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Open Defecation

“Compressed demand”: How Uttar Pradesh is making sure rural sanitation subsidies for toilets go to the most needy

Arun Kumar Dobhal's picture

When the “Swachh Bharat Mission-Gramin” (SBM-G) was launched in October 2014 with the goal of making rural India free from open defecation by 2019, it gave states and districts more flexibility than previous national sanitation programs had. This led to a successful experiment in Uttar Pradesh called “demand compression”.

The state was preparing to use a tried-and-tested triggering process, where trained motivators concentrate their efforts on a community to help improve their understanding of safe sanitation and stimulate demand for toilets in rural communities where open defecation is still common. However, they faced a problem. If all the households that were eligible for government subsidies would actually claim them, funds would soon run out. With an estimated 15 million households across Uttar Pradesh without a toilet and eligible for a government subsidy of around $200, about $3 billion would be needed.

Household toilet constructed from own resources

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].

What happens when the playground is also the potty?

Emily C. Rand's picture

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.

 

Six steps to a successful sanitation campaign

Suvojit Chattopadhyay's picture

new latrineInadequate sanitation costs India $54 billion a year. To that, add the challenge of juggling our nationalistic aspirations of superpowerdom with the ignominy of housing the largest share of human population that defecates in the open.  In light of this, here are six steps to a success sanitation campaign.

Amid many reports that the Swachh Bharat Abhiyan (SBA) is failing, we need a dose of optimism. While SBA might be failing, it certainly isn’t the first, nor will it be the last state-led sanitation programme to fail in India. Our large schemes to tackle this challenge have, more often than not, ended up as models of just what one should avoid doing if they are serious about bringing about total sanitation.
 
It is now widely acknowledged that conventional approaches are not working: those that set up a false dichotomy between construction and behaviour change; those that are content with pit latrines as opposed to functional toilets; those that use reductionist conceptions such as communities being open defecation free rather than focusing on personal and environmental sanitation and hygiene as a whole; and those that settle for incremental coverage instead of full coverage from the start.
 
However, it’s not that there are no success stories within India or in our immediate neighbourhood. For one, the experiences of locally-embedded NGOs that have taken their interventions to scale can be highly instructive. There have also been state-led successes in Maharashtra and Himachal Pradesh that can offer valuable lessons. So what could some key design elements in a sanitation programme be?
 

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