PRSP Process - Bangladesh

1. PRSP Process - Bangladesh Civil society comments on the iPRSP (December 2002) Water, Sanitation and Hygiene education for all

2. An overview Water • In Bangladesh 74% of the population have access to safe drinking water (considering arsenic contamination of ground water) • Peoples who are living in informal settlements of urban areas do not have the legal right to access water from public water service providing agencies

3. Sanitation • 13.5% of rural households use sanitary latrines • Overall access including simple pit latrine is 43.4% (combined rural urban) with an increase of about 1% per annum • Sanitation coverage in metropolitan slums only 13.5%

4. Hygiene One of the main causes of water borne diseases are faecal- oral transmission. • Only 26.3% people wash their hand with soap and ashes after defecation (only 7% with soap). • Only 3% people wash their hand with soap before having a meal, feeding children and preparation of food • A large number of people use unsafe water for cooking, bathing and washing utensils

5. Lack of safe water, poor sanitation and unhygienic behaviour causes water borne diseases which includes • Diarrhoeal • Dysentery • Typhoid • Worm Infestation • Hepatitis • Scabies • Trachoma The 3 main diseases for child mortality are Pneumonia, Diarrhoeal and Dysentery

6. Impact • Every day 20,000 metric tons of human excreta are deposited on public lands and waterways. This is one of the main causes of contamination surface water • 125,000 children under five die each year from diarrhoeal disease, 342 children per day • Diarrhoeal disease causes 5.75 million disability adjusted life years – 61% of total DALYs. • 5 billion taka (us$ 80 million) is spent every year for the treatment of hygiene related diseases • Every child in Bangladesh suffers an average of three to five diarrhoeal attacks in each year, which is a major contributor to malnutrition • Women and girls suffer the most from water, sanitation and hygiene deficiencies. A lack of privacy in sanitation increases the risks of urinary tract infection, reproductive health problems and physical attack.

7. WaterAid’s participatory impact assessment, Looking Back, cites the following connections between water projects and different aspects of poverty: • Improvements in livelihoods and productive time • Minimising the costs of healthcare due to significant reduction in diarrhoeal and other water-related diseases • Reduction in infant and maternal mortality and morbidity • Improved mental health • Increased school attendance, especially for girls • Improvements in the quality of family life • Increased participation in social/community activities and observance of religious obligations • Enhanced self-esteem of individuals and communities

8. The stated iPRSP goals • Remove the ‘ugly faces’ of poverty by eradicating hunger, chronic food insecurity, and extreme destitution; • Reduce the number of people living below the poverty line by 50 percent; • Attain universal primary education for all girls and boys of primary school age; • Eliminate gender disparity in primary and secondary education; • Reduce infant and under five mortality rates by 65 percent, and eliminate gender disparity in child mortality;

9. Reduce the proportion of malnourished children under five by 50 percent and eliminate gender disparity in child malnutrition; • Reduce maternal mortality rate by 75 percent; • Ensure access of reproductive health services to all; • Reduce substantially, if not eliminate totally, social violence against the poor and the disadvantaged groups, especially violence against women and children; • Ensure comprehensive disaster risk management, environmental sustainability and mainstreaming of these concerns into the national development process.

10. Major Thrust Areas Regarding Health • urban primary health • emergency health care • major public health problems such as dengue and arsenic • broadening the net of curative health care services for the poor • enabling broad-based access to reproductive health services

11. Chapter structure of iPRSP • "what the broad lessons are from the past development experience" • "where we stand now in terms of poverty and social indicators" • "what do the voices of the citizens suggest" • "where we would like to go by the year 2015" • "how we are going to reach the social targets" • "what would be the macroeconomic framework for poverty reduction in the medium-term" • "how do we know that we are reaching our targets"

12. 5 strategic elements • accelerating pro-poor economic growth • fostering human development of the poor • women’s advancement and closing of gender gaps • social protection • participatory governance and enhancing non-material dimensions

13. Accelerating pro-poor economic growth – infrastructure development Improved and safe water supply and sanitation services will be emphasized for • Reducing health costs • Improving malnutrition • Increasing productivity of labor • Reducing time spent by women and children in water collection • More productive use of time and resources by poor households

14. How will this happen? Following the National Water Supply and Sanitation Policy 1998, a development framework will be worked out to address the issues in a comprehensive manner.

15. Millennium Development Goals Reduce under-five mortality by two-thirds Improve lives of 100 million slum dwellers Half the number of people without access to water supply and sanitation Eradicate extreme poverty and hunger

16. WSSD Plan of Implementation Key Points • Halve by 2015 proportion of people unable to reach or to afford safe drinking water…and the proportion of people who do not have access to basic sanitation. • By 2020, achieve significant improvement in the lives of at least 100 million slum dwellers • Launch programme of actions, with financial and technical assistance, to achieve the MDG on safe drinking water, and halve by 2015 the proportion of people without access to basic sanitation

17. WSS and PRSP What do we, as sector actors, want to incorporate about water, sanitation and hygiene in the full PRSP? As sector actors, where do we want to see safe WSSanHy in the full PRSP, what section, chapter, approaches? As sector actors do we want to add a separate goal in the full PRSP about safe WSSanHyP, and if so, what would that stated goal be?