Waterborne Diseases and Water Resource Management in Bihar: Analysing Relationships through an Eco-social Systems Approach

Background: Since 2000, WASH has been propagated as a public health intervention for waterborne diseases. Although it has a positive outcome in reducing the disease burden, it has failed to prevent the resurgence and re-emergence of waterborne diseases. This is because it doesn’t take a systemic view of water, which is crucial for understanding and tackling water related health issues. Objective: The study aimed to understand the relationship between waterborne diseases and water resource management as reflected in policies and programmes and the people’s responses to water related problems in eco-hydro-sensitive districts of Bihar. Methodology: Following the historical eco-social framework, the data was collected from purposively selected study areas at three levels— state, district and village- using primary and secondary data sources. Applying a mix methods approach, the study used structured and semi-structured interviews, group discussions and observation at the community level and in households. Results: At the macro level, drinking water changed from wells to hand-pump to tap water, and water coverage shifted from habitation to households. A reductionist approach gave way to a holistic water management programme. Data from IDSP shows that the number of waterborne diseases in Bihar has declined since 2014. A traditional water resource management method has been rejuvenated in Gaya district and Patluka, the study village. Modern interventions in Buxar district and its study village, Tilak Rai Ka Hata, have been observed. Cases of waterborne diseases have increased in Buxar; while they have remained almost the same in Gaya. Conclusion: WASH alone would not be a sufficient intervention to combat waterborne diseases. Water management through an ecosystem approach with contextual integration of technology is warranted along with WASH to control waterborne diseases.