Conclusion Contaminated water sources, insufficient sanitation, and limited hygiene practices are major factors undermining children’s health in many low- and middle-income nations. Our study examined how household behav- iors influence the incidence of waterborne diseases in children ages 5–9 years living in areas with substandard housing and a lack of standard services (areas that have been cat- egorized as suburban slum environments) of Khulna District, Bangladesh. Our survey findings show that diarrhea and skin infec- tions are the most common waterborne ill- nesses among children here. Our analysis reveals that factors such as parental educa- tion, handwashing habits, participation in NGO programs, and access to fresh water have a significant effect on waterborne dis- ease incidence. Moreover, our results showed that heads of households expressed a WTP for improved water services specifically to receive safe, hygienic water from KWASA around the clock. But children’s experiences with water access, availability, and reliability often are merged into broader household-level data, making it difficult to pinpoint child-specific risks. Because many WASH interventions tar- get entire households rather than children specifically, further research is needed to explore child-centered dimensions of water insecurity that more directly affect child health. To meet Sustainable Development Goal 6 (SDG6), it is crucial for policymakers to focus on child health by ensuring access to clean and safe water. AI Disclaimer: The authors declare that generative AI tools were used to assist in improving the language, grammar, and over- all readability of this article. The intellec- tual content, data analysis, interpretation, and conclusions are entirely the authors’ own work. The authors have thoroughly reviewed and verified all content gener- ated or edited using AI tools and take full responsibility for the integrity and accuracy of the final article. Corresponding Author: Wasim Akram, MS, PhD, Assistant Professor, Department of Eco- nomics, Southeast University, Dhaka, Bangla- desh. Email: wasim.akram@seu.edu.bd
TABLE 3
Estimation of Willingness to Pay (WTP) to Ensure a Hygienic Water Supply for 24 Hours, at the Household Level
Variable
WTP Logit Model
Marginal Effect of the WTP Logit Model
1.84 ** (0.89) -1.02 (0.06) 3.66 * (2.08) 0.79 * (0.27) 0.41 (0.12) 2.58 (8.45) 1.58 ** (0.45) 1.67 (0.45) 0.89 (0.05) 1.58 (0.67) 0.78 *** (0.16)
1.35 ** (0.66) -0.97 (0.65) 2.86 * (2.01) 0.45 * (0.20) 0.38 (0.05) 3.98 (6.45) 1.01 ** (0.29) 0.70 (0.55) 0.76 (0.39) 0.99 (0.46) 0.61 *** (0.29)
CAG
CSX
PED
SLY
PYI
HFM
HNP
RNT
PLF
NNC
HWB
CCW
0.89 (0.05)
0.10 (0.10)
Observations
300
300
Log-likelihood ratio
-109.76
Probability > Χ 2
0.0024
* p < .10. ** p < .05. *** p < .01. Note. The dependent variable is the willingness of a household to pay 240 BDT ($1.98 USD) every month to ensure a 24-hr supply of fresh water for drinking and sanitation (1 = agreed to pay and 0 = not agreed to pay; base outcome). Standard errors are in parentheses. See Table 1 for descriptions of the variable abbreviations. BDT = Bangladeshi taka; USD = United States dollar.
Khulna is one of Bangladesh’s most climate- vulnerable districts, and its water resources are under major stress. As such, it is vital for both government agencies and NGOs to prioritize safeguarding these stressed natural resources. This action can be achieved by monitoring water quality parameters in line with the Envi- ronment Conservation Rules, 1997. It is essential for the government to priori- tize the effects of urbanization, industrializa- tion, migration, environmental degradation, and potential climate change on bodies of water in Khulna District. This safeguarding
can be achieved through the implementa- tion of innovative pollution controls, with a particular focus on groundwater conserva- tion and the reduction of pollution in sur- face water. Regular monitoring of groundwa- ter quality parameters should be conducted to ensure that they are in compliance with drinking water standards. It is necessary to reevaluate monitoring objectives and iden- tify the most critical parameters (i.e., arsenic, heavy metals such as iron [Fe] and manga- nese [Mn]) to be monitored based on the most recent information.
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October 2026 • Journal of Environmental Health
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