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

## TL;DR

This study uses advanced statistical methods to identify factors influencing access to WASH facilities in Bangladesh, highlighting the need for integrated policies to improve health and equity.

## Contribution

The study introduces a GLMM approach for analyzing WASH data, showing better performance than traditional logistic regression.

## Key findings

- Basic handwashing facilities are linked to household head's age, education, and maternal factors.
- Access to basic drinking water is primarily influenced by the household's wealth index.
- Combined WASH facilities depend on socio-demographic factors like household size and media exposure.

## 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).