The World Health Organization (WHO) has developed several standardized methods used worldwide in healthcare, from handwashing techniques to pain management frameworks and surgical safety protocols. When people search for “WHO method,” they’re most often looking for the WHO hand hygiene technique, though the WHO pain ladder and surgical safety checklist are also widely referenced. Here’s what each involves and how it works in practice.
The WHO Hand Hygiene Method
The WHO hand hygiene method is a step-by-step technique designed to ensure every surface of the hands gets cleaned. It comes in two versions: one for soap and water, and one for alcohol-based handrub. The core movements are the same for both, covering palms, between fingers, the backs of hands, and thumbs in a specific sequence so nothing gets missed.
For soap and water, the entire process should take 40 to 60 seconds. You wet your hands first, apply enough soap to cover all surfaces, then work through the steps: rubbing palms together, rubbing each palm over the back of the opposite hand with interlaced fingers, palm to palm with fingers interlaced, rubbing the backs of fingers against the opposite palm, rotating each thumb in the clasped opposite hand, and rubbing fingertips in a circular motion against each palm. After rinsing under clean running water, you dry with a single-use towel and use that towel to turn off the tap so you don’t recontaminate your hands.
For alcohol-based handrub, you apply a palmful of product and follow the same rubbing sequence until your hands are completely dry. The WHO recommends avoiding hot water for handwashing, as repeated exposure can cause skin irritation over time. Handrub is the default choice when hands aren’t visibly dirty, while soap and water is necessary when you can see dirt, grime, or contamination on your skin. Sanitizers need to contain at least 60% alcohol to be effective.
Why the Technique Matters
Hand hygiene improvement programs following the WHO method can prevent up to 50% of avoidable infections acquired during healthcare delivery. These programs also generate economic savings averaging 16 times their cost of implementation, making them one of the most cost-effective interventions in all of medicine. The structured, step-by-step approach exists because casual handwashing tends to miss key areas, particularly fingertips, thumbs, and the spaces between fingers, where bacteria commonly survive a quick rinse.
The WHO Pain Ladder
The WHO analgesic ladder is a three-step framework originally developed for cancer pain management. It guides treatment decisions based on pain severity, starting with the mildest interventions and escalating only when needed.
- Step 1 (mild pain): Over-the-counter pain relievers like ibuprofen or acetaminophen, sometimes combined with additional supportive treatments.
- Step 2 (moderate pain): Weaker prescription pain medications such as codeine or tramadol, often combined with the step 1 options.
- Step 3 (severe, persistent pain): Stronger prescription pain medications like morphine or fentanyl, again potentially combined with non-opioid options.
The idea is simple: start at the step that matches the patient’s pain level and move up only if relief is inadequate. At every step, doctors can add supportive treatments (called adjuvants) that address specific pain types, such as nerve pain or inflammation. While originally designed for cancer care, this stepwise approach has influenced pain management across many areas of medicine.
The WHO Surgical Safety Checklist
The WHO surgical safety checklist is a standardized set of checks performed at three critical moments during any surgery. Think of it like a pilot’s preflight checklist, but for the operating room.
The first phase, called “Sign In,” happens before anesthesia begins. The surgical team confirms the patient’s identity, the procedure being performed, and that specific instruments needed for the surgery are available. The second phase, “Time Out,” occurs just before the first incision. This is when the team pauses to verify key details and confirm steps like giving preventive antibiotics. The third phase, “Sign Out,” takes place before the patient leaves the operating room. The team counts all instruments, sponges, and needles to make sure nothing has been left inside the patient.
Studies of the checklist in practice show that the instrument and sponge count during Sign Out is the check most likely to catch a problem, prompting corrective action roughly 18 to 24% of the time in high-volume surgical centers. Confirming that specific instruments are ready (during Sign In) and verifying antibiotic administration (during Time Out) are the next most frequently triggered items.
The WHO BMI Classification
The WHO also established the standard body mass index (BMI) categories used globally to classify weight status in adults. BMI is calculated by dividing weight in kilograms by height in meters squared. The WHO categories break down as follows: underweight is a BMI below 18.5, normal weight falls between 18.5 and 24.9, overweight is 25 or above, and obesity is 30 or above.
These cutoff points are based on population-level data linking BMI ranges to health risks. They’re widely used in public health surveillance and clinical screening, though they have well-known limitations. BMI doesn’t distinguish between muscle and fat, doesn’t account for where fat is stored on the body, and the risk thresholds may differ across ethnic groups. Many clinicians use it as a starting point alongside other measurements rather than a standalone diagnostic tool.