The effects of climate change on water security have become increasingly apparent with the increasing salt contamination of freshwater sources in coastal Bangladesh. In 2011, the Climate Change and Health Promotion Unit (CCHPU) of the Bangladesh Ministry of Health and Family Welfare began its response to this problem through the installation of small-scale reverse osmosis desalination plants in 10 villages of Satkhira district, using a Community Based Adaptation Private-Public Partnership model (CBA-PPP) with support from World Bank. The purpose of this paper is to evaluate the implementation of this model in terms of clean water accessibility, health impact and long-term sustainability of operations. Primary data was collected from focus group discussions with water collectors and project committee members at plants in Nalta Sharif and Nowapara villages. Secondary data on sub-district waterborne diarrhea admission rates were obtained from the Institute for Epidemiology, Disease Control and Research (IEDCR) and total diagnosis rates of waterborne illnesses in the sub-district of Debhata were acquired from Debhata Health Complex. In Nalta Sharif, participants found supply of water, long wait times and limited hours at which water could be retrieved to be the most significant barriers to accessibility. However, in Nowapara, it was found that financial constraints, largely due to electricity costs, were the main barrier to access. In both villages, participants observed a noticeable reduction in waterborne illness rates since the plants became operational. This was supported by the surveillance data from Debhata, which showed significant reductions in rates of all waterborne illness rates that were monitored. Thus, the intervention was found to be effective in reducing waterborne illness rates, but was inadequate in meeting the drinking water demand for the communities. Long-term sustainability was a major issue in both communities, emphasizing the importance of financial planning for the survival of such projects.
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