The Cycle of Debilitation: A Framework for Understanding the Dynamics of Displacement in Sudan Following the April 2023 Crisis

Background: Access to safe water, sanitation, and hygiene (WASH) remains a pressing concern for vulnerable women in Bangladesh, particularly those residing in slums, rural regions, and indigenous communities. Objective: This study explores the link between WASH-related challenges and psychosocial stress experienced by women in three under-resourced communities in Chittagong: the Marma ethnic group in Taraboniya village, the Jhautola slum in Chittagong city, and the rural village of Kodurkhil, Chittagong. Methods: Employing a mixed-methods design, the study integrates structured surveys with 250 women, 15 focus group discussions, and on-site observations to examine disparities in water access, sanitation, menstrual hygiene management, and associated health impacts. Results: The results indicate substantial inequities in WASH access. Slum and indigenous communities face the most critical shortages due to inadequate infrastructure, overcrowding, and seasonal fluctuations in water availability. Women in these areas carry a disproportionate burden of WASH-related tasks, leading to physical fatigue and emotional distress. The lack of safe and private sanitation facilities contributes to widespread anxiety, fear, and social stigma - particularly around menstruation. Adolescent girls and pregnant women encounter additional obstacles, including limited access to sanitary products and hygienic disposal options. Conclusions: This study highlights the urgent need for WASH strategies that are not only gender-sensitive but also address both the structural and psychosocial dimensions of water and sanitation insecurity. By amplifying women’s lived experiences, the research offers actionable insights for more inclusive and equitable WASH policy development in Bangladesh.