Sanitation coverage in Bangladesh since the millennium: consistency matters

Abstract

Household surveys in Bangladesh between 1994 and 2009 assessed sanitation access using questions that differed significantly over time, resulting in apparently inconsistent findings. Applying the WHO and UNICEF Joint Monitoring Programme's 2008 definition for open defecation and improved sanitation facilities excluding shared facilities to the compiled data set, sensible sanitation coverage trends emerge. The percentage of households openly defecating declined at a rate of about 1.8% per year from 30% in 1994 to 6.8% in 2009, primarily due to changes in rural areas. Access to individual improved sanitation facilities nearly doubled from about 30% in 2006 to 57% in 2009, with both rural and urban areas showing impressive progress. Access to shared improved latrines also nearly doubled from about 13% in 2006 to 24% in 2009, with the urban slums recording the greatest gain from 17% in 2006 to 65% in 2009. Shared improved latrines are only slightly less clean than individual ones. Dependence on shared improved latrines increases with population density. In 2007, 20% of the poorest households still openly defecated, although more of them (38%) shared a latrine of any type. A poverty reduction program is recommended to address this equity issue, although applying consistent definitions is crucial to documenting progress.