Effectiveness of hand hygiene campaigns and interventions across the League of Arab states: A region-wide scoping review.

Hand hygiene is a standard public health practice for limiting the spread of infectious diseases, yet they are still not routine global health behaviors. This review aimed to examine the effectiveness of various hand hygiene interventions conducted across the League of Arab states, identify gaps in the existing literature, and propose areas for future research and intervention development. A scoping review was conducted across 16 databases for relevant publications published up to and including October 2023. Forty studies met the inclusion criteria; of these 34 were hospital-based and six community-based. Of the reviewed studies, 24 provided adequate details that would enable replication of their intervention. Eighteen of the studies used some variation of the World Health Organization's Five Moments for intervention content or assessment. More than half (n=25) reported health care worker or student hand hygiene behaviors as an outcome and fifteen studies also included some form of patient-centered outcomes. Six studies specified the use of theory or framework for their evaluation design or intervention content, and four studies mentioned use of local government guidelines or recommendations. Future research should focus on bridging the literature gaps by emphasizing community-based studies and integrating cultural nuances into intervention designs. Additionally, applying theoretical frameworks to hand hygiene studies could enhance understanding and effectiveness, ensuring sustainable improvements in hygiene practices across diverse settings in the Arab League states.