Alumni 2008-2009

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Stephanie Fisher
Country: UK
Background:
Research Project: Water quality beyond the source: an Evaluation of BRAC's WASH Programme in rural Bangladesh

Abstract: In this investigation, questionnaires and focus group discussions were used to explore the knowledge, attitudes and practices of mothers of children under five in rural Bangladesh with regard to drinking water storage and point-of-use treatment, and the barriers that prevent them from utilizing safer options. The questionnaire also examined the child’s burden of diarrhoeal disease, and associations were sought between the incidence of diarrhoea and the extent to which the above practices and other, hygiene-related practices, were performed. Furthermore, tests were performed on drinking and tubewell water to ascertain the extent of post-source contamination, and seek associations between contamination and these practices. The above was conducted in three Bangladeshi villages, two of which were part of the BRAC WASH programme, and one of which was subject to no intervention by BRAC or any other NGO, thereby enabling an evaluation of the success of the programme.

It was found that, in general, practice of good safe water management and hygiene followed knowledge, and, on occasions, occurred even in the absence of knowledge. However, where such practices incurred costs, for example in treating water and using soap, the association between knowledge and practice was less clear. While no factors proved significantly associated with post-source contamination, multinominal logistic regression revealed that the child’s consumption of unclean water inside the home, the child’s consumption of potentially unclean water or water-based products outside the home, and the mother’s use of soap, were significantly associated with the child’s incidence of diarrhoea. Comparison of the two BRAC WASH villages and the one non-intervention village, using Fisher’s exact test, revealed the presence of the intervention to be significantly associated with a better knowledge of the causes of diarrhoea and of safe water management, with many better practices, and with a lower incidence of diarrhoeal disease among the under-fives, suggesting that the intervention had indeed been successful.

However, of the three factors demonstrated to be significantly associated with the diarrhoeal incidence, only one, the child’s consumption of unclean water inside the home, was shown to be significantly associated with the presence of the intervention. This suggests that, despite the apparent success of the BRAC WASH programme, were it to modify its approach and further target the children’s consumption of potentially unclean water outside the home, and the households‟ use of soap, then it might be able to reduce the diarrhoeal incidence to a greater extent, and achieve an even greater impact among the communities in which it works.