Congress Resources: Papers, posters and presentations

< Return to abstract list

The Role Of Agriculture, Water, Sanitation, Hygiene (ag-watsan) Nexus On Health: Synergies And Trade-offs In Rural Bangladesh

Congress: 2015
Author(s): Mohammad Monirul Hasan (Bonn, Germany)

Keyword(s): Sub-theme 13: Non-conventional sources of water,
Abstract Introduction There are handful of studies that focused on water, sanitation and hygiene separately but none of the studies has focused on integrated investment on these three which could be more cost or outcome effective than the isolated approaches and the link to agriculture of these three is even more scant in literature (Tsegai, Mcbain, & Tischbein, 2013). Investment in water and sanitation could be economically justified on the basis of time saving alone (Churchill, 1987). Although it is not esoteric to understand that WATSAN are upstream interventions, likely to have broad impact on wellbeing and health (Hunter, MacDonald, & Carter, 2010; Mara, Lane, Scott, & Trouba, 2010), little research has been carried out on causal pathways through which WATSAN may impact health (Schmidt, 2014). The linkage of agriculture with WATSAN is less discussed and almost absent in the economic literature. To explore the relationships among agriculture (AG) and WATSAN, it is necessary to identify the synergies and trade-off as well as the threshold levels that could affect human health outcomes. It is also important to know the investment behavior of the rural households in maintaining a multipurpose system of AG-WATSAN which could benefit them in the agricultural production as well as the maintaining good health. The missing linkages in AG-WATSAN nexus is commendable to explore for contributing in the economic literature.

Irrigated agriculture being contaminated by problematic WSH situation affect human health through crops as well as domestic water use from open irrigation canals, traditional furrow and open drainage ditches (Tsegai et al., 2013). The issue of water, sanitation and hygiene (WSH) and irrigated agriculture might compete for quality water resource because of the increasing demand (increased population, increased income and change of nutrition behavior towards more water demanding food items), supply of quality water resources and increasing threat of climate change (Tsegai et al., 2013). It is well established that safe hygiene is the single most cost-effective means of preventing infectious disease but the investment in hygiene is low both in health and water-sanitation sector (Val Curtis et al., 2011). Hence irrigation has some direct and indirect linkages to human health and nutrition which is less discussed topic in the literature. Hygiene behavior is associated with socio-economic factors such as income, wealth, education, age, social norms, beliefs and modern life-style attitude all of which are associated with risk of infectious diseases (Valerie Curtis et al., 1995).

Methods Sample: To find out the linkage among the domain of AG-WATSAN, the baseline data of Bangladesh Integrated Household Survey (BIHS) 2011-12 from IFPRI is used which is addressed as (Ahmed, 2013). BIHS baseline survey is a nationally representative survey. Health outcome is measured in terms of diarrhoea prevalence of under 5 children.

Economic framework (Reduced form equation) It is useful to begin with simple household production model where value of health production was brilliantly introduced (Becker, 1965). Following the conventional one-person farm household framework (Barnum & Squire, 1979) by incorporating health production, non-separable determination of production, consumption and health decision and multiple household members, household utility function can be written as from (Pitt & Rosenzweig, 1985; Strauss & Thomas, 2008), the reduced form demand equations for food and health. As the outcome variables are binary in nature, we have used logistic regression model for the analysis.

Result and Discussion: According to the BIHS (2011-12) data, 75% households have access to improved sanitation, 85% have access to improved drinking water and 65.7% have access to improved water for general use. Irrigating households represents the agricultural households and we will analyse agricultural household on the basis of farm size and irrigation status. Irrigating households have more access to improved water and improved sanitation than the non-irrigating households. The same trend is true for the farm size and the per-capita expenditure of the household. Farming households have more access to WATSAN. Again, irrigating households' children have more diarrhoea prevalence than the non-irrigating households. For the child anthropometric, the score is better as water and sanitation status improves. The worst anthropometric is higher for bad water and sanitation condition. In the regression analysis, we have found that improved sanitation, improved drinking water, cultivatable land, household education etc. are negatively associated with the bad anthropometrics scores of the under five children. On the other hand irrigating households and size of the household have positive association with the bad anthropometrics.

Conclusion There is a strong association among agriculture-water-sanitation and hygiene. The dilemma of water-sanitation is not complete without the role of hygiene and the economics of the hygiene practices in the households is needed to be explored as it causes a major health problems in Bangladesh. Agricultural households have more assets and activities but they don't maintain good hygiene practices. Most of the cases they don't do and in some cases they are ignorant about this issues. So the present paper focuses on the synergies and trade-offs of this important domains where agriculture-water-sanitation-hygiene and health are needed to be seen in a same framework of analysis. 1. Ahmed, A. (2013). Bangladesh Integrated Household Survey (BIHS) 2011-2012 (Dataset). Washington, D.C.

2. Barnum, H. N., & Squire, L. (1979). An econometric application of the theory of the farm-household. Journal of Development Economics. doi:10.1016/0304-3878(79)90037-3

3. Becker, G. (1965). A Theory of the Allocation of Time. The Economic Journal, 75, 493–517. doi:10.2307/2228949

4. Churchill, A. A. (1987). Rural water supply and sanitation: time for a change. Curtis, V., Kanki, B., Mertens, T., Traoré, E., Diallo, I., Tall, F., & Cousens, S. (1995). Potties, pits and pipes: explaining hygiene behaviour in Burkina Faso. Social Science & Medicine (1982), 41(3), 383–93. Retrieved from

5. Curtis, V., Schmidt, W., Luby, S., Florez, R., Touré, O., & Biran, A. (2011). Hygiene: new hopes, new horizons. The Lancet Infectious Diseases, 11(4), 312–21. doi:10.1016/S1473-3099(10)70224-3

6. Hunter, P. R., MacDonald, A. M., & Carter, R. C. (2010). Water Supply and Health. PLoS Medicine, 7. doi:10.1371/journal.pmed.1000361

7. Mara, D., Lane, J., Scott, B., & Trouba, D. (2010). Sanitation and health. PLoS Medicine, 7. doi:10.1371/journal.pmed.1000363

8. Pitt, M. M., & Rosenzweig, M. R. (1985). Health and nutrition consumption across and within farm households. The Review of Economics and Statistics, 67(2), 212–223.

9. Schmidt, W.-P. (2014). The elusive effect of water and sanitation on the global burden of disease. Tropical Medicine & International Health : TM & IH, 00(00), 1–6. doi:10.1111/tmi.12286

10. Strauss, J., & Thomas, D. (2008). Health over the life course. In Handbook of Development Economics (Volume 4., Vol. 4). Elsevier B.V. doi:10.1016/S1573-4471(07)04054-5

11. Tsegai, D., Mcbain, F., & Tischbein, B. (2013). Water, sanitation and hygiene: The missing link with agriculture (No. 107). Bonn. doi:ISSN 1864-6638

2011 IWRA - International Water Resources Association - - Admin