Research Article iMedPub Journals British Journal of Research 2020 www.imedpub.com Vol.7 No.2:55 ISSN 2394-3718 DOI: 10.36648/2394-3718.7.2.55 Assessment of Knowledge, Attitude, and Practice of WASH and Nutrition in Emergencies: A Study on a Haor Area of Bangladesh Affected by Floods Md Azizul Haque* and Sourabh Chakraborty Jodhpur School of Public Health, Maulana Azad University, Jodhpur, Rajasthan, India *Corresponding author: Haque MA, Ph.D. Scholar, School of Public Health, Maulana Azad University, Jodhpur Rajasthan, India, E-mail: [email protected] Received Date: April 24, 2020; Accepted Date: May 02, 2020; Published Date: May 08, 2020 Citation: Haque MA, Chakraborty S (2020) Assessment of Knowledge, Attitude, and Practice of WASH and Nutrition in Emergencies: A Study on a Haor Area of Bangladesh Affected by Floods. Br J Res Vol.7 No.2:55. Keywords: Knowledge; Attitude; Practice; WASH; Abstract Nutrition; Emergencies; Haor area; Bangladesh; Flood Background: Haor is a bowl-shaped large tectonic depression. It receives surface runoff water by rivers and Introduction canals, and consequently, a Haor becomes a very The World Health Organization [1] estimates that more than extensive water body in the monsoon and dries up mostly in the post-monsoon period. The Haors are considered one billion people are without access to safe and adequate the most productive wetland resources of Bangladesh. drinking water sources. Annually a significant number of illnesses and deaths as a result of waterborne diseases are Objective: The objective of the study was to assess the reported. Diarrhea-related illnesses alone are estimated to Knowledge, Attitude, And Practice (KAP) of WASH and cause two to three million deaths per year; the majority of nutrition in the emergency because of floods in the Haor which are children [2]. Countries and development partners area of Bangladesh. have been working incessantly to ensure access to safe water and sanitation services to people of all socio-economic Methodology: This is a cross-sectional survey of 252 statuses. Being a disaster-prone country, Bangladesh has a households using face-to-face interviews. long history of both natural and human-made disasters and emergencies [3]. Especially, the country is widely known for Result: The found male were 177 (70.2%), Age groups the natural disasters it faces due to its geophysical position [4]. (31-40) 77 (30.6%), marital status married 238 (94.4%), Most of Bangladesh lies in the largest delta in the world, the Occupation farmer 155 (61.5%), Education illiterate 188 Bengal Basin, formed by the Ganges, Brahmaputra, and (74.6%). Most of the respondents (92.1 %, n=232) in the Meghna (GBM) river system. The total area of wetlands in study area get their drinking water from the deep tube Bangladesh is estimated to be 7-8 million hectares or about well. The majority of the respondents (65.5 %, n=165) do 50% of its total land surface [5]. This includes 5.4 million not treat their drinking water. Almost all (98.9%, n=86) the hectares of open and closed lakes on floodplains that are households that treat their drinking water store it in jars. inundated every year [6]. Wetlands are defined as low-lying Only 1 (1.1%) household was found to store the treated ecosystems where the groundwater table is always at or near drinking water in the pitcher. None of the respondents the surface that also include areas of marsh, fen, bog, (100%, n=252) knew how to prepare oral rehydration floodplain, and shallow coastal areas [7]. The vast coverage of solution. Most of the households (95.2%, n=240) had latrines, whereas 12 households (4.8%) had none. 222 wetlands has both advantages and disadvantages. Wetlands respondents (92.5%) reported that all the members use provide a wide range of economic, social, and ecological the latrines. In 14 households (5.8%), the latrine is used benefits [8]. From the perspective of a developing country, only by a person with a physical challenge. In 4 cases wetlands are an important source of commercial fishing, (1.7%), we found only adult men and women being the agriculture, seasonal livestock grazing, wood collection, and users of the latrine. All the respondents (100%, n=222) ecotourism. However, owing to its physical and hydrological reported that they use the latrine regularly. features, human settlements in and around the wetlands became the hard-to-reach places, and consequently, the least Conclusion: Despite the success in the water and developed areas in the country. Among the identified hard-to- sanitation sector as a result of continuous effort, hard-to- reach places [9], Haor is one of the most important ones reach marginal areas of the countries are still lacking because of its importance both in terms of economic adequate facilities and provision of such supports. productivity and biodiversity. The basin supports a large