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BACKGROUND Hygiene promotion interventions are likely to be more effective if they target the determinants of handwashing behaviour. Synthesis of the evidence on the determinants of handwashing behaviour is needed to enable practitioners to use evidence in hygiene promotion programming. PURPOSE To identify, define and categorise the determinants of handwashing behaviour in domestic settings and to appraise the quality of this evidence. METHODS We conducted an integrative review, searching three databases for terms related to handwashing and