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Towards a cleaner Bangladesh: Safe water, sanitation, and hygiene for all

Qimiao Fan's picture
 
 The World Bank
Bangladesh has made progress in recent years in the field known as WASH -water, sanitation access, and hygiene. Image courtesy: The World Bank

Community-Led Total Sanitation might be the greatest Bangladeshi export you’ve never heard of.  In countries across Asia, Africa and Latin America, a consensus has emerged that the best approach is Community-Led Total Sanitation, which is widely credited with changing people’s behavior around the world to no longer defecate in the open, which has greatly improved global health.

Bangladeshis can take plenty of pride in these far-away accomplishments. That’s because it is Northern Bangladesh - more specifically the Mosmoil village in Rajshahi district - that pioneered this approach seventeen years ago. Its success at home led to its widespread adoption abroad.

Safe drinking water is a right and proper sanitation is dignity of the citizens. Proper management of freshwater ecosystems and access to safe water and sanitation are essential to human health, environmental sustainability and economic prosperity. Water and sanitation are at the core of sustainable development critical to the survival of people and the planet. Goal 6 of Agenda 2030 not only addresses the issues relating to drinking water, sanitation and hygiene, but also the quality and sustainability of water resources worldwide.

The ‘Global Water Supply and Sanitation Assessment’ by World Health Organization (WHO), United Nations Children Fund (UNICEF), Water Supply and Sanitation Collaborative Council (WSSCC) reported that in 2012 about 40% (2.6 billion) of the world’s population was without access to safe water. Approximately 4 billion cases of diarrhea each year causes 2.2 million deaths, and majority of them are children under the age of five. This situation in Bangladesh is also challenging. A study by Water and Sanitation Program (WSP) wing of the World Bank reveals that Bangladesh incurred a loss of Tk295.48 billion in 2010 due to inadequate sanitation, which is 6.3% of the GDP.
 
Indeed, there is much to emulate in Bangladesh’s remarkable progress in recent years in the field known as WASH -water, sanitation access, and hygiene. Today, 98 percent of the population gets drinking water from a technologically improved source – water which comes from a manmade structure– up from 79 percent in 1990.  Bangladesh also largely succeeded in providing access to basic sanitation. It is estimated that only three percent of the population practice open defecation, down from 34 percent in 1990, thanks to behavior change campaigns and the building of many new toilets. 

But, much has yet to be done. Bangladesh has still a long way to go to meet the Sustainable Development Goal (SDG) of providing universal access to clean water and sustainable sanitation by 2030. The World Bank recently completed a study, the WASH Poverty Diagnostic, which examines the remaining challenges in ensuring access to safe water, sanitation, and hygiene. The findings are startling.

Africa Hydromet Forum: Improving climate and weather forecasting to build disaster resilience

Ede Ijjasz-Vasquez's picture

Photo: JC McIlwaine / UN Photo

There is no doubt that extreme weather events are increasing in frequency and severity. In Africa alone, 90% of all disasters in recent decades have been driven by weather and climate. While we cannot stop them from striking, we can tell people about them, managing the risk that they present – by advancing our work in hydromet.

Hydromet is the union of hydrology and meteorology, combining water, weather, and climate studies as a formidable force in a government’s ability to accurately understand, forecast, and communicate storms and hazards. This means that something as simple as an accurate weather forecast, or the monitoring of river levels could make the difference between a farmer losing his/her entire crop or a fisherman knowing when best to head out to sea.  

Because of the lack of high-quality hydromet services, countries suffer GDP losses every year from flooding, cyclones, and other storms. Madagascar and Nigeria, for example, each lost more than 1 percent of GDP in a single year from storms.

