Access to appropriate personal hygiene items is a precondition to enable relevant hygiene practices and is crucial in all phases of an emergency. In the acute response phase, the most essential hygiene items need to be prioritised as these are critical determinants for survival and reducing public health risks. Such items include soap for personal hygiene and laundry, two 10-20 litre water containers (one for collection and one for the storage of water, with lids and taps and of a size and type appropriate for the age and carrying capacity of those collecting the water) as well as locally appropriate menstrual products, including underwear, if needed P.7. It is also important to consider the needs of those who have faecal or urinary incontinence who may urgently require incontinence pads or other items to ensure their well-being and dignity.

Additional items that support the wellbeing and dignity of the affected population can also be considered but may be more appropriate for the stabilisation and recovery phase. Depending on the context and in close consultation with the affected population, additional items may include toothpaste, toothbrush, shampoo, hairbrush, shaver, mirror, nail cutter, potty, scoop or nappies, toilet paper, insecticide-treated bed nets or communal items such as cleaning equipment or solid waste containers. 

In addition to providing access to hygiene items, it is important to consult with users about appropriate disposal mechanisms at home as well as in communal facilities and institutions such as schools. A system to collect and dispose of packaging waste P.5 should be established and space provided for laundry, drying facilities or incinerators, particularly for menstrual products. 

The initial assessment (chapter  A ) should include a market assessment P.8 and household income analysis. It should assess gender roles in expenditure decisions and the availability of hygiene items (addressing the specific items needed by some groups) through local, regional or international markets. If possible, local markets should be used and supported. The latter can be achieved through, for example, providing vouchers, conditional or unconditional cash transfers, grants to market vendors to recover stock, transport vouchers or by supporting traders to increase warehousing capacity or infrastructure for hygiene items. The potential risks of offering hygiene items via cash assistance include price increases, the quality of products on the local market, cultural barriers such as women having to buy from male vendors or adolescent girls potentially being dependent on caregivers to make purchasing decisions. 

Market-based interventions may also include longer-term economic recovery options through business model development, access to financial services (e.g. micro-loans) or the rehabilitation of roads, transport or telecommunication networks P.8. Working through markets partly shifts the management of quality and safety risks away from humanitarian implementers and onto local market actors and beneficiaries. Whether or not the market is providing the quantity and quality of relevant hygiene items needs to be monitored and interventions adjusted accordingly. Giving the affected population the choice does not absolve humanitarian implementers of the responsibility of ensuring access to hygiene items and WASH services that are inclusive, reach the most vulnerable and meet minimum humanitarian standards.

Access to hygiene items should, if possible, have been considered in the preparedness phase. Following an assessment of cultural practices and local preferences, preparedness WASH equipment, hygiene items and consumables can already be stockpiled. The scope for MBP can also be explored in the pre-emergency phase - using, e.g. pre-crisis market analysis. Market-based interventions may also include longer-term economic recovery options P.8.

Process & Good Practice

• Coordinate with other sectors [P.99] to provide market-based assistance P.8 and/or hygiene items or to select distribution mechanisms.

• Involve the affected population (including marginalised groups, such as older persons, children and people with incontinence or persons with disabilities) in selecting context appropriate hygiene items. It may include asking questions such as: what is culturally appropriate? What is the priority? What are the preferences for different user groups? What can people provide for themselves?  

• Assess people’s different personal hygiene needs. Some people need different or greater quantities of personal hygiene items because of their gender, age, health, disability or mobility status. They may need more specific items such as bedpans, sitting aids, commode chairs, incontinence items or plastic covers for mattresses.

• Conduct pre-crisis hygiene items market assessment whenever possible to understand market functionality before and after the crisis. Monitor and evaluate market prices, quality and the diversity of hygiene products during the whole project period (monitoring both the seller and the buyer/community). 

• Work with the affected population, local authorities and other actors to plan how people will collect or buy hygiene items.

• Identify and address all potential barriers to accessing distribution locations or distribution systems (e.g. for women and girls, older or ill people and persons with disabilities, the excluded or outcast population). Consider gender-disaggregated distributions or the inclusion of female staff at distribution locations.

• Provide accessible information about content, location, timing, intended recipients and eligibility criteria for hygiene items/kits or cash/voucher-based assistance P.8.

• Consider using a dedicated distribution team for a central distribution of hygiene items (or vouchers or cash distributions). It is of utmost importance to assure the safety and security of the population (and the distribution team) and to ensure that households can transport all their distribution items safely home.

• Provide accessible information on the appropriate use of the distributed hygiene items: no distribution without information. 

• Establish a reliable and regular supply of consumables such as soap, menstrual and incontinence materials.

• Distribute hygiene items in combination with other essential items (e.g. food) if possible, to address multiple needs at the same time for the convenience of the target population. This also saves time and resources across sectors. Coordination and collaboration with other sectors will be required P.9.

• Seek feedback from affected people M.5 on the appropriateness of the hygiene items chosen and their satisfaction with the mechanism for accessing them.