Assessing Opportunities for WASH and STH Control in Bangladesh
In September 2013, CWW joined the WASHplus program of FHI 360 to conduct a USAID-sponsored assessment in Bangladesh of the water, sanitation and hygiene (WASH) and STH control landscapes. The assessment sought to identify opportunities for collaboration between stakeholders in the WASH and STH control sectors.
In Bangladesh, considerable achievements have been made in improving the health of the population over the past 25 years. Infant and child mortality has declined dramatically, and deaths from diarrheal disease have been reduced (UNICEF, 2014). Further, the government has committed to controlling infections caused by intestinal worms (soil-transmitted helminthiasis, or STH). Bangladesh has also made great strides in reducing open defecation practices through multiple efforts, including community-led total sanitation, but completely stopping the practice of open defecation and ensuring safe disposal of fecal waste remains a challenge. (AusAid, 2011)
At the request of USAID, the WASHplus program of FHI 360 was tasked to identify opportunities for collaboration between stakeholders working to control STH and those working to improve hygiene and access water and sanitation. In September, CWW joined WASHplus/FHI 360 staff members on a site visit to Bangladesh and interviewed over twenty stakeholders from twelve different government and non-government organizations (NGOs) in Dhaka and the southern coastal region.
Discussions with local government staff and with teachers at primary schools revealed some of the challenges faced by program implementers. At one government-run school, the teachers told the team that neither the school’s water pump nor its latrine functioned, and that children had to bring water to school from home and use a neighbor’s latrine during school hours. Teachers expressed the desire to learn more effective methods of teaching hygiene to their students. Teachers also noted the need for proper infrastructure and maintenance of school WASH facilities to enable good hygiene practices by the children.
Overall, the assessment team found that an enabling environment for WASH and STH control integration in Bangladesh exists. Political will for improving WASH conditions in Bangladesh is high. Several governmental and NGOs work with communities and schools to improve handwashing and latrine use, and the majority of stakeholders recognize the value of integrated programming.
The team developed a list of potential recommendations for WASH and STH control integration in Bangladesh, which were presented to USAID and the Ministry of Health and Family Welfare. Recommendations included:
- Supporting the development of coordination mechanisms, such as a national hygiene stakeholder group, to promote effective allocation of resources and bolster government-led efforts to improve hygiene conditions in schools and communities.
- Strengthening capacity of teachers to implement hygiene education activities in schools.
- Identifying operational research opportunities--due to its extensive human resources and unique setting, Bangladesh is a promising environment for operational research efforts into the impact of WASH on STH reinfection. This research could provide lessons for many countries around the world.
CWW thanks the Government of Bangladesh and the many NGOs and private citizens who contributed their time to take part in the assessment.
UNICEF. Bangladesh Country Statistics. Accessed January 15, 2014. Available at http://www.unicef.org/infobycountry/bangladesh_bangladesh_statistics.html.
AusAid. Bangladesh: WASH Sector Brief, prepared for the Institute for Sustainable Futures, University of Technology Sydney, October 2011. Available at http://www.irc.nl/docsearch/title/178523.