The impacts of piped water on water quality, sanitation, hygiene and health in rural households of north-western Bangladesh - a quasi-experimental analysis
Center for Development Research (ZEF), Uni-Bonn
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We investigate the impacts of piped water on water quality, sanitation, hygiene and health outcomes in marginalized rural households of north-western Bangladesh, using a quasi-experimental analysis. A government organization- the Barindra Multipurpose Development Authority (BMDA) - established a piped water network to provide improved water to these rural households, for whom potable water is scarce. Using propensity score matching, the study compares a treated and a control group of households to identify gains in the water-sanitation, hygiene and health outcomes. We find that the BMDA piped water infrastructure generates a positive impact on improved water access and reduces the distance and time for collecting drinking water significantly. However, we find no improvement of the drinking water quality, measured as the extent of faecal contamination (count of pathogen bacteria E. coli per 100 ml of water) at the point of use. The hygiene status of the food utensils is also not improved, as they were tested positive to E. coli contamination in control and treatment households a like. The clear benefit of the BMDA intervention is on the hygiene behaviour: handwashing with soap before feeding children is higher among treated households. Similarly, these households possess bigger water containers. We deduct from this that the intervention has a clear impact on the quantity of water used for household purposes. However, we do not find evidence of immediate health benefits, such as decreased prevalence of diarrhoea for under-five children, though longer term health impacts of access to piped water are observed in child anthropometrics. In particular, weight-for-age and weight-for-height z-scores of under-five children are improved. We also provide evidence that the percentage of underweighted children is reduced significantly due to piped water use.