EFFECT OF HAND-WASHING BEHAVIOR ON CHILDREN HEALTH-COST IN RURAL BANGLADESH
PDF

Keywords

health cost
health-hazard
health-hygienic equipment
willingness to pay
hand-washing

How to Cite

Ahmed, S., Hossain, T., Ferdous, M. Z., Baroi, J., Hossain, M. B., Rohman, M. M., … Arafat, S. M. N. (2025). EFFECT OF HAND-WASHING BEHAVIOR ON CHILDREN HEALTH-COST IN RURAL BANGLADESH. Social Development: Economic and Legal Issues, (13). https://doi.org/10.70651/3083-6018/2026.1.02

Abstract

Children’s health status is an important issue in developing their physical and mental growth, which is somehow closely connected with behavior and the physical effects of other factors. Most of the parents and school authorities are not serious about children’s health issues, which is a very common scenario in developing countries, that cause health-hazard. In this research, the authors try to find out the effect of child diseases and WTP for purchasing health-hygienic equipment on the health costs of children. Health-hazard is caused by several factors were living in an unhygienic environment, and malnutrition are the major factors in previous research. In this paper, the authors consider 300 primary school-going children who were affected in the year 2025, where a set of independent variables has been considered that affect the dependent variable. Firstly, from Models 1 and 2, it is highlighted that children’s age, the educational level of children, households’ monthly income, daily hand washing behavior, and freshwater supply act negatively on the number of diseases affecting children. Secondly, for Models 3 and 4, where ELC connects negatively with WTP for purchasing health-hygienic equipment. Moreover, parents’ educational level, monthly income, and hand washing behavior act positively with WTP for purchasing health-hygienic equipment as well. Therefore, a child’s disease and daily hand-washing behavior are negatively connected. School authorities and local government can play an effective role in enriching children’s health status.

https://doi.org/10.70651/3083-6018/2026.1.02
PDF

References

1. Ahsan, N., Hadiujjamana, S., Islam, S., Nasrin, N., Akter, M., Parvin, G. A., & Hossain, S. (2021). Willingness to pay for improved safe drinking water in a coastal urban area in Bangladesh, Water Policy, 23(3), 633–353. https://doi.org/10.2166/wp.2021.031

2. Aiello, A. E., & Coulborn, R. M. (2008). Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. American Journal of Public Health, 98(8), 1372–1381. https://doi.org/10.2105/AJPH.2007.124610

3. Alam, N. (2009). Prevalence and costs of childhood diarrhoea in the slums of Dhaka (SANDEE Working Paper No. 46-09). South Asian Network for Development and Environmental Economics. https://www.sandeeonline.org/uploads/documents/publication/875_PUB_Working_Paper_46.pdf

4. Berggreen, S., & Mattisson, L. (2023). Willingness to Pay to Prevent Water and Sanitation-Related Diseases Suffered by Slum Dwellers and Beneficiary Households: Evidence from Chittagong, Bangladesh. Department of Economics, Lund University. BMC Public Health, (13), 757. http://dx.doi.org/10.1186/1471-2458-13-757

5. Chittleborough, R. C., Nicholson, A. L., Young, E., & Bell, S R, (2013). Implementation of an educational intervention to improve hand washing in primary schools: process evaluation within a randomised controlled trial. BMC Public Health, (13), 757. https://doi.org/10.1186/1471-2458-13-757

6. Curtis, V. A., & Danquah, L. O. (2009). Planned, motivated and habitual hygiene behaviour: An eleven country review. Health Education Research, 24(4), 655–673. https://doi.org/10.1093/her/cyp002

7. Curtis, V., Schmidt, W, Luby, S., Florez, R. & Biran, A, (2011), Hygiene: new hopes, new horizons. The Lancet Infectious Diseases Journal, (11), 312–321. https://doi.org/10.1016/s1473-3099(10)70224-3

8. Freeman, M. C., & Stocks, M. E. (2014). Hygiene and health: systematic review of hand washing practices worldwide and update of health effects. Tropical Medicine and International Health & International Health, (11), 258–267. https://doi.org/10.1111/tmi.12339

9. Graves, J. M., Daniell., W. E., Harris, J.R., Obure, A.F. & Quick, R. (2012). Enhancing a safe water intervention with student-created visual aids to promote hand washing behavior in Kenyan primary schools. International Quarterly of Community Health Education, 32(4), 307–323. https://doi.org/10.2190/iq.32.4.d

10. Halder, A., Carole, T., Akhter, S., Bhuiya, A., Johnstone, R. & Luby, S, (2010), Observed hand cleanliness and others measures of hand washing behaviors in rural Bangladesh. BMC Public Health, (10), 545. https://doi.org/10.1186/1471-2458-10-545

11. Heijnen, M. and Greenland, K. (2015). Level of Behaviour Change Achievable by Handwashing with Soap Interventions: A rapid Review (Department for International Development (DFID) report). https://assets.publishing.service.gov.uk/media/57a0896bed915d622c0001f5/EoD_HDYr3_04_April2015_WASH_Behaviour_Change.pdf

12. Islam, S., Afrin, S., Ahsan, N., Haider, M.Z., Mamun, T.M. & Das, D. (2019). Households’ Willingness to Pay for Disaster Resilient Safe Drinking Water Sources in Southwestern Coastal Bangladesh. International Disaster Risk Science, (10), 544–556. https://doi.org/10.1007/s13753-019-00229-x

