In Bangladesh, WASH has significant impact in high disease burden households

Mar 20, 2024


Mahbubur Rahman
from the Environmental Health and WASH, Health System and Population Studies Division, icddr,b
Pearl Anne Ante-Testard
from University of California, San Francisco, USA
Benjamin F. Arnold
from University of California, San Francisco, USA

A child having a lipid based nutrient supplement (LNS) in Bangladesh. Photo: icddr,b.


Deaths caused by diarrhea among children less than five years old are highest in poor communities in sub-Saharan Africa and South Asia, including here in Bangladesh. Children from households in the lowest socioeconomic position in rural Bangladesh have some of the highest rates of diarrhea, exacerbated by heavy rainfall during the monsoon season.

Given this, can rural households in Bangladesh minimize the risk of climate-related diarrhea for their children? Does household socioeconomic position impact the effectiveness of improved water, sanitation, and handwashing (WASH) interventions in reducing the risk of diarrhea?

A recent study answered these and other important questions by examining the impact of improved WASH interventions on reducing child diarrhea during the monsoon period in households of varying socioeconomic position in rural Bangladesh.

Researchers discovered that socioeconomic position influenced the number of reported cases of child diarrhea: the poorest households reported 2.2 times more cases of child diarrhea than the wealthiest households. Without WASH interventions, these households lacked resiliency against the impacts of diarrhea during the monsoon season compared to wealthier households.

However, the findings also show that poorer households can significantly decrease the risk of diarrhea. This can be achieved either through improved WASH interventions alone or in combination with lipid nutrient supplements, along with exclusive breastfeeding and complementary food for infants during the monsoon season.

Reductions in child diarrhea cases due to improved WASH interventions were most significant among the poorest households. The study showed that during the monsoon period, the households that implemented WASH interventions had half the reported diarrhea cases compared to those who did not.

The study projected that during the monsoon season, WASH interventions could prevent 734 cases of diarrhea per 1,000 children under three years old per month in rural Bangladesh. WASH interventions have the potential to reduce socioeconomic inequalities in child diarrhea.

Data such as these enable policymakers to target areas of greatest public health burden, targeting those who can most strongly benefit. This kind of evidence is timely for confronting climate change and making informed decisions on WASH strategies for low-income populations in climate-sensitive areas of Bangladesh, where poor communities are hit especially hard.