Hygiene & well-being

The issues

Preventable diseases, resulting from poor hygiene and sanitation, still pose a significant global health challenge. Every year over 3.5 million children die before the age of five because of diarrhoea and acute respiratory infections. One billion people lack access to safe drinking water. Tooth decay and gum disease affect the majority of people in both developed and developing countries.  Up to 90% of school children have cavities.

Simple changes can prevent much of this. Helping people access the right products, such as soap and toothpaste, is an important first step. Yet this is not enough. Encouraging people to change their habits, like washing hands with soap before touching food and after going to the toilet, is essential. This is what our health and hygiene programmes set out to achieve.

Our approach

Our brands have recognised the potential difference they can make to people's health.

Our approach is to:

• make effective products that deliver health benefits and promote well-being

• transform people's everyday habits through effective behaviour change campaigns

• work with partners to achieve wider improvements in health and well-being.

Helping people meet their hygiene needs has always been at the core of our business. Ever since the launch of our Lifebuoy soap, over 100 years ago, we have been making a significant contribution to the health and hygiene of people in both the developed and developing world. More recently, the launch in India of Pureit, our household water purifier, offers consumers a convenient way to provide safe drinking water for their families.

Many of our brands have integrated health, hygiene and well-being into their mission and identity. For example, Lifebuoy continues to lead handwashing and behaviour change projects, while improving oral health is a core part of Signal/Pepsodent/Close Up's mission.

Our Global Health through Hygiene Programme works with our brands and partners such as the London School of Hygiene & Tropical Medicine, UNICEF and the World Bank, to improve our technical capability in the area of health and hygiene, particularly in evaluating behaviour change.

Encouraging behaviour change

Around the world billions of people do not wash their hands with soap at the critical times during the day to prevent the spread of germs. Through its Lifebuoy brand, Unilever is working with governments, health agencies and non-profit groups to campaign to change this, by promoting good health and hygiene habits. Examples of hygiene education programmes are described below.

Global Handwashing Day

Lifebuoy co-founded the first-ever Global Handwashing Day on 15 October 2008. We worked closely with NGOs, governments and other companies to launch the day in 75 countries around the world. Lifebuoy teams co-ordinated a range of activities in 23 countries to raise awareness of the importance of handwashing. In Bangladesh we worked with the government and others to create handwashing activities in 75 000 schools across the country, in the process breaking the Guinness World Record for the highest number of people washing their hands with soap at one time. 

Activities in other countries included:

• Sri Lanka: handwashing stations set up in schools and the largest petition for handwashing by pupils 

• India: celebrity endorsement by international cricketer Yuvraj Singh at events organised with the India Ministry of Health. Unilever staff helped to launch hygiene training programmes in government buildings, under-privileged schools and factories

• Indonesia: Lifebuoy hosted education events in Jakarta and across other major cities, attended by government officials and other partners

• South Africa: school children were taught proper handwashing techniques at a 'clean up your school' rally. 

• Ghana: the Lifebuoy team set up handwashing stations at truck stops and markets, while school children participated in handwashing workshops.

Swasthya Chetna

In India, Lifebuoy's hygiene education programme, Swasthya Chetna (Health Awakening), has touched the lives of millions of people in rural areas.  Over 2002—2008 the campaign has reached 120 million people in nearly 51 000 villages. It has also delivered commercial benefits for the brand, driving up sales of soap in districts where the campaign has run. We have also reached a further 13 million people since 2002 through similar programmes in Bangladesh, Pakistan, Sri Lanka, South Africa, Vietnam and Indonesia.

Berbagi Sehat

A study of our Berbagi Sehat (Sharing Health) programme in Indonesia, which is aimed at mothers and children, showed that 84% of those we reached now reported washing their hands with soap after using the toilet, compared to an average success rate of 58% in other programmes of this type.

Glowgerm

One of the key elements of Lifebuoy's hygiene education programmes is the 'glowgerm' demonstration. This counters the common misconception that 'visibly clean' is 'hygienically clean'. When held under ultra-violet light, glowgerm powder glows on the dirt left behind on hands washed only with water, providing a dramatic reminder of the need for thorough handwashing with soap.

Evaluating effectiveness

Unilever's distinctive approach is to put the monitoring and evaluation of behaviour change at the heart of our programmes. We have greatly advanced our understanding through our partnerships and innovative measurement techniques.

Smart sensor technology

Our smart sensor technology is now widely regarded as the best way of measuring handwashing behaviour. By placing a sensor inside a soap bar researchers can gather accurate data unobtrusively during handwashing trials and thereby monitor the extent to which different types of awareness-raising initiatives actually lead to changes in behaviour in people's homes.

In Bangladesh in 2008, we carried out a study using this smart sensor technology, with funding from the Gates Foundation as part of our involvement with the World Bank's Global Public-Private Partnership for Handwashing with Soap.

We used the same technology in a project in Uganda, in partnership with UNICEF. We wanted to test whether working with children through school-based hygiene awareness programmes was an effective way of delivering handwashing messages to families. The results were very positive. Families whose children had been through the awareness programme increased their use of soap by almost a third compared with families of children who had not.

Sharing our marketing skills

The In Safe Hands programme, developed by Lifebuoy and our Marketing Academy, is also built on the insight that behaviour change is needed to achieve health improvements.

Following successful workshops in East Africa and Vietnam, we took our In Safe Hands programme to Indonesia in 2008. This programme teaches marketing skills to public sector health professionals and is designed to help them develop effective handwashing and behaviour change campaigns for their local communities. To date it has reached nearly 300 health professionals and made an important contribution to national health campaign development.

