Generalized linear mixed model approach for analyzing water, sanitation, and hygiene facilities in Bangladesh: Insights from BDHS 2022 data

Abstract

This study explores the key determinants and barriers to effective WASH facilities in Bangladesh, which are crucial for mitigating health issues and ensuring equitable access. By analyzing the 2022 Bangladesh Demographic and Health Survey (BDHS) data and accounting for design clustering using a Generalized Linear Mixed Model (GLMM), this study's methodology demonstrates superior performance compared to conventional logistic regression, as supported by Akaike Information Criterion (AIC) and likelihood ratio test (LRT). The study found that basic handwashing facility was significantly linked to the household head's age, partner's education, media exposure, women's empowerment, wealth index, and maternal factors such as - age and education of mothers of under 5 children. Basic sanitation was associated with regional factors, the household head's sex and age, household size, partner's education, working status, wealth index, and maternal factors. Access to basic drinking water was largely driven by the wealth index, while combined WASH facilities were influenced by household head's sex and age, household size, partner's education, working status, media exposure, wealth index, and maternal characteristics. The findings indicate that addressing WASH challenges in Bangladesh requires an integrated, multi-dimensional policy approach that considers key socio-demographic and economic factors-a strategy essential for achieving 6th Sustainable Development Goal (SDG).

Fig 1. Flowchart of sample selection from the BDHS 2022 dataset.