However, instead of looking at potential future damages, we must look at how hydromet services can help cities and communities flourish with greater resilience today:

Starting life strong in slums: the role of engaging vulnerable groups on sanitation and nutrition

Claire Chase's picture
This blog is co-authored with Lawrence Haddad, Executive Director, The Global Alliance for Improved Nutrition (GAIN)

Other co-authors: 
Beatrice Montesi, GAIN  
Martin P. Gambrill, The World Bank 
Rebecca Jean Gilsdorf, The World Bank

 
Children in a slum in Dhaka, Bangladesh.
Credit: UN Photo/Kibae Park

Crowded slums, poor sanitation and unhealthy diets.  It’s a potent cocktail and for too many families across the world, a daily reality.  Right now, an estimated one billion people live in slums and that number is expected to double by 2030. Slums are where the many deprivations facing the urban poor collide, including lack of access to clean drinking water, sanitation, safe and nutritious foods, sufficient living space, durable housing and secure tenure (UN Habitat).  They’re where human waste is routinely emptied into streets, canals, and garbage dumps. And where overcrowding and low rates of immunization and breastfeeding combine to exacerbate the already perilous problems children face.

Children growing up in these surroundings are at a higher risk of death and disease and are more likely to be chronically malnourished (Ezeh et al. 2017). For example, forthcoming World Bank research from Bangladesh shows that children living in slums are 50 percent more likely to be stunted than children living in other urban areas. This doesn’t just have implications for today - children who are stunted early in life go on to learn and earn less, and face a higher risk of chronic disease as they grow older. Tragically, these effects are often passed on to offspring, trapping families in poverty and malnutrition for generations, as per findings in a forthcoming World Bank report called Uncharted Waters.

Starting a marathon with a broken ankle: how poor water and sanitation sets children behind

Maximilian Leo Hirn's picture
Children in Koutoukalé, Niger

Have you ever wondered how your life chances are affected by where you were born? Odds of being born at all are already miraculously small, but only one in ten of us is born into the relative security of a high-income country. What if you are born in Niger or in the Democratic Republic of the Congo (DRC)? Before you could even walk or talk, your challenges would be daunting. That's because, despite progress, deaths of children under five years old are more than twenty times higher than in the EU and nearly ten times higher than in China.

Even if you survived, you would confront another major risk to your development: malnutrition. In Niger and DRC, almost one out of every two children is stunted. Stunting has significant and long-lasting negative effects on early childhood development, impeding physiological and mental development, and making small children more vulnerable to disease. Starting off in life stunted is akin to starting a marathon with a broken ankle.

Gender equality hits the highway in Northern Brazil

Satoshi Ogita's picture


Young women, some still girls, await long-haul truck drivers that stop by a gas station in the State of Tocantins, located in the North region of Brazil. Here, impoverished women and girls look to get extra cash in exchange for sex, a phenomenon seen on a daily basis in small towns along the federal highway BR-153. The high dropout rate of girls and gender-based violence are commonplace there. While better road infrastructure brings more economic opportunities to the region, higher road traffic and activity can also increase social risks like gender-based violence.   
 
A World Bank’s multisectoral project in Tocantins seeks to improve efficiency of road transport, in particular, state and rural road network, and to support institutional strengthening in the following five sectors: public administration, agriculture, tourism, environment, and education. While the project does not include any roadwork specifically on the highway BR-153, it aims at reducing existing risk of gender-based violence along the highway as part of the education component of the project.  
 
Schools play an important role in building respectful relations between girls and boys, challenging gender-based stereotypes and combatting discrimination that contributes to violence against women and girls. Accordingly, based on the level of the dropout rate and violence statistics, six high schools along BR-153 were selected to host a pilot initiative to improve awareness of gender-based violence and in the area.

Engaging communities in the Golden 1,000 Days in Nepal

Kaori Oshima's picture
Field survey team in Nepal
A field survey team for the qualitative study holding a focus group discussion with women in one of the SHD project communities. Photo credit: World Bank

In Nepali, “Sunaula Hazar Din” means, “Golden 1000 Days” – which is a critical window of opportunity between conception and the age of two years that, with good health and nutrition, can mitigate the risks of malnutrition that hamper a child’s long-term physical and cognitive development.