variety of wetland biodiversity and works as a natural reservoir. A total of 373 haors cover a total of 858,450 hectares © Copyright iMedPub | This article is available from: http://www.imedpub.com/ 1 British Journal of Research 2020 ISSN 2394-3718 Vol.7 No.2:55 of land [10]. Unfortunately, natural disasters (especially maintained. Before taking any photograph or audio, written monsoon floods and flash floods) frequently make permission was taken from the participants. We adhered to all emergencies in these hard-to-reach areas. One such even set the rules and regulations of the Bangladesh government as the stage for our study. A devastating flash flood broke out in well as Maulana Azad University of Jodhpur, India in all 7 haor districts of Bangladesh in April 2017. Almost 371,381 conducting the research. hectares of Boro rice-the the main crop of this single cropped region-catastrophically got damaged; 90% damage been reported at many places. An estimated 5,081 crore BDT (620 million USD) of damage of rice, fish, fodder occurred [11,12]. Most of the local health services became partially functional or fully closed due to the lack of health practitioners and medicine supply. Pregnant women, lactating mothers, and children were lacking essential maternal and child health support/services. Acute shortage of clean drinking water arose. Most children stopped going to school. Local health services became partially operational but there is a huge lack of health personnel and medicine. Pregnant women, lactating mothers, and children faced a lack of essential maternal and child health support/services [11,12]. The government and development partners may have faced challenges in the rapid provision of water and sanitation support. Understanding the Figure 1: Study area. water and sanitation situation of such a disaster is, thus, necessary. Therefore, the main objective of the study was to assess the Knowledge, Attitude, and Practice (KAP) of WASH Statistical analysis and nutrition in the emergency because of floods in the Haor area of Bangladesh. Descriptive statistics, frequency, percentage, etc. were estimated as appropriate. Binary logistic regressions were Methodology performed to predict the outcome of water treatment, soap use for washing hands, breastfeeding of infants within 1 hour of birth, feeding children aged 6-23 months more than four Study area groups of food, and taking rest my pregnant mothers, from The study was conducted in a northern village of education level, family size and monthly income of the Bangladesh named Jagir Para under the Union named households. All levels of significance were set to =0.05. All Gaokandia under Durgapur Upazila (sub-district) of Netrokona statistical tests were performed using the software package district of Mymensingh division (Figure 1). Durgapur Upazila is IBM SPSS Statistics for Windows, version 24.0 [14]. in Netrokona District with an area of 278.3 sq. km., with a population of around 224,893. It is located between 24°57' Result and 25°12' north latitudes and in between 90°28' and 90°47' east longitudes [13]. It is surrounded by the Meghalaya state Water of India on the north, Kalmakanda Upazila on the east, Dhobaura Upazila on the west, and Netrokona Sadar and Water source: Most of the respondents (92.1%, n=232) in Purbadhala Upazilas on the south. The Garo hills and valleys the study area get their drinking water from the deep tube are in the northern part of the Upazila. Among others, well. The rest of the respondents collect water from dug well indigenous communities such as Garo and Hajongs live in this (6.7%, n=17) or other sources (1.2%, n=3) such as open water Upazila. The rivers passing through the Upazila are Kangsa, bodies. Someshwari, and Old Someshwari. Treatment of water: Majority of the respondents (65.5%, n=165) do not treat their drinking water. A logistic regression Sampling and data collection was performed to ascertain the effects of income, family size Data were collected from a cross-sectional survey of 252 and educational status on the likelihood that participants treat households using face-to-face interviews. We sampled from their water before drinking. The logistic regression model was those households that have at least 1 child. statistically significant, (χ2 (6)=128.9, p<0.001). The model explained 55.3% (Nagelkerke R2) of the variance in treating Ethical consideration water and correctly classified 81.3% of cases. Overall contribution of all the predictors i.e. income (Wald (2)=11.7, The approval letter from the BMRC (Bangladesh Medical p=0.003)), family size (Wald (2)=23.8, p<0.001) and Research Council) as well as from the authority of Maulana educational status (Wald (2)=54.5, p<0.001) were significant. Azad University of Jodhpur, India were taken for the Respondent who had passed Class VIII were 6.6 times conduction of the research.