Bangladesh WASH sector: large-scale impact assessment

The Sanitation, Hygiene Education and Water Supply in Bangladesh (SHEWA-B) programme was launched by UNICEF in 2007 with a primary focus on sanitation and hygiene promotion. It is one of the largest WASH programmes ever attempted in a developing country, and reached a target population of 21.4 million people by the end of 2013. Progress is assessed using a three-pronged monitoring system that incorporates external (third-party) process monitoring, participatory community-based monitoring, and a comprehensive health impact study to gauge how programme outputs are influencing hygiene behaviour change and the incidence of diarrhoea and acute respiratory infection in children under five. This paper describes the methodology and scope of the health impact study, presents preliminary results, and discusses the importance of impact studies in refining programme strategies and contribution to the global WASH evidence base.