Application of Qualitative Information System in Assessing Household Water, Sanitation and Hygiene Behaviors in Rural Bangladesh: A Cross-sectional Comparative Study

Ensuring the condition of water, and sanitation facilities is the early step to behavior change. However, mere provision of facilities does not ensure the desired behavioral change, thus health benefits. To improve health of the rural poor, the water, sanitation and hygiene (WASH) program of Bangladesh Rural Advancement Committee (BRAC) has been working in rural sub-districts since 2006. The main objective of the present study is to assess the status and quality of hygiene practice of some WASH indicators by the application of qualitative information system (QIS). This was a cross-sectional comparative study between intervention and comparison areas. A multi-stage random sampling technique was used to select study samples, where each sub-district was considered as a cluster. Total 880 households were selected randomly from 22 upazilas for data collection. Thirty-six interviewers grouped into twelve were trained intensively on data collection tools and techniques. Both observed (spot check) and self-reported data were collected using structured questionnaire to assess the status and quality of WASH practices. The scaling principles of qualitative information system (QIS) were applied to analyze data on WASH behaviors. The uniqueness of QIS method is that WASH practices are monitored and measured by collecting quantitative information on qualitative aspects. More households in intervention areas than comparison areas scored above benchmark in using arsenic free and protected drinking water source (69%. vs. 53%). There was no significant difference between the areas in terms of installing latrine within 12 steps of tubewell. Higher proportion of households in intervention areas had clean and two-pit latrines than comparison areas (61% vs. 34%). Drinking water was collected and stored safely from the safe source by 65% households in intervention areas higher than the comparison areas (65% vs. 52%). Unhygienic sanitation practices (e.g., open defecation, latrine without ring-slab, water seal) were found higher among the households in comparison areas than intervention areas (56% vs. 22%). More households in intervention than comparison areas reached at above benchmark in maintaining hygiene. However concern over unhygienic sanitation behaviors and relative distance between latrine and tubewell is required for enabling environment thus public health.