Access to water, sanitation, and hygiene (WASH) facilities and key influencing factors in coastal households, Bangladesh.

This study assessed the accessibility and determinants of water, sanitation, and hygiene (WASH) facilities in Bangladesh's climate-sensitive coastal region, which is highly vulnerable to sea-level rise, salinity intrusion and extreme weather events. A cross-sectional survey was conducted from March to July 2023, involving 471 households across nine subdistricts within three coastal zones using a three-stage cluster sampling technique. Multivariable logistic regression was performed to identify the associated factors, considering WASH indicators (as defined by the WHO/UNICEF Joint Monitoring Program) as outcomes and sociodemographic characteristics as exposure variables. Findings revealed that, 56.9 % of households had limited access to drinking water, 43.3 % lacked improved sanitation, and 48.2 % were without basic hygiene facilities, while only 10.6 % had basic access to all three WASH services. Compared to the richest households, poor households (asset-based index) were 76 % less likely (adjusted odds ratio [AOR]: 0.24, 95 % confidence interval [CI]: 0.16-0.54) to have water access. Households located in the southeastern region had 1.67 (AOR: 1.67, 95 % CI: 1.02-2.74) times higher odds of having water access than those in the southwestern part. Larger households and those headed by fishermen were 39 % (AOR: 0.61, 95 % CI: 0.40-0.93) and 70 % (AOR: 0.30, 95 % CI: 0.14-0.65) less likely to have sanitation access compared with smaller households and those headed by service holders, respectively. Households having adults with primary incomplete or only primary education were significantly associated with reduced access to hygiene and combined WASH facilities, respectively, whereas wealth was a significant factor for WASH facilities. The findings thus underscore the need for targeted interventions including subsidised disadvantaged occupational groups and community-based education programs to improve WASH access in this vulnerable zone.