Nepal C Dey and Tahera Akter
A comprehensive intervention of safe water, sanitation and hygiene is required to ensure environmental sanitation, thus, to break the cycle of disease transmission. BRAC WASH-I programme has been working in 150 upazilas (sub-districts) since 2006 to improve health status of the rural poor. This study aimed to measure indicators of environmental sanitation by economic groups (e.g. ultra poor, poor and non-poor) from baseline to end line. Thirty thousand households from 50 upazilas were selected following a multi-stage sampling design. Data were collected from households through direct interview using pre-tested questionnaire. The matched households in both surveys were included in the analysis. Chi-square and T-tests compared the differences between indicator values. Results show that change in use of tubewell water from baseline to end line among the poor and non-poor increased by 14.7% and 9.6%, while the status remained nearly same among the ultra poor (by 0.6%). The change in building concrete platform was found highest among the ultra poor (by 124.9%) compared to the poor (by 53.6%), and non-poor (by 37.2%) respectively. Cleanliness of tubewell platform increased by 183.3% in the ultra poor which was better performing group than the poor, and non-poor. Sanitary latrine use increased in all the economic groups by 159.2% in the ultra-poor, 99.6% in the poor and 53.6% in the non-poor from baseline to end line respectively. The change in latrine cleanliness was found higher among the poor (by 66%) compared to the ultra poor (by 60.1%) and non-poor (by 54%). Disposal of children feces at fixed place was found nearly twice as high among the ultra-poor than that of other economic groups. Nevertheless, the practice of disposing waste water generated from tubewell to a fixed hole decreased by 2.4% and 9.1% among the ultra-poor and non-poor, while the situation remained almost same among the poor (by 0.2%) respectively. Reported sickness decreased from baseline to end line by 83.1%, 81.6% and 80.3% among the poor, non-poor and ultra-poor respectively. Disposal of wastes (solid or liquid) needs to be in such way which resists disease transmission.