Ensuring the condition of safe water, and sanitation facilities is the early step to behaviour change. However, mere provision of facilities does not ensure the desired health benefits. To address this issue, BRAC Water, Sanitation and Hygiene (WASH) programme has been working to improve health of the rural poor through comprehensive interventions. To improve the monitoring of WASH outcomes and to assess the quality of hygiene practice, an improved system called qualitative information system (QIS) is used by the programme. The present study aimed to assess the status and quality of practice of some key hygiene behaviours and also assess the quality of drinking water based on chemical and microbiological water
parameters. Besides, this study also explored users’ perceptions on drinking water interventions in a coastal district where safe water crisis is a growing problem due to arsenic and salinity using qualitative method.
We adopted cross-sectional comparative study design for intervention and comparison areas to measure the status of hygiene behaviours at household level. The total estimated sample was 960 households. A multi-stage random sampling
was used to select study samples, where each upazila was considered as a cluster. Twenty-four upazilas (13 BRAC WASH intervention upazilas and 11 non-intervention upazilas) were selected systematically for data collection. The scaling principles of qualitative information system (QIS) were applied in collecting and analysing data on WASH behaviours. Besides, we collected a total of 542 water samples from 12 out of 24 upazilas for laboratory test of some chemical parameters of drinking water. We also tested arsenic level of drinking water in the field using “Econo Quick” arsenic test
kit. A total of 160 water samples from 80 households in 4 nearby upazilas of Dhaka district were collected to test microbial status of drinking water at source and point of-use. “Weighted Arithmetic Water Quality Index” method was applied to assess suitability of water for drinking purpose. A total of 8 FGDs and 4 KIs were conducted to explore user’s perceptions of drinking water interventions in two upazilas of Bagerhat district.
A higher proportion of households in the intervention areas compared to the comparison areas used arsenic free tubewell which had concrete platform and no latrine in 12 steps. Statistical significant difference was found in having concrete tubewell platform, while the association was insignificant regarding ‘no latrine within 12 steps of tubewell’. Only 5% households in the intervention areas used unsafe sources of drinking water (e.g., arsenic affected tubewell, open source). About half of the households in the intervention areas stored drinking water safely and the proportion was higher than the comparison areas. Hygienic use of latrines (ring-slab with water seal) was found significantly higher in intervention areas over comparison areas. Over 94% of households in the intervention areas higher than the comparison areas, used fixed latrine (i.e. ring-slab latrine with/ without water seal). Intervention areas were found nearly free from open defecation. More households in the intervention areas compared to the comparison areas covered the pits with soil after disposing of the sludge. The proportions of households in the intervention areas were more than double compared to the comparison areas in using safe water for hand washing and having special hand washing station. However, the lower proportion of households in the intervention areas compared to the comparison areas had no provision of water in or near the latrine for hand washing after defecation.
Drinking water quality based on different parameters showed that drinking water at sample sites was found slightly alkaline but within acceptable limits. The mean iron concentrations in water exceeded WHO standards (0.3 mg/L) at all sample sites but remained within Bangladesh standards (1.0 mg/L) at a few sample sites. Salinity was relatively higher in coastal districts. After laboratory confirmation, arsenic concentrations exceeded acceptable Bangladesh limits in Shibchar (Madaripur). Microbial status of drinking water showed that about 57.5% and 7.5% of water samples collected from tubewells (sources) and consumption points were found free from fecal contamination. Of the total sampling sites, about one-third of the households had good quality water for drinking based on the water quality index (WQI). However, the majority of the households used poor quality drinking water. Higher values of iron, manganese, and arsenic reduced drinking water quality. In two upazilas of Bagerhat district, available water sources (e.g., shallow tubewells) were mostly contaminated by arsenic and salinity. In such context, BRAC’s drinking water interventions through deep tubewell, piped water supply and pond sand filter were perceived as safe by the users. Piped water supply had been well accepted by the users due to improved water quality, taste and clearness. In Chitalmari, the users of pond sand filter found it safe because water passed through many layer resulted in less disease occurrence.
An improved status has been found in most of the wash behaviors except sludge management while pit is full. In sludge management, we found environmental consciousness among the households, but they were unaware about the potential benefits of compost making out of the sludge and using it eventually for productive purposes. Bacterial status of drinking water samples indicates hygienic water management at intermediate stages i.e. from collection to storage at home. Water safety of piped water can be maintained through regular check-up of pipe water quality, cleaning of water tank and pipe line. According to the respondents, PSF approach has been fully successful, however its number or capacity needed to be
improved to meet the demand of water.