Safe drinking water

In India we sell a unique water purifier, Pureit, that provides water that is 'as safe as boiled' without needing electricity or pressurised tap water. The purifier removes harmful germs. Its germkill performance has been tested and verified by a range of scientific, medical and public health institutions, and meets the criteria of the Environmental Protection Agency (EPA), the toughest regulatory agency in the US.

Pureit protects against waterborne diseases like diarrhoea, jaundice, typhoid and cholera, without depending on boiling, electricity or pressurised tap water—thereby making safe drinking water more accessible to urban and rural consumers. Trials in India have shown that use of Pureit can halve the incidence of diarrhoea.

One unit costs €32 and has a running cost around half a euro cent per litre, making it a much more affordable option for these consumers. During 2008, the product was rolled out to 23 states in India, and reached all 28 states by early 2009.  It is now bringing safe drinking water to more than 5 million people in a million households.

Hindustan Unilever and UNICEF are working together on a project to bring safe drinking water to schools and day-care centres in low-income communities in South India.

Improving oral health

Tooth decay and gum disease are one of today's most common ailments. The World Health Organization has identified oral health as a neglected area of general health. The consequences of poor oral hygiene can begin with discomfort and pain, but can lead to life-threatening illnesses. Around the world, over 1 billion people do not brush their teeth with a fluoridated toothpaste at all, while over 2 billion do not brush twice a day. In developing countries, where there is low awareness of oral hygiene and poor healthcare infrastructure, 90% of dental caries remain untreated. Brushing teeth is important not only for good oral hygiene and general health, but having clean teeth and fresh breath contribute to well-being and personal confidence.

Signal/Pepsodent/Close Up's mission is to improve oral health by getting children and their families around the world to brush day and night using fluoride toothpaste.

Here, too, changing everyday habits is critical. As one of the market leaders in toothpaste, we have the opportunity to make a difference. Every year through school-based oral hygiene programmes, Signal/Pepsodent/Close Up reaches more than 4 million children.

The campaigns emphasise the importance of twice daily brushing with a fluoridated toothpaste as this has the greatest impact on improving oral health around the world.  We have also decided to focus on children since we believe that brushing habits that last are best forged during childhood.

This mission is at the heart of our partnership with the FDI World Dental Federation which now covers 40 countries.

Understanding and measuring the impact of our campaigns is key to achieving tangible results – the same smart sensor technology we use to analyse handwashing habits is also used to observe toothbrushing habits accurately and unobtrusively.

Unilever regularly contributes our research on oral health in external journals. For example, Unilever employees presented papers at the FDI Annual World Dental Congress in Stockholm in 2008 in a symposium entitled 'Design for behaviour change and better oral care'. See link to the International Dental Journal Supplement to read more.

Enhancing self-esteem & well-being

Many of our brands help people feel good and look good every day, which can enhance both physical and emotional well-being. Some have dedicated campaigns on empowering and raising the self-esteem of women.

This continues a tradition going back as far as the 1890s. The vision of one of our founders, William Lever, was to improve women's well-being by making everyday household care products more affordable.

Today, poor self-image affects the confidence and well-being of many people, especially young girls and women. How a person feels about their personal appearance and hygiene can boost their self-esteem and confidence. This is true in all communities around the world – in developing as well as developed countries.

Dove Self-Esteem Fund

Dove's Campaign for Real Beauty aims to improve self-esteem among young people by challenging traditional stereotypes of beauty. Dove's Self-Esteem Fund aims to reach 5 million young people over 2005—2010. In 2008 it reached over 1 million people in 27 countries, taking the total to date to over 3.5 million. Examples of the campaign include BodyTalk workshops addressing body image and self-esteem which reached 69 000 people in the UK, and similar workshops delivered by our partner, the Girl Scouts of the USA, which reached another 240 000. Dove also launched a Real Beauty day, reaching 10,000 children around the world through self-esteem workshops in local schools and youth groups.

Vaseline Skin Fund

Skin conditions such as eczema often cause great discomfort and can have a negative impact on people's well-being. Our Vaseline skin care brand has set up the Vaseline Skin Fund to focus the brand's ambition to improve the lives of those affected by skin conditions. The Fund aims to benefit 3 million people worldwide by 2012, by providing better access to knowledge, advice, and support to those affected.

In 2008, the Vaseline Skin Fund supported projects such as the Eczema and Sensitive Skin Education programme, a website created in partnership with the National Eczema Association in the US. The site offers practical information on the care and treatment of eczema and sensitive skin.

Perceived age

In 2008, Unilever scientists investigated the difference between perceived facial age (ie how old an individual looks) and actual age (ie how old an individual is), to establish the factors that affect the ageing process in different parts of the world. These factors included genetics, diet, sleep, exercise, psychological stress, and skincare treatments and products.

The research focused on 1 350 people (predominantly women), at seven locations across the world. It looked at the skin as an organ fundamental to the health and well-being of an individual, and recognised that the appearance of facial skin should be studied as part of the body as a whole. A web-based tool was used to determine how old a subject looked from a high-definition photograph. These studies have provided important information on behaviours that are associated with looking younger and therefore healthier, since facial ageing is also known to be linked to mortality and longevity. Studies in twins have also revealed that those who look oldest for their age tend to die youngest.

The results of the Unilever studies showed that younger appearance was more common for subjects who did not smoke, ate fruit and vegetables regularly, avoided high sun exposure, had good dental hygiene (eg cleaning teeth twice a day), frequently used facial moisturisers four or more times a week, and who undertook moderate levels of physical activity on a daily basis. In China, the studies also showed that socio-economic factors contribute to the ageing process. Those who looked younger tended to work indoors, had more years of education, had fewer household members, and more frequently visited their doctor.

Working with the University of St Andrews, UK, we generated average facial images of good and bad agers from around the world. Sixteen individual faces were merged to create the UK averages, 14 were used for those from China.