Adequate and effective water, sanitation and hygiene (WASH) measures has always been considered crucial for public health and the COVID-19 pandemic has yet again reinforced this reality. It is now a common knowledge that handwashing is one of the most effective ways to prevent the spread of Covid-19 and other infectious diseases. Frequent and proper hand hygiene is one of the most important measures that can be used to prevent infection with the coronavirus as there are two main routes of transmission of the coronavirus: respiratory and poor hygiene.
According to the recent report by World Health Organisation (WHO)/UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation, and Hygiene, 3 in 10 people worldwide could not wash their hands with soap and water within their homes. The situation is worse in South Asia as 2 in 5 people here do not have handwashing facility with soap and water on premises.
According to this report, in Bangladesh, 68.3 million people lack safely managed drinking water, while 103 million people lack safely managed sanitation facilities. Moreover, 61.7 million people do not have access to basic hygiene in the country. Additionally, 107 million people in Bangladesh do not have basic handwashing facilities with soap and water at home. The study also found out that almost half of schools in Bangladesh do not have facilities for washing hands with soap and water.
Provision of improved water and sanitation facilities and stopping open defecation practices are of paramount importance in order to achieve SDG 6: clean water and sanitation for all. Drinking water can be tainted with human or animal excreta which contain pathogens such as bacteria and virus. It can be contaminated with chemical and physical contaminants with detrimental effects on human health. That is why it is critical to obtain drinking water from an improved source so that transmission of diarrhea and other water borne diseases can be prevented.
Inadequate sanitation and lack of sanitation are closely related to diarrheal diseases such as cholera, typhoid, rotavirus, hepatitis and other worm infestation. These diarrheal diseases can aggravate malnutrition. Open defecation practices are prevalent due to lack of toilets. People use fields, forests, open water bodies, or any other open spaces due to lack of toilets. Open defecation practices and inadequate sanitation facilities are particularly dangerous because contact with human waste can cause infectious diseases. Access to a hygienic toilet facility is critical to reduce the transmission of pathogens. According to WHO/UNICEF JMP, a basic sanitation service consists of a sanitation facility that hygienically separates human excreta from human contact (that is, an improved sanitation facility) that is not shared with other households.
From the JMP report we understood where we stand among other countries in terms of access to safe water and improved sanitation facilities. Now we want to explore further, we want to understand whether Bangladesh was able to make progress over the course of time. We would like to understand what the situation has been during the last decade in rural Bangladesh in terms of the availability and accessibility of households' main drinking water sources and available sanitation facilities based on data collected through panel households survey. The International Food Policy Institute (IFPRI) has conducted the Bangladesh Integrated Household Survey (BIHS) which is a nationally representative three round panel survey of rural Bangladesh. The survey collected data on rural households' main drinking water sources and available sanitation facilities.
In the BIHS data, we see that percentage of rural households that are using piped water (either into dwelling or into yard or plot) has slightly increased from 1.6 per cent in 2011-12 to 2.1 per cent in 2015 and 3.4 per cent in 2018-19. The vast majority of rural households in Bangladesh is still reliant on tube well or other types of wells as a source for their drinking water. According to the data, percentage of households that collected drinking water from tube wells owned by the respective households has increased gradually from 51.1 per cent in 2011-12 to 61.9 per cent in 2015 and 64.1 per cent in 2018-19. Many rural households do not own a tube well so they collect drinking water from community tube wells and other types of wells in their locality. Collecting drinking water from such a source also showed a decreasing trend as 34.3 per cent of the households in 2011-12, 33.7 per cent of the households in 2015 and 29.8 per cent of the households in 2018-19 reported to use these sources for drinking water collection. Sadly, a small percentage of households reported to use surface water (from river, canal or pond) which also showed a decreasing trend during the three rounds of data collection (2.6 per cent in 2011-12 and 1.6 per cent in both 2015 and 2018-19).
When we shift our focus towards available sanitation facilities among rural households in Bangladesh, the BIHS survey data show that there have been positive changes in sanitation facilities used in rural Bangladesh. The majority of the rural households use pucca latrines and sanitary latrines without flush. The percentage for households with pucca latrines remains somewhat the same over the three rounds of survey (48.7 per cent in 2011-12, 44.8 per cent in 2015 and 48.8 per cent in 2018-19). The percentage of households reported to use sanitary latrines without flush increased from 25.5 per cent in 2011-12 to 42.5 per cent in 2015 and that further increased to 46.5 per cent in 2018-19. Use of sanitary latrines with flush is yet to become common among rural households in Bangladesh as only 0.4 per cent of households reported to use it in 2011-12 which slightly increased to 1.3 per cent in 2015 and further slightly increased to 2.2 per cent in 2018-19. Use of community latrines is becoming unpopular among rural households as 2.3 per cent of households reported to use it in 2011-12 which decreased to 0.2 per cent in both 2015 and 2018-19 which can be considered an improvement. Open defecation is becoming practically nonexistent in rural Bangladesh as from 3.7 per cent households reporting it in 2011-12 to the percentages decreasing to 3.5 per cent in 2015 and 0.6 per cent in 2018-19.
In the light of the above analysis of the data, we can conclude that even though the JMP report highlighted on the facts that how Bangladesh is massively lagging behind in comparison with other countries in the world, the data from BIHS suggest that the country has been improving, albeit slowly, in terms of improving drinking water and sanitation facilities. Ensuring WASH facilities must be a policy priority for a developing country like Bangladesh, especially during the ongoing COVID-19 pandemic.
People must be made more aware of the importance of basic hygiene practices like washing hands properly with soap and water to avoid the risk of getting infected by coronavirus. Bangladesh needs to accelerate its efforts to ensure improved drinking water and sanitation facilities for all citizens so that SDG 6 can be achieved by 2030.
Md Sadat Anowar is a Research Analyst at the International Food Policy Research Institute (IFPRI).