Sustainability of a water, sanitation and hygiene education project in rural Bangladesh: a 5-year follow-up

Abstract

An integrated water supply, sanitation and hygiene (WSH) education intervention project was run by the International Centre for Diarrhoeal Disease Research, Bangladesh, over the period 1983-87. In the intervention area the project provided handpumps, pit latrines, and hygiene education to about 800 households. The control population did not receive any interventions, but had access to the usual government and private WSH facilities. After 1987 no external support was provided to maintain these provisions. A cross-sectional follow-up survey, which was carried out in 1992, involved about 500 randomly selected households from the intervention and control areas. In 1992 about 82% of the pumps were still in good functional condition and of these, 94% had been functioning well in 1987. Fewer latrines were functional in 1992 (64%) than at the end of 1987 (93%). In the former intervention area about 84% of the adults were using sanitary latrines in 1992 compared with only 7% in the control area. Knowledge related to disease transmission, however, was poor and similar in both areas. People claimed that they used the WSH facilities to improve the quality of their lives. The prevalence of diarrhoeal diseases in the 1992 survey among the control population was about twice that among those in the intervention area.

PIP: This study presents the findings of a 1992 follow-up survey to determine the behavioral and health benefits of the Mirzapur Handpump Project during 1984-92. The project was part of an integrated water supply, sanitation, and hygiene (WSH) education intervention project run by the International Center for Diarrheal Disease Research in Bangladesh. The project was implemented during 1984-87 in five villages in Mirzapur subdistrict among 880 households with 148 improved handpumps, one twin pit latrine for almost every household, and extensive hygiene education. The control area included 750 households with about 42 handpumps. Local women participated in selecting installation sites, maintaining tubewells and latrines, and collecting data. The last program repairs were made in 1987. Findings from the 1992 survey reveal that the percentage of working pumps declined from 100% to 82% during 1987-92. 75% of respondents believed that maintenance was shared by users. The remaining 25% in the intervention area and all in the control area claimed that repair was taken care of by the owners. 84% used tubewell water because of the improved quality. Use of sanitary latrines was the same over time. Use was 83% in the intervention area and only 8% in the control area. There was a decline in the percentage of proper functioning latrines from 98% in 1987 to 64% in 1993. Hygiene practices remained poor in 1993, but still higher than in the control area. Knowledge of the transmission of diarrhea was poor in 1992 and similar in control and intervention areas. Diarrheal morbidity in the previous 24 hours was significantly lower in the intervention area. Findings indicate improvement in health practices but little understanding of WSH practices and improved health. The monitoring measures were useful in determining project sustainability