Abstract
The majority population in Bangladesh depends on groundwater resources for clean drinking water consumption. Due to climate change, recent studies indicated a declining trend in groundwater levels followed by severe contamination challenges. Pollutants, primarily inorganic and organic chemical contaminants such as E. coli, arsenic (As), iron (Fe), and manganese (Mn), pose serious public health concerns, including neurological disorders, cardiovascular problems, cancer, and deterioration of water quality. However, there is limited research to understand the role of socio-behavioural determinants towards clean drinking water accessibility and public health interventions in LMICs. Ensuring access to clean drinking water requires a holistic, community-driven approach that accounts for safety protocols and support systems. This study implemented a mixed-method approach to understand the socio-behavioral determinants to aid public health interventions using a phase-wise approach: firstly, we analyzed the survey data from 371 household participants to evaluate their awareness levels regarding water quality and formal safety initiatives. In the phase-II of the study focuses on solution development for public health administration in Bangladesh. This phase specifically proposes an integrated socio-behavioural policy intervention framework, using a systematic, theory-driven methodological approach, including a PRISMA-guided systematic review and thematic analysis.
The findings revealed a systemic knowledge vacuum in Bangladesh. The awareness index (mean score) dropped precipitously to 13.57/100. A one-sided t-test yielded a T-statistic of -86.87 (p < 0.001), providing overwhelming evidence that awareness levels are critically below the required threshold for institutional engagement. In phase-II, the structured SLR synthesis resulted in the development of ‘Clean Water Public-Knowledge Intervention Framework (CW-PIC)’, a structured six-layer conceptual model/approach that explicates how socioeconomic and behavioural mechanisms shape both the uptake and sustained diffusion of clean water practices. The framework comprises six interlinked layers: (1) socio-economic drivers and constraints, (2) behavioural biases (HBM), (3) fundamental biases, (4) awareness interventions design, (5) behavioural response and adoption, and (6) health and economic outcomes. Information flows across these components in a hierarchical manner, reducing fundamental biases and improving outcomes. The empirical findings from phase I were explicitly embedded within the CW-PIC framework to anchor the framework in the Bangladesh context. The framework provides actionable insights for policymakers, public health practitioners, and development agencies seeking to design context-sensitive, behaviourally informed water governance strategies in LMICs, including Bangladesh.