Sunaula Hazar Din (SHD) is also the local nickname of the Government of Nepal’s recently completed “Community Action for Nutrition Project”, implemented by the Ministry of Federal Affairs and Local Development and  financially supported by the World Bank from 2012 to 2017. The project aimed to improve practices that contribute to reduced under-nutrition of women of reproductive age and children under the age of two and to provide emergency nutrition and sanitation response to vulnerable populations in earthquake affected areas.

The project used a “Rapid Results Approach (RRA)”, where target communities formed groups of nine members that would collectively select and work on an activity to address malnutrition for 100 days. RRA focused especially on the “1000 days” households– namely, households with children under 2 years and pregnant and/or lactating women and also had community -wide interventions targeted to address malnutrition.  

To better understand the local dynamics around the SHD design and activities, a qualitative study was conducted, with support from the South Asia Food and Nutrition Security Initiative (SAFANSI).

The study team gathered the voices of various stakeholders, including the community members, facilitators, and the village and district-level authorities. Listening to the voices of these stakeholders makes development practitioners and project teams recognize how participatory designs may work as expected – or not – in a specific context.

The economic impact of the Syrian conflict: Estimate it yourself

Shanta Devarajan's picture
Homs, Syria - ART Production | Shutterstock.com

Everyone agrees that conflicts impose huge costs on economies, including massive destruction of infrastructure and housing, disruption of trade, transport and production, not to mention the loss of lives and widespread human suffering. Yet quantitative estimates of these costs are hard to come by.     

Beyond nutrition, investing in livestock can also deliver on health

Franck Berthe's picture
Scenes from Al Nnuhoud Livestock Market, North Kordofan where livestock is brought
and traded from places nearby.
Photo: Salahaldeen Nadir / World Bank



When the United Nations negotiators recently met in New York to track progress on the Sustainable Development Goals (SDGSs), a number of side events to the High-Level Political Forum were organized to emphasize the crucial role of agriculture. I attended a couple of these events and took the opportunity to illustrate why investments in livestock will pay dividends for sustainable development, and more particularly for health. 

Karnataka Becomes India’s First State to Safely Dispose Biomedical Waste at all Public Health Facilities

Suresh Mohammed's picture

What happens when infected needles, syringes, plasters, surgical gloves and intravenous sets are disposed of carelessly? Well, for a start, they spread hepatitis and HIV, not only among the poor rag-pickers who unsuspectingly handle them, but also infect all the waste around, multiplying the hazard manifold.  Then, when the waste is not properly incinerated, it causes further damage, polluting the very air we breathe. Liquids wastes are particularly harmful; they can leach into the soil and contaminate the water supply, with often devastating consequences.

Yet it is heartening to see how a few dedicated individuals can make a difference.
 

Nurses using needle cutter to destroy used syringes

Providing better healthcare in Afghanistan – A view from the field

Fahimuddin Fahim's picture


Although I have extensive project management experience in Daykundi Province, the scale and impact of the System Enhancement for Health Action in Transition (SEHAT) Program is truly inspiring—for example, the 39 centers that deliver the Basic Package of Health Services (BPHS) together serve over 77,000 outpatients per month. In October 2016, these centers managed the delivery of 615 babies, with as many as 69 deliveries in Temran Basic Health Center alone.
 
In fact, when it comes to female health, SEHAT has ensured that there is at least one female staff member in every health center. This has partly been possible because of the successful implementation of community-level education programs, such as the Community Midwifery Education (CME) and Community Health Nursing Education (CHNE). The program has also strengthened community-based health care by setting up health Shuras (councils) in all locations covered by SEHAT and implemented specific controls on qualifications and credentials of health workers.
 
SEHAT is a program of the Ministry of Public Health (MoPH), supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors. An NGO, PU-AMI, was contracted by MoPH between 2013 and June 2017 to deliver BPHS in Daykundi, in line with national health goals outlined by the ministry. These goals include reducing mother and child deaths and improving child health and nutrition. Thus, the program focuses on increasing access, building capacity, strengthening coordination, promoting use of monitoring and evaluation data, and enabling better support for pharmaceutical supplies.


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