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Groundwater currently provides 98 percent of all the drinking water supply in Bangladesh. Groundwater is found throughout Bangladesh but its quality (that is, arsenic and salinity contamination) and quantity (that is, water storage depletion) vary across hydrological environments, posing unique challenges to certain geographical areas and population groups. Yet, no national-scale, multi-hazard groundwater risk maps currently exist enabling water resource managers and policy makers to identify areas that are vulnerable to public health. This paper develops, for the first time, groundwater risk maps at the national scale for Bangladesh that combine information on arsenic, salinity, and water storage, using geospatial techniques, linking hydrological indicators for water quality and quantity to construct risk maps. A range of socioeconomic variables, including access to drinking and irrigation water supplies and social vulnerability (that is, poverty), are overlaid on these risk maps to estimate exposures. The multi-hazard groundwater risk maps show that a considerable proportion of land area (5 to 24 percent under extremely high to high risks) in Bangladesh is currently under combined risk of arsenic and salinity contamination, and groundwater storage depletion. As few as 6.5 million (2.2 million poor) to 24.4 million (8.6 million poor) people are exposed to a combined risk of high arsenic, salinity, and groundwater storage depletion. The multi-hazard groundwater risk maps reveal areas and exposure of population groups to water risks posed by arsenic and salinity contamination and depletion of water storage.

Drinking Water --- Groundwater --- Public Health --- Salinity --- SDGs --- Sustainable Development Goals --- Water and Human Health --- Water Contamination --- Water Resources --- Water Supply --- Water Supply and Sanitation --- Water Supply and Sanitation Economics --- Water Treatment and Quality

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The fallout of nitrogen pollution is considered one of the largest global externalities facing the world, impacting air, water, soil, and human health. This paper combines data from the Demographic and Health Survey data set across India, Vietnam, and 33 African countries to analyze the causal links between pollution exposure experienced during the very earliest stages of life and later-life health. The results show that pollution exposure experienced in the critical years of development-from birth until age three-is associated with decreased height as an adult, a well-known indicator of overall health and productivity, and is robust to several statistical checks. Because adult height is related to education, labor productivity, and income, this also implies a loss of earning potential. The analysis begins within an assessment in India, where the data are more available, and is then extended to geographic settings including Vietnam and 33 countries in Africa. The results are consistent and show that early-life exposure to nitrogen pollution in water can lower height-for-age scores during childhood in Vietnam and during infancy in Africa. These findings add to the evidence on the enduring consequences of water pollution and identify a critical area for policy intervention.

Demographic and Health Survey --- Drinking Water --- Environment --- Health --- Human Capital --- Hydrology --- Nitrogen Pollution --- Pollution Management and Control --- Stages Of Life --- Stunting --- Water and Human Health --- Water Pollution --- Water Resources --- Water Resources Management

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In this paper, the impact of salinity on maternal and child health in Bangladesh is analyzed using data from the Bangladesh Demographic Health Surveys. A U-shaped association between drinking water salinity and infant and neonatal mortality is found, suggesting higher mortality when salinity is very low or high. With fresh drinking water, the marginal effect of salinity measured by groundwater electricity conductivity on infant death is always negative. With brackish drinking water and slightly saline water, the negative effect is small. As drinking water becomes moderately saline, the predicted probability of infant death starts to increase, and the marginal effect becomes and remains positive. The relationship between drinking water salinity and neonatal death shows a similar pattern. Finally, freshwater with very low concentration of healthy minerals and severely saline water with very high detrimental sodium can be harmful for infant and neonatal health during pregnancy. Severe salinity needs to be addressed if the recent gains in infant and neonatal mortality are to be sustained, especially in the coastal areas of Bangladesh.

Drinking Water --- Early Child and Children's Health --- Health --- Health and Sanitation --- Health, Nutrition and Population --- Infant Mortality --- Maternal Health --- Reproductive Health --- Salinity --- Water and Human Health --- Water Quality --- Water Resources

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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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This paper proposes a framework that examines three levels of access to infrastructure-nominal, effective, and quality-adjusted access. Most conventional indicators measure nominal access-whether a household has physical access to a service in or near the house. By contrast, effective access incorporates functionality and use of service, and quality-adjusted access raises the bar by incorporating quality metrics. The paper illustrates the analytical utility of this conceptual framework by deploying data from a survey of 14,200 households in 15 Kenyan cities in 2012-13.First, the analysis finds that these cities fall far short of delivering universal access to basic infrastructure. Second, for most services there a large gap-3 to 41 percentage points-between nominal and effective access. When the bar is raised to include quality of service, the drop-off in the proportion of those with access is even more dramatic. These findings suggest that conventional nominal measures overreport the level of service in urban communities, and that current approaches to infrastructure delivery might be enhancing availability of a service without ensuring that the service is usable-that is, functional, reliable and affordable. Third, there is an infrastructure access gap between nonpoor and poor households, as well as formal and informal settlements. Fourth, hedonic regression analysis reveals that four services-electricity, water, toilets, and garbage collection-are associated with higher rents. The analysis has broader implications for understanding and measuring service access. It raises important questions as global discussions turn to indicators for the Sustainable Development Goals.

Energy --- Energy Policies and Economics --- Engineering --- Environmental Engineering --- Hydrology --- Inequality --- Poverty Reduction --- Sanitary Environmental Engineering --- Sanitation and Sewerage --- Small Private Water Supply Providers --- Town Water Supply and Sanitation --- Urban Transport --- Water and Human Health --- Water Resources --- Water Supply and Sanitation Economics