A Cost-Illness Analysis of Economic Burden of Unimproved Water Use on Households: Empirical Evidence from Dhaka Urban Riparian Areas

Abstract

The rapid urbanization and increasing industrial establishment near Dhaka’s rivers are creating environmental pressure on nearby communities. And people due to several factors are forced to use unimproved water from the nearby waterbodies. This study looks at how using unsafe water affects the health, health expenditure and poverty of 1,826 families living near the Turag River in Dhaka. It uses two main ways of measuring the impact: one that looks at the cost of getting sick and another that considers what people miss out on when they are ill. Quantitative methods like descriptive statistics, Ordinary Least Squares (OLS), Tobit, Logit, and Propensity Score Matching (PSM) were used to find out how the use of unimproved water is connected to illness, treatment costs, and household poverty. About 28.36% of the households surveyed used water from different waterbodies like river, canal, or pond water, for washing, bathing, or cooking at some time during the year. People were more likely to use this kind of water during the dry season compared to the monsoon season. Households that used the unimproved water had more people who were sick, about 1.4 compared to 1.0 among the non-user households. They also had more cases of stomach, skin, and diarrhea illnesses. These households spent an average of Tk.321 more each month, which adds up to about Tk.3,852 every year, on medical treatments. The censored (Tobit) regression results showed that the ordinary least squares estimates missed the true size of these effects, and Propensity Score Matching supported the initial differences between groups after adjusting for observable household traits, suggesting that the connections found are not just because of differences in observable characteristics. Poverty and how it changes over time are closely linked to people using unimproved water. The households that are poor for a long time suffers more than others. The study shows that even though there has been more development of pipes and tube wells, many families living near rivers still pays a higher indirect cost for using unimproved water. These costs make poverty worse and slow down Bangladesh’s progress towards its goals for health and reducing poverty.