In Bangladesh, changing behaviors for better health


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A toilet in Chunarughat, Hobigonj reduces fecal contamination for this family (World Bank/M. Monir)
A toilet in Chunarughat in the Habiganj district in Bangladesh has helped reduce fecal contamination for Amena Begum and her family. Credit: World Bank/M. Monir

Amena Begum resides in a village in the Habiganj district in Bangladesh and is a mother to three young children.  Last year Amena spent US$100 to construct a toilet to ensure her three children were hygienically protected from feces.
Even though her family members have adapted to using the toilet, exposure to fecal contamination can occur anywhere.  For example, while playing outside, a child may accidentally ingest soil with animal feces, or the child could be exposed when he or she eats food off of dishes washed with pond water.  
It is also not uncommon for families without toilets to throw feces into a nearby bush, which remains exposed in their living area. These actions can lead to the contraction of hazardous, lethal diseases and create a traumatizing effect on the lives of many children, not to mention the unfavorable impact on the environment.
A new study on early childhood diarrhea in rural Bangladesh found that despite high on-site latrine access, frequent fecal contamination was present along all environmental pathways investigated. Human fecal markers on children’s hands and in soil, and rotavirus in stored water, soil and on hands had been detected. Animal (particularly ruminant) fecal markers were highly prevalent in water, soil and on hands.

Changing behaviors will help improve child health and development

The study observed that reducing open defecation helped contribute to low overall levels of human fecal contamination. To further preventing fecal exposure among children under 5 years, additional program interventions beyond promoting toilet use are recommended to minimize exposure to both human and animal fecal contamination. 

The study suggests that changing household behaviors will complement access and use of improved latrines in rural Bangladesh, especially:

  • Safe management of child feces, including hardware (e.g. potties) that prevents child feces from touching the ground
  • Handwashing with soap, including enabling products (e.g. handwashing stations to keep soap and water conveniently located)
  • Use of chlorine tablets and safe storage containers for treating and hygienically storing household drinking water
  • Use of improved water sources (or chlorinated water) for cleansing utensils, dishes, and produce
  • Discouraging children from intentionally or accidentally eating soil
If Amena had not constructed a toilet, her son could have suffered from bacterial diarrhea more often and could have even died. All family members should be aware of these viral diseases and keep their children safe by making sure they wash their hands properly with soap, use the toilet and especially do not defecate in the open or eat soil. Unhygienic practices can be prevented if villagers are provided thorough knowledge and take the necessary precautions for a better, healthier lifestyle.


Rokeya Ahmed

Water and Sanitation Specialist

Join the Conversation

MJ Alam
January 10, 2017

If you would get real world picture you may suggest more sharply, we shouldn't draw any picture comparing to East-Europe or Latin American Countries in all the way, we need to build our trust first, we need to be more transparent, and many many thanks .. for your suggestion about the behavioral change. Problems are those when we don't get the real information, without correct information how would you measure what tablet or capsule you should use. Thank you :-)

MJ Alam
January 10, 2017

we need to develop our trust, we need proper solution, more sharp real world practical suggestion for the development of health and business growth, improper answer / suggestion for personal benefits and interest doesn't bring any appropriate solution, what you want to push into our developing mind.

Vandana Mehra
January 11, 2017

Nice blog Rokeya! When conducting research in Uttar Pradesh: when questioned on the reasons for continuing with Open Defecation, lack of money and space figure more commonly than ‘habit’, which displays the presence of a positive disposition to ‘wanting a toilet’ if the structural barriers are met. This is further reinforced by the insights on ‘competing priorities’ where it figured in the top 3 for women and in the top 6 for men. "Awareness" -- specially on issues around child feces -- does not translate into action or changed behaviors. Lots of gaps still exist between awareness and action!

Zahid Hossain Khan
January 17, 2017

Dear Colleagues,
Greetings from Grameen Development Society (GDS) in Bangladesh.
We have the honor to you that Grameen Development Society (GDS) is a non Government Voluntary human development Organization. This Organization has been conducting various socio-economic development activities such as Water  Supply & sanitation, Environment & Climate Change, Education, Health, awareness, legal aid, and protection to the persecuted women and children are worth mentioning.
As such if we get enlistment enrollment from you we will be able to speed up and extend and development our effort.
Under the circumstances we pray and hope that you would be kind enough to enlist enrollment our organization as member and oblige thereby.
Thanks & regards,
Mr.Zahid Hossain Khan
Executive Director
GDS - Grameen Development Society
"Khan Villa"
West Kawnia, Jail Bagan
Barisal- 8200, BANGLADESH

Ahsanul Kabir
January 18, 2017

Honorable Rokeya Apa , studied the write up ; Very interesting and helpful for Sanitation and HP intervention. Wishing , we will have more precious writing on up coming days ...Ahsan , M&E Specialist , BRWSSP , DPHE