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Water, sanitation, and hygiene interventions are increasingly recognized as essential for improving nutritional outcomes in children. Emerging literature describes the negative effects of poor sanitation on child growth. However, limited evidence has shown a link between water quality and nutritional outcomes. Similar to poor sanitation, it is plausible that water contaminated with E. coli could affect the nutritional status of children through various possible biological pathways, such as repeated episodes of diarrhea, environmental enteropathy, parasites, or other mechanisms that inhibit nutrient uptake and absorption. This study explores the relationship between contaminated water and stunting prevalence among children younger than age five years, using unique cross-sectional data from the 2012-13 Bangladesh Multiple Indicator Cluster Survey, which was one of the first nationally representative surveys to include water quality testing for E. coli. E. coli contamination in drinking water is measured at household and source points. Stunting is measured using height-for-age z-scores for children under five, where a child is considered stunted when he or she is two or more standard deviations below the median of the World Health Organization reference population. The results of multiple probit regression models indicate a 6 percent increase in the prevalence of stunting in children who are exposed to highly contaminated drinking water at household point compared with those exposed to low-to-medium contamination. When contamination is measured at the source level, the association is greater, with a 9 percent increase in the likelihood of stunting when exposed to a high level of contamination.

Drinking Water --- Early Child and Children's Health --- Early Childhood Development --- Fecal Contamination --- Health --- Health and Sanitation --- Health, Nutrition and Population --- Hygiene --- Hygiene Promotion and Social Marketing --- Sanitation --- Water --- Water and Human Health --- Water Quality --- Water Resources --- Water Supply and Sanitation

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Urban slum residents often have worse health outcomes compared with other urbanites and even their rural counterparts. This suggests that slum residents do not always benefit from the "urban advantage" of enjoying better access to health-promoting services. Limited access to water and sanitation services in slums could contribute to poor health of slum residents. In Bangladesh, these services generally are not delivered through formal utilities, but rather through well-functioning informal markets that are operated by middlemen and local providers. This paper analyzes a household survey to examine living conditions and quality of access to water and sanitation services in small-, medium-, and large-sized slums across Dhaka, Bangladesh. The analysis finds that access to water and sanitation services is overall quite high, but these services are subject to important quality issues related to safety, reliability, and liability. Although water access is nearly universal, water services are often interrupted or sometimes inaccessible. Sanitation is commonly shared, with the average ratio being 16 households to one facility. When considering fecal sludge management, the study finds that only 2 percent of these households have access to the Joint Monitoring Programme's conceptualization of "safely managed sanitation." The paper also finds strong evidence that water and sanitation services are operated by middlemen at various stages of service provision such as installation, management, and payment collection. The paper provides a snapshot of the differential quality in access to these services based on the monetary welfare level of the household. The snapshot shows that access to water and sanitation services is highly correlated to per capita household consumption levels, although quality remains low overall within slums. Overall, it is likely that the informality of water and sanitation services may exacerbate social and environmental risk factors for poor health and well-being.

Communities and Human Settlements --- Engineering --- Environment --- Environmental Engineering --- Health and Sanitation --- Hydrology --- Poverty --- Sanitary Environmental Engineering --- Sanitation --- Sanitation and Sewerage --- Slums --- Small Private Water Supply Providers --- Town Water Supply and Sanitation --- Urban Governance and Management --- Urban Housing --- Urban Housing and Land Settlements --- Water --- Water and Human Health --- Water Supply and Sanitation --- Water Supply and Sanitation Economics