost-effective model was scaled up to Kasese district as part of preparedness and response efforts for the 2018-2020 EVD outbreak in the neighboring Democratic Republic of Congo (DRC) and to the districts of Amuru, Tororo, Moroto and Kotido during the COVID-19 pandemic response.

Key Achievements

  • 6 ABHR production units were established in 6 districts
  • Over 50,020 liters of ABHR were produced and distributed.
  • Accessibility to ABHR improved at over 218 health facilities and 7 Points of Entry.
  • 300 hand washing stations and liquid soap distributed to 122 sites
  • 1 Abstract presented at the International Conference of Emerging Infectious Diseases in August 2022.
  • 1 Abstract presented at the 8th Infection Control Africa Network Conference in November 2021, Received Gold Award for the best scientific presentation.
  • ABHR curriculum developed and piloted
  • Protocol for cleaning and disinfection of ABHR containers developed and piloted
  • National stakeholder engagement meeting with national, district, regional and partner representation.


  1. Fred Tusabe, Judith Nanyondo, Matthew J Lozier, Maureen Kesande, Olive Tumuhairwe, Martin Watsisi, Fred Twinomugisha, Alexandra Medley, Julius Mutoro, Mohammed Lamorde, David Berendes
    Improving Access to Alcohol-Based Hand Rub in Primary Health Care Facilities in Uganda using a district-led approach
  2. Berendes, D., Martinsen, A., Lozier, M., Rajasingham, A., Medley, A., Osborne, T., … & Handzel, T. (2022). Improving water, sanitation, and hygiene (WASH), with a focus on hand hygiene, globally for community mitigation of COVID-19. PLOS Water, 1(6), e0000027.
  3. Lamorde, M., Lozier, M., Kesande, M., Akers, P., Tumuhairwe, O., Watsisi, M., … & Berendes, D. (2020). Access to Alcohol-Based Hand Rub Is Associated With Improved Hand Hygiene in an Ebola-Threatened District of Western Uganda. Infection Control & Hospital Epidemiology, 41(S1), s457-s457.

Success stories

Project Handover Reports

Abstracts presented at international conferences

  1. Fred Tusabe, Maureen Kesande, Alexandra Medley, Ishida Kanako, Linda Namara, Evelyn Makena Mugambi, Ruth Kikonyogo, Judith Nanyondo, Sauda Yapswale, Lydia Caroline Nalule, Carolyne Amuge, Francis Ociti, Herbert Isabirye, Adelline Twimukye, Herbert Nabaasa, Caroline Pratt, Mushtaq Dualeh, David Berendes, Mohammed Lamorde
    Capacity Building on Local Production of Alcohol-Based Handrub: Evaluation of a Virtual Practical Course. Accepted for presentation at the WHO ICPIC conference in Geneva, 12th-17th September 2023
  2. Maureen Kesande, Judith Nanyondo, Fred Tusabe, Sauda Yapswale, David Berendes, Matthew Lozier, Alexandra Medley, Caroline Pratt, Christina Craig, Francis Ociti, Herbert Isabirye, Mohammed Lamorde
    Approach for Sustainable District–Led Production and Distribution of Alcohol-Based Hand Rub in Uganda. Presented at the International Conference on Infectious Diseases, Atlanta Georgia, 7th -10th August 2022, SHEA Spring Conference Seattle, GA, March 2o23.
  3. Sauda Yapswale, Francis Ocitti, Maureen Kesande, Fred Tusabe, Herbert Isabirye, Kanako Ishida, Judith Nanyondo, Alexandra Medley, David Berendes, Mohammed Lamorde
    Current practices of cleaning and disinfecting alcohol-based handrub containers at healthcare facilities in rural Uganda. Accepted for presentation at the University of North Carolina, UNC WASH and Health Conference, October 2023