Glob Health Action. 2026 Dec 31;19(1):2611646. doi: 10.1080/16549716.2025.2611646. Epub 2026 Feb 2.
ABSTRACT
BACKGROUND: Bangladesh faces substantial inequalities in water, sanitation, and hygiene (WASH), with disparities across sociodemographic groups and between urban and rural populations. Evidence on temporal changes in household WASH access and its determinants remains limited.
OBJECTIVE: To assess changes in household WASH and examine the influence of sociodemographic factors on access, using data from two national hygiene surveys at national and urban-rural levels.
METHODS: In this repeated cross-sectional study, differences in WASH outcomes between the 2014 National Hygiene Baseline Survey and the 2018 National Hygiene Survey were assessed using prevalence differences (PD), and associations with sociodemographic factors were examined using generalized estimating equations (GEE).
RESULTS: From 2014 to 2018, rural households maintained near-universal basic drinking water, while urban households showed a slight decline. Basic sanitation increased substantially in rural areas (PD = 27.8), driving national gains (PD = 25); urban changes were nonsignificant. Basic hygiene improved minimally across all levels. Higher socio-economic status was linked to better WASH outcomes, while larger households had poorer status. Rental housing was associated with unimproved drinking water (Coef.: 1.9) and lower basic sanitation (Coef.: -0.9) but better overall hygiene than self-owned homes. Urban households had lower access to basic drinking water and sanitation, yet better basic hygiene facilities than rural households.
CONCLUSION: Household WASH improved substantially, especially in rural sanitation and hygiene, while urban areas showed stagnation. Socio-economic status, household size, and housing tenure are key determinants, highlighting the need for targeted interventions to ensure equitable, universal WASH coverage.
PMID:41623016 | DOI:10.1080/16549716.2025.2611646
