The role of water supply in improving health in poor countries (with special reference to Bangla Desh).

The literature on water supply and health is strikingly heterogeneous in design, in method, and in conclusions (1) and “offers little in explaining water’s health impact beyond confirming the existence of a general association between improved quality and increased quantity of domestic water and a reduced incidence of enteric disease” (2). Several excellent recent reviews examine the relevant literature (1-5). This review addresses itself to the role of improved water supplies in easing the burden of infection in poor countries. Since the relationship between health and water is so markedly affected by the cultural, socioeconomic, and ecological characteristics of an area, it is recognized that universal conclusions are impossible and general ones are of limited practical value. The approach taken in this paper, therefore, is to examine in detail a limited set of studies that have been conducted in the same environment, a rural area of Bangla Desh. The analysis is illustrative rather than comprehensive. Through examination of these studies, general methodological problems will become apparent, the difficubties in drawing a consensus from a set of studies of essentially the same population will become clear, and the ways in which imperfect information may yet be useful in formulating policy will be illustrated.