Vol. 14 No. 1 DOI: 10.20473/jkl.v14i1.2022.55-62 ISSN: 1829 - 7285 E-ISSN: 2040 - 881X 55 Corresponding Author: QUALITY OF HANDWASHING IN INFORMAL WORKERS IN INDONESIA Basuki Rachmat 1 *, Antonius Yudi Kristanto 1 , Totih Ratna Sondari 1 1 National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jakarta 10560, Indonesia Article Info Submitted : 19 November 2021 In reviewed : 21 December 2021 Accepted : 6 January 2021 Available Online : 31 January 2022 Keywords : Handwashing, Quality of handwashing, Informal workers, Formal workers Published by Fakultas Kesehatan Masyarakat Universitas Airlangga Abstract Introduction: Worker behavior of handwashing with soap in the informal sector has rarely not been studied in Indonesia. This study was conducted to determine factors related to the quality of handwashing performed by workers in the formal and informal sectors in Indonesia. Methods: The research used secondary data from Indonesia Basic Health Research. The research design was cross-sectional, and a total sample included was 421,404 workers at the productive age of 15-64 years across 34 provinces in Indonesia. The data collected included age, gender, marital status, education, place of residence, occupation, and handwashing practice. The determinants were identifed using binary logistic regression. Results and Discussion: Results showed that 1.9% of workers did not wash their hands, and 35.0% only washed their hands with water; most of them worked in the informal sector (77.5%). Regarding the characteristics of workers, age (OR=1.17; 95% CI: 1.14–1.21), gender (OR=1.23; 95% CI: 0.93–0.99), education (OR=2.07; 95% CI: 2.01–2.14), and formal workplace (OR=1.43; 95% CI: 1.40-1.46) were mostly related to the quality of handwashing. Conclusion: The government is expected to formulate a structured policy in educating the workers, especially for male, young (15-24 years), low educated, and informal workers, about good handwashing. This study recommends that the government should use the current research fndings to target proper population for the policy implementation. ORIGINAL RESEARCH Open Access *) basukir2009@gmail.com INTRODUCTION Informal workforce gives irregular income from unregistered entities. According to the Statistics Indonesia in 2019, the informal workforce consists of entrepreneurs assisted by temporary workers and families, farm/ agricultural workers, non-agricultural workers, and unpaid family labor. According to the Statistics Indonesia in 2019, 74.08 million people (7.27%) work in the informal sector in 2019 (1). Occupational Health Eforts (OHE) are used to develop occupational health in the informal sector in Indonesia. The implementation of OHE includes promotive, preventive, curative, and rehabilitative services. OHE is a type of community empowerment to protect informal workers from adverse impacts and free them from work-related health problems (2). Protection from the risk of disease transmission through infected palms is by handwashing with soap in running water. According to the World Health Organization (WHO), three billion people or 40% of the world’s population do not have handwashing stations with soap and water (3). Three-quarters of those who lack access to water and soap live in the world’s poorest countries. According to scientifc evidence and recent experience, eforts to improve hand hygiene globally can prevent approximately 165,000 deaths from diarrheal diseases each year (4). Improving hand hygiene strategies can reduce healthcare-associated infections and antimicrobial resistance (5-6). Access to hand hygiene in public and home facilities is critical to protecting workers’ health and reducing the risk of future outbreaks. The benefts of handwashing with soap (HWWS) for personal and community health are reducing 23-40% of people with diarrhea, 16-21% of people with respiratory diseases such as colds, and 58% of diarrhea cases in people with weak immunity (7). One of the eforts to improve hand hygiene is to facilitate basic access to handwashing facilities equipped with soap and water, both at home and in public facilities. According to BPS data, the population with handwashing facilities with soap in fve years has increased quite well. The best increase in handwashing facilities occurred in the frst three years of 2016, 2017, and 2018 at 66.28%, 68.16%, and 78.87%, respectively. Meanwhile, the growth of handwashing facilities decreased in 2019 to 76.07% and increased again in 2020 to 78.3% (8). Even though some informal workers and their families live in urban areas, they will still be at risk of contracting the virus. The surroundings are too crowded