The study finds that the govt’s rural sanitation programme, implemented by NGOs, was unable to reduce exposure to faecal matter.
A recently published Lancet paper looks at the impact of the erstwhile Total Sanitation Campaign in the coastal Puri district in Odisha. The study finds that the government’s rural sanitation programme, implemented by NGOs and community-based organisations, was unable to reduce exposure to faecal matter. As a result, this sanitation programme had no impact on the incidence of diarrhoea and malnutrition. The authors of the paper conclude that in order to realise concrete and sustainable health benefits, sanitation programmes need to increase both the coverage and use of toilets, as well as improved hygienic practices.
No one denies the importance of good sanitation and the impact it has on human health. It must follow therefore that the lack of positive impact is down to poor implementation of the sanitation programme in the study area. In fact, a process evaluation of the programme concludes that the implementation was far from perfect, both in terms of the levels of coverage achieved and the levels of awareness. Over an implementation period of 13 months (January 2011—January 2012), the villages where the programme was implemented saw an increase in toilet coverage from 9% to 63%, but only 38% of the households had a functional toilet. It would have been interesting to learn more about the gap between toilet construction and usage (25 percentage points). In any case, the state of implementation, the authors point out, is typical of the prevalent Total Sanitation Campaign across the country.