13. Jamieson, D., & Bremen, J. (2006). Disease Control Priorities in Developing Countries. Oxford University Press. https://www.ncbi.nlm.nih.gov/books/NBK11728/

14. Luby, S. P., & Agboatwalla, M. (2005). Effect of handwashing on child health: A randomized controlled trial. The Lancet, 365(9463), 225–233. https://doi.org/10.1016/S0140-6736(05)66912-7

15. Nabi, M. H, Rupa, F. H, Jahan I, Hasan ABMN, Naz F, Masud I, et al. (2025). Water, sanitation, and hygiene (WASH) factors and the incidence of communicable diseases in Urban Bangladesh: Evidence from municipal areas. PLOS Neglected Tropical Diseases, 19(7), e0013329. https://doi.org/10.1371/journal.pntd.0013329

16. Nicholson, J. A., Naeeni, M., Hoptroff, M., Matheson, J. R., Roberts, A. J., Taylor, D., Sidibe, M., Weir, A. J., Damle, S. G., & Wright, R. L. (2014). An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities. Tropical Medicine & International Health, 19(3), 284–292. https://doi.org/10.1111/tmi.12254

17. O’reilly, C. E., Freeman, M. C., Ravani, M., Migele, J., Mwaki, A., & Ayalo, M. (2008). The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, 2006. Epidemiology & Infection, 136(1), 80–91. http://dx.doi.org/10.1017/S0950268807008060

18. Rabie, T., & Curtis, V. (2006). Hand washing and risk of respiratory infections: a and sanitation sector in developing countries: a conceptual model, a review and a guideline. International Journal of Environmental Health Research, 11(3), 1–19. https://doi.org/10.1111/j.1365-3156.2006.01568.x

19. Rajaraman, D., & Varadharajan, K. S. (2014). Implementing effective hygiene promotion: lessons from the process evaluation of an intervention to promote hand-washing with soap in rural India. Public Health, (14), 1179. https://doi.org/10.1186/1471-2458-14-1179

20. Rhee, V., Mullany, L. C., & Khatry, S. K. (2008). Impact of maternal and birth attendant hand-washing on neonatal mortality in southern Nepal. Archives of Pediatrics and Adolescent Medicine, 162(7), 603–608. https://doi.org/10.1001/archpedi.162.7.603

21. Salifu, I., & Peprah, J. A. (2021). Effect of Household Water Treatment on Child Diarrhoea in a Low Middle Income Country. https://doi.org/10.13140/RG.2.2.19686.75842

22. Scott, B. E., & Schmidt, W. P. (2008). Marketing hygiene behaviours: The impact of different communication channels on reported hand-washing behaviour of women in Ghana. Health education research, (233), 392–401. https://doi.org/10.1093/her/cym056

23. Sidibe, M., Shukla, N., & Rustagi, A. (2009). Inducing the habit of soap usage in an urban community setting. In Proceedings of the 3rd WHO International Conference on Children’s Health and the Environment (Busan, South Korea).

24. Tobin, V., & Van, K. (2005). Water, sanitation and hygiene education for schools: Roundtable proceedings and framework for action (Oxford, UK, January 24–26). IRC International Water and Sanitation Centre. https://www.ircwash.org/resources/water-sanitation-and-hygiene-education-schools-roundtable-meeting-oxford-uk-24-26-january

25. UNICEF. (2023). Early childhood development: UNICEF vision for every child. Nutrition and Child Development Programme Group. https://www.unicef.org/media/145336/file/Early_Childhood_Development_-_UNICEF_Vision_for_Every_Child.pdf

26. United Nations Children’s Fund. (2022). UNICEF disability inclusion policy and strategy, 2022–2030. UNICEF. https://www.unicef.org/media/134031/file/UNICEF_Disability_and_Inclusion_Strategy_2022_2030_Short_Version.pdf

27. Vindigni, S. M., Riley, P. L, & Jhung, M. (2011). Systematic review: hand washing behaviour in low- to middle-income countries: outcome measures and behaviour maintenance. Tropical Medicine & International Health, 16(4), 466–477. http://dx.doi.org/10.1111/j.1365-3156.2010.02720.x

28. World Health Organization. (2002). Better health for poor children: A special report (WHO/FCH/CAH/02.5). https://www.who.int/publications/i/item/WHO-FCH-CAH-02.5

29. World Health Organization. (2018). Nurturing care for early childhood development: A framework for helping children survive and thrive to transform health and human potential. https://iris.who.int/server/api/core/bitstreams/781de51d-4cef-482e-bb3b-c2b3becf3c9f/content

30. Xuan, L. T. T., Hoat, L. N., Rheinländer, T., Dalsgaard, A. & Konradsen, F. (2011). Sanitation behavior among schoolchildren in a multi-ethnic area of Northern rural Vietnam. BMC Public Health, (12), 140. https://doi.org/10.1186/1471-2458-12-140

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2026 Shakil Ahmed, Tanbir Hossain, Mst. Zannatul Ferdous, Juli Baroi, Md. Belal Hossain, Md. Mahmudur Rohman, Ila Islam Ritu, S. M. Naser Arafat