Investigating Nutrition-Sensitive WASH : Nurturing the 'Early Years' of Life with Water, Sanitation, and Hygiene--Evidence and Policy Levers for Bangladesh

Bangladesh made a number of laudable development achievements in the early millennium but can and should do more to improve human capital and the wellbeing of its population. Coupled with impressive achievements in poverty reduction and economic growth are meeting many of the Millennium Development Goals (MDGs)—such as reaching nearly universal access to primary education, gender parity in primary and secondary education, ensuring food security, lowering infant, child, and maternal mortality rates, improving immunization coverage, and increasing access to improved water sources. Nurturing a child’s early years can help nations boost human capital to become more diverse, competitive economies. Improving early childhood development requires multi-sectoral action. Advancements in early childhood development will not be possible without improvements in water, sanitation, and hygiene (WASH). This report will discuss several analyses that demonstrate the importance of WASH in nurturing the early years. The report begins with an examination of progress in achieving human development outcomes, many of which are specifically used to measure early childhood development and human capital. The next section will present a poverty risk model used to measure differences in WASH-related disease burden among wealth groups and populations with and without access to basic water and sanitation services. The third section discusses WASH deprivations in community health centers that reduce quality of care, and the fourth section measures the unique environmental exposures from inadequate WASH faced by slum dwellers, an often neglected yet high-risk population for poor health and undernutrition. The proceeding four sections then present original econometric analyses linking various components of WASH to childhood stunting, early childhood skills, infant mortality, and school enrollment. The final section concludes and provides recommendations on how Bangladesh’s WASH sector can prioritize the early years in future investments.