According to WHO 2012 estimates, Water, Sanitation and Hygiene (WASH) was responsible for 842 000 annual deaths from diarrhoea and 15% of the Global Burden of Disease in Disability- Adjusted Life Years (DALYs). In South Africa, diarrhoea and respiratory infections are a major public health problem, and are amongst the top causes of death in children. Respiratory and diarrhoeal infections are ranked the 2nd and 3rd leading causes of death amongst the under-5 population, and the 3rd and 4th biggest killers in children between ages 5-14 years. Unsafe or lack of water supply, inadequate sanitation services and poor hygiene (WASH) are ranked high on the list of risk factors causing infections, diseases and subsequent deaths amongst South African children, many of which are preventable by simple hygiene practices. The overall goal of the Hand Hygiene Behaviour Change Strategy 2016-2020 is to prevent and reduce the prevalence of diarrhoea and other diseases related to poor water, sanitation and hygiene, particularly in children under 5 years, through the promotion of safe hand hygiene practices as a key and proven intervention. The strategy aligns to government’s National Development Plan (NDP) goals of the reduction of Infant and Child Mortality, and to prevention of disease and promotion of health in the country. The strategy outlines approaches to hand hygiene promotion, its implementation framework and identifies with children and caregivers as the primary target audience. It focuses on increasing knowledge and perceived importance of sanitation and hygiene practices, with the long term objective to instill and sustain the habit of washing hands with soap amongst South Africans.