With 80.06% of the population having access to basic HH services, Pakistan’s hand hygiene sector is the second most mature of the countries surveyed. Notably, the increase in access of 15.75% between 2015 and 2020 was significantly higher than most other countries. The key driver of this progress was the integration of hand hygiene into the Pakistan Approaches to Total Sanitation and the Clean and Green Pakistan programs. Although Pakistan scores are low – 1.33 and 1.10 on the HHAFT Tracker and Assessment’s 4-point scale, respectively – the government of Pakistan showed its increased commitment to universal hand hygiene by being the first country to develop and launch its HH4A roadmap.


Prepare for Action1.80
Analyse the Situation / Assess the Need1.25
Prioritise Actions1.00
Execute Plans1.33
Monitor, Evaluate and Course Correct1.25

Pakistan’s Federal Minister of Climate Change launched the country’s National Roadmap for HH4A in 2021 and costed plans in 2022. The roadmap outlines priority sectors and settings to advance HH4A, though guidance around inclusivity and infrastructure needs to be refined, and national indicators need to be set. It also provides a framework for action plans, monitoring systems, and private sector engagement. Although exploration of a financing strategy has been initiated and costed action plans have been developed at the provincial level, budgetary allocations have not been made. The lack of clear financing is a critical barrier to continued progress for the other parameters.


Data and Information1.25
Capacity Development1.00

Although the roadmap is in place, and lead ministry and coordination mechanisms exist at the national level, a considerable amount of coordination and decentralization still needs to take place across all parameters to expedite and strengthen roadmap implementation at provincial level. Expanding capacity building tools will be central to progress. Pakistan can leverage a well-developed M&E framework and integrate HH indicators. However, lack of financing remains an impediment but efforts to develop private sector engagement plans may open future financing opportunities.