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Open Defecation

Changing the village, changing the country

Robin van Kippersluis's picture
How do you persuade people to use a toilet? This is an urgent question across rural India: somewhere near half a billion people are still defecating in the open, and the Swachh Bharat Mission is urging them to stop by 2019.

India has about 650,000 villages. Many have tried different techniques - some successfully, some not. What if there were a “Google of sanitation”, where you could search for success stories of others who have faced the same situation, and a “LinkedIn of Sanitation” where you could reach out to peers with questions?
Pictures: Left: Ms Lunga Devi from Pawa, Pali is interviewed by Government officials in Rajasthan on how she became a natural leader on ODF in her village and helped it transform, as part of the ‘World Bank - Capturing Local Sanitation Solutions’ training.  Right: Villagers from Muzzafarpur district in the State of Bihar talking about local sanitation solutions.

Self-Help Women’s Groups in India help change behavior around diets and toilet use to improve health

Vinay Kumar Vutukuru's picture



Sushila Devi, a mother of four in the rural Rohtas district of Bihar, India, has no significant assets and depends primarily on casual labor for income. She recently was able to take out a bank loan of INR 12,000 (US$180), which she used to construct a toilet in her family home

It was the Self-Help Group (SHG) in her village that persuaded Sushila of the importance of sanitation for her children’s health and nutrition, and helped her get the loan she needed. SHGs generally consist of 12 to 15 rural women, grouped into larger federations. They engage with formal financial institutions to help unbanked households access financial services, acting as platforms for standardized large-scale sensitization of community members on a variety of subjects.

Sushila’s actions are part of a larger change driven across Bihar by the recently launched Bihar Transformative Development Project (BTDP), commonly known as JEEViKA-II. This joint initiative of the Government of Bihar and the World Bank covers 300 (56 percent) of the blocks of rural Bihar. The project is working through SHGs to deliver awareness, training, finance, and monitoring on sanitation and nutrition in an integrated manner.

The “5Ds”: Changing attitudes to open defecation in India

Vandana Mehra's picture
In the village of Bharsauta in Uttar Pradesh, India, construction worker Vishwanath lives with his wife, four children and their elderly parents. Three years ago, the government paid to build a toilet in their house. But the job was not done well: the pit was too shallow, it overflows frequently, and the smell makes it suffocating to use.

Building institutional capacity for rural sanitation: India’s Uttar Pradesh State

Mariappa Kullappa's picture
Uttar Pradesh (UP), India’s most populous state with about 200 million people, has historically not performed well on sanitation. According to census figures from 2001 and 2011, the proportion of rural UP dwellers with a toilet increased slightly during the first decade of this century. However, the population grew as well, meaning that, overall, 13 million more people were defecating in the open in 2011. 

Rajasthan tells an unexpected story of stopping open defecation under Swachh Bharat Mission

Mathews K. Mullackal's picture
Rajasthan has become an unlikely frontrunner in sanitation. Until recently, it was among Indian states with the lowest rates of toilet coverage. With a difficult terrain, scarce water, and low levels of literacy, the slow pace of progress was not surprising.

Since 2011, that has changed. As shown in Figure 1, the proportion of people with access to a toilet has more than trebled – from under 20 percent to nearly 68 percent. Of 9,892 Gram Panchayats, the local level of government in India, almost a third – 3,545 – has been declared free of open defecation. That includes all Gram Panchayats in five of the state’s 33 districts, with more set to follow. What has gone right?

 

3 steps to improve rural sanitation in India - a pathway to scale and sustainability

Joep Verhagen's picture
Child using a latrine in Rajasthan. 
Photo credit: World Bank

Almost 600 million Indians living in rural areas defecate in the open. To meet the ambitious targets of the Indian government’s Swachh Bharat Mission Grameen (SBM (G)) – the rural clean India mission – plans to eliminate open defecation by 2019. SBM (G) is time-bound with a stronger results orientation, targeting the monitoring of both outputs (access to sanitation) and outcomes (usage). There is also a stronger focus on behavior change interventions and states have been accorded greater flexibility to adopt their own delivery mechanisms. 
 
The World Bank has provided India with a US$1.5 billion loan and embarked on a technical assistance program to support the strengthening of SBM-G program delivery institutions at the national level, and in select states in planning, implementing and monitoring of the program.

New tactics to nudge habit change for open defecation behavior

Jacqueline Devine's picture
Open defecation remains a critical global health challenge, affecting almost 1 billion people around the world and contributing significantly to the estimated 842,000 people who die each year because of poor sanitation, hygiene practices, and unsafe water supplies [1].
 
Most behavior change approaches and frameworks for addressing open defecation have focused on relatively conscious, “reflective”  drivers of behavior, including people’s emotions (such as pride or shame), rational knowledge (e.g., of germ theory), social norms, and explicit action plans (such as commitments to change). Using the framework popularized by renowned social psychologist Daniel Kahneman [2].<, these factors can be described as “System 2” drivers of behavior i.e., relatively conscious and motivational factors. It is now well established, however, that human behavior can also be heavily influenced by “System 1” drivers i.e., relatively automatic, cue-driven factors [3].

Que se passe-t-il lorsqu’un enfant joue et fait ses besoins au même endroit ?

Emily C. Rand's picture
Also available in: English
Imaginons que vous êtes une maman en train de faire la lessive à la borne-fontaine située à proximité de la maison. Votre enfant de deux ans, qui joue par terre, a besoin d’aller aux toilettes. Que faites-vous ? Il y a de fortes chances pour que vous le laissiez faire ses besoins par terre, là où il se trouve.

Selon une analyse récemment menée par le Fonds des Nations Unies pour l'enfance (UNICEF) et le Programme pour l’eau et l’assainissement (WSP) de la Banque mondiale dans un certain nombre de pays clés, plus de 50% des ménages ayant des enfants de moins de trois ans indiquent n’avoir pris aucune précaution d’hygiène la dernière fois que l’un d’eux a fait ses besoins. Ce qui signifie, concrètement, que les enfants défèquent là où ils se trouvent et que leurs excréments sont laissés là, à l’air libre. Par ailleurs, les excréments d’autres enfants du voisinage sont jetés dans une rigole ou un fossé, ou bien enterrés ou jetés avec les déchets solides, et restent donc dans l’environnement direct de la zone d’habitation.

 

What happens when the playground is also the potty?

Emily C. Rand's picture
Also available in: Français

Imagine you are a busy mother scrubbing your laundry next to the public water stand near your yard. You realize your two year old — who is playing in the dirt — has to go to the toilet. What do you do? Chances are good you might just let them go on the ground somewhere nearby.

According to a recent analysis by the United Nations Children Fund (UNICEF) and the World Bank Global Water Practice's Water and Sanitation Program (WSP) in key countries, over 50 percent of households with children under age three reported that the feces of their children were unsafely disposed of the last time they defecated. What this really means is that children are literally pooping where they are and their feces are left there, in the open. Meanwhile, the feces of other children in the neighborhood are put or rinsed in a ditch or drain, or buried or thrown into solid waste streams that keep the feces near the household environment.

 

A Basic Need to Help Children

Alassane Sow's picture

Alassane Sow, World Bank Country Manager for Cambodia, and Rana Flowers, UNICEF Representative to Cambodia, wrote an op-ed for The Phnom Penh Post. Read the op-ed below, courtesy of The Phnom Penh Post.

Did you know that in communities where a high proportion of people defecate outdoors, children are on average shorter than children living in communities where most people use toilets?

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