Hand-washing and hygiene: Improving primary school toilets

Written by: Dr Catherine Stones | Published:
Encouragement: The 123GermFree resources help to drive pupils' attention to the soap, sink and dryer (images: supplied)

Toilet areas in schools can sometimes be neglected, resulting in poor hand hygiene and pupils reluctant to use the spaces. Dr Catherine Stones has been looking into how we can change this using some very simple ideas

For any headteacher, the toilet space is unlikely to be a priority – it is a functional space that children only briefly albeit frequently use. Given all the pressures on learning, teaching and assessment, it is easy to neglect these spaces.

As a university researcher, I have been interested in these toilets and wash areas for many years and, in particular, how simple and cheap design changes can improve children’s satisfaction with toilets and improve hand-washing rates.

I have also spent a lot of time in primary school toilets themselves! And talking to children and teachers about them. At best the primary school toilets I have seen are clean with basic “wash your hands” instructions and signage.

At worst they are dirty, smelly with a range of neglected and muddled hand-washing signs or no signs at all. In the latter cases, it is really no wonder that children do not always wash their hands and wish to leave the space as soon as they can.

Transforming toilets

It is time to take primary school toilets seriously. Research findings show us that the toilet environment can have an impact on children’s health and wellbeing (and of course, their levels of absenteeism).

A review report for Scotland’s Commissioner for Children and Young People (Burton, 2013) highlighted three key problems associated with neglected school toilets – poor hand-washing leading to the rapid spread of common infection and absenteeism, unsociable behaviour and bullying, and “withholding” leading to problems of constipation, incontinence and dehydration. There is a plethora of academic texts highlighting these same problems.

Many school toilets still need to be practically improved, but in low-cost and creative ways.

ERIC – a children’s bowel and bladder charity – has created a set of guidelines for school toilets (see further information) that highlight physical changes that can be made to improve your facilities.

In addition, small changes to the walls and messaging within your toilets can make a big difference to the overall look and feel of your toilets and to hand-washing rates.

Get the pupils involved

Child involvement is key to improving toilet spaces. One large primary school ran focus groups with children and revamped their toilet areas accordingly. Using the feedback from the children, the school was able to make targeted improvements to the toilet areas.

ERIC encourages child-led designs to be installed on the wall of the toilets too. If a child-led or child-friendly design features on the walls it can heighten the visual appeal of the space to make it more welcoming and friendly.

ERIC also highlights the involvement of children to help manage the space – for example, ensuring the soap is topped up, or checking that hand towels are present.

The 123GermFree project

At the University of Leeds, we have worked on a number of projects looking at ways to improve hand hygiene in primary schools. We ran co-design sessions with children at three primary schools to create a set of wall sticker/poster designs and resources – called 123GermFree – most of which are free to use.

We found that bringing colourful characters, targeted messages and a consistent set of designs and messages into the school toilet areas improved both soap-use, cleanliness of hands (tested via swab tests), and general satisfaction with the spaces.

A headteacher at a school where the designs were installed commented how the state of the boys’ toilet floors had improved and toilets were flushed more often.

Children made comments such as “it’s fun”, “persuasive” and “I like it because it decorates it and because last time it was quite boring – it was just blank”. As such we know that child-led design can make a difference.

Through our 123GermFree initiative we encourage three simple steps to good hand hygiene using three characters to promote the three steps:

  • Super soap
  • Warrior water
  • Dynamic dryer

The resources use persuasive graphics and fun visuals, activities and learning materials. All the designs are available to download and print for free (schools can purchase additional semi-permanent adhesive vinyl stickers from the university for a small cost if they prefer).

Of course, there are a range of companies offering more permanent solutions – such as colourful toilet doors or even full wall wraps - to raise the visual appeal and “entertainment” factor of your facilities.

Whatever approach you choose, go for designs that can also act as messages to encourage good behaviour and hygiene so that both appeal and motivation are enhanced.

Free to download: Examples of some of the freely available 123germfree resources, including the 1, 2, 3 characters and the Sink Song.

Three simple steps

Try to encourage children to use all three steps – soap, water, drying. The final step – drying – can be easily missed. Through casual observation of wash areas in general, some boys were seen just wetting, rather than soaping hands and then running wet hands through their hair or rubbing wet hands on their trousers. The latter two activities only serve to spread germs further.

Ensure your children understand why all three steps are important by focusing on this in a science lesson and drawing on content from the national curriculum. Engage your children in fun classroom-based activities including demonstrations about germ spread, such as Glitterbug (see online).

Persuading pupils

Remember, the school toilet zone is not just one area – a simple sticker saying “wash your hands” near the soap area for instance, can have a limited impact.

Instead think of your school toilet area as a potentially “persuasive space” to encourage good hand hygiene during the pupils’ “journey” through the space. Through our research we identified four key components of this persuasive space worth considering:

  • Motivational Moments: What can you put in a cubicle, while the child is sat or stood still, to motivate them to wash their hands?
  • Promotional Pathway: What can you put on the walls/floors to lead them to the sink area?
  • Device Drivers: How can you draw attention to the sink area/soap or drying devices?
  • Room Reminders: In the general wash area, what can you put up to remind children about hand-washing?

This can be a useful framework for getting your own children or staff team involved in designing your toilet spaces.


To summarise there are some simple steps your school can take to improve school toilets and hand hygiene:

  • Engage your children in focus groups/workshops to understand the problems in your particular school – it is a valuable and insightful exercise.
  • Use self-generated or existing resources to brighten up and make your toilet spaces more appealing and educational.
  • Consider what messages you are using in your toilet spaces to encourage good hand hygiene and use the four zones of persuasive space design to plan your message location.
  • Devise a strategy to ensure your hand-washing facilities are always usable – consider using pupil ambassadors to help with this.
  • Dr Catherine Stones is an associate professor in graphic design at the University of Leeds.

Further information & resources

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