Referral journeys, seasonal access, and service quality
Health, water, and sanitation
Health and WASH evidence must follow the path from household need to transport, staff, supplies, language, referral, affordability, safe water, sanitation, and outcomes.
Research cutoff: 4 September 2026. Generated visuals are editorial context, not evidence.
Editorial image · generated, not documentary evidenceexplanation
A facility is the start, not the end, of care
Facility, staff, supplies, affordability, language, referral, completion, and outcome form one care chain.
Reach first contact
Record route, travel time, monsoon interruption, cost, physical accessibility, opening hours, communication, and language support.
Receive usable care
A facility count must be joined to staff attendance, diagnostics, medicines, privacy, affordability, respectful treatment, and continuity.
Complete referral
Track origin, destination, reason, acceptance, transport, elapsed time, accompaniment, and whether the patient could make the journey.
Observe outcome
Separate activity from resolution. Follow completion, follow-up, health outcome, patient experience, and any barrier or complaint.
No complete current CHT dashboard was located
Recent qualitative evidence identifies distance, terrain, cost, communication, and perceived discrimination as interacting barriers. A December 2024 Bandarban District Hospital extract is one facility-month snapshot and contains anomalies that prevent robust vacancy or attendance rates.
Sources: MS0254–MS0259 and MS0266.
Editorial image · generated, not documentary evidenceevidence
Water and sanitation change with season, quality, and use
Water source, sanitation, monsoon access, quality, and data limitations must be read together.
| District | Spring as main water source | Open defecation / no latrine |
|---|---|---|
| Bandarban | 16.21% | 20.21% |
| Khagrachhari | 2.90% | 2.64% |
| Rangamati | 14.19% | 4.07% |
Infrastructure category is not service quality
These categories do not establish microbiological safety, dry-season continuity, walking time, disability access, privacy, maintenance, or whether a latrine functions. Para-level quality and seasonality evidence remains unresolved.