Product accessibility

Several studies suggest that the frequency of hand cleansing is determined by the accessibility of hand hygiene facilities. A reliable supplier (industrial or local at the health-care facility) is essential to ensure a continuous supply of products. If industrial products are not available or are too expensive, products may be produced within the local setting in accordance to the formulations and the methods described in the WHO Guideline Implementation Toolkit, available at http://www.who.int/gpsc/en/. However, even if a simple method is proposed, it is difficult to regulate the quality control of locally made products, and more sophisticated but feasible methods to monitor quality are needed. 

Cost

The promotion of hand hygiene is highly cost effective, and the introduction of a waterless system for hand hygiene is a cost-effective measure.

While the cost of hand hygiene products will continue to be an important issue for departments responsible for purchasing such products, the level of acceptance of products by HCWs is even more important.

An inexpensive product with undesirable characteristics may discourage hand hygiene amongst HCWs and the resulting poor compliance will not be cost effective.