An electronic processor is operatively connected with at least one video camera, or additionally or alternatively a non-camera-based sensor, and at least one annunciator to process real time video acquired by the at least one video camera in real time to perform a hand hygiene compliance enforcement method for encouraging use of a hand sanitation station. The real time video is analyzed to determine an occupancy time interval over which a sanitation zone imaged by the real time video is occupied. Whether a hand sanitation event occurs is determined based on images of a wash station zone extracted from the real time video acquired during the occupancy time interval. The at least one annunciator is controlled to annunciate a hand hygiene compliance status based on the determination of whether a hand sanitation event occurs.