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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?
 

Why do sanitation campaigns fail?

Suvojit Chattopadhyay's picture

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.
 

The false dichotomy among sanitation-for-all advocates

Suvojit Chattopadhyay's picture

The sanitation debate has suffered from a seemingly irreconcilable dichotomy when it comes to identifying the best approach towards sanitation for all.

A good way of blocking progress in an argument is to present two aspects of a whole as a dichotomy. The sanitation debate, in recent years, has suffered from a seemingly irreconcilable dichotomy when it comes to identifying the best approach towards sanitation for all. This is the one that pits subsidies against motivation and correspondingly, construction against behaviour change communication. And yet, in a comprehensive and prudent programme design, there is no need for these ideas to be opposed to each other. I call this then, the false dichotomy in the world of sanitation advocates.

The current sanitation programme in India has at its centre a subsidy and incentive for individual households constructing toilets. This is a programme that has clearly not worked, irrespective of the minister or bureaucrat at the helm of affairs. India holds the ignominious record of having the largest number of people defecating in the open. At the same time, the popularity of the community-led total sanitation (CLTS) approach has risen. This approach depends on using shame and motivate as a call to action to build basic pit latrines (rejecting subsidies completely) and has worked in multiple countries around the world, as well as in certain states in India.
 

Despite the Growth, India Needs its Activists

Suvojit Chattopadhyay's picture

Activists are under attack in India. Columns such as this one on how misguided activism has created a “mess (that) will take some time to be sorted out” are not uncommon in the popular press these days. Part of this is mainstream journalists trying to make sense of a field where the motivations and incentives of the primary actors is hard to fathom. It is far easier to paint everyone as disruptive and regressive.

I am not an activist myself. However, the space for constructive activism in India is one that I care about. I will therefore, attempt to present a contrarian argument, advocating for greater space for activism in India.

It is still fashionable to present growth and development as a dichotomy. This is at a time when income inequality qualifies as possibly the biggest threat to India’s future. An aspiring global super power, we have the unenviable burden of literally hiding our poor behind make-shift screens every time we organise an international event or an important dignitary visits us. Many of those who are left out of the growth story also simultaneously suffer from disadvantageous social status and lack basic capabilities, due to an inability to access quality education, healthcare and the like. The experience of the past seven decades has shown that neither the state not the market on their own can empower citizens to exercise “individual preferences” that will pull them out of the vicious cycle of poverty.

How Soap Operas and Cable TV Promote Women’s Rights and Family Planning

Duncan Green's picture

Taking a break from the How Change Happens book this week to head off to Harvard for a Matt Andrews/ODI seminar on ‘Doing Development Differently’ + a day at Oxfam America on Friday. Will report back, I’m sure. Meanwhile, I’ve just finished the draft chapter on the power of social norms, and how they change (and can be changed). ODI provides an absolute gold mine of a crib sheet on this in the shape of Drivers of Change in Gender norms: An annotated bibliography, by Rachel Marcus and Ella Page with Rebecca Calder and Catriona Foley.

Here’s one of the excerpts that caught my eye:

Jensen, R. and Oster, E. (2007) ‘The Power of TV: Cable Television and Women’s Status in India’. Working Paper 13305. Cambridge, MA: NBER

Media (R)evolutions: Emerging Markets to Lead Sales of Technology Devices in 2015

Roxanne Bauer's picture
New developments and curiosities from a changing global media landscape: People, Spaces, Deliberation brings trends and events to your attention that illustrate that tomorrow's media environment will look very different from today's, and will have little resemblance to yesterday's.

2015 forecasts for sales of technology devices indicate global stability as the market remains at around one trillion USD, where it has hovered for the last three years. However, the forecasts also predict shifts at the country level as the top ten largest growth markets will increase by over $10 billion. Emerging markets, in which both volume and pricing contribute to positive sales, will dominate this growth. 

India will experience the highest growth rate, primarily driven by smartphones sales, followed by China. China's technology device market represents an interesting case study because it is predicted to grow by just $1.8 billion in 2015-- a mere 1% increase over the estimated 2014 total-- but that is still large enough for second place. 
 
Emerging Markets to Lead Tech Sector Growth in 2015
Infographic: Emerging Markets to Lead Tech Sector Growth in 2015 | Statista
You will find more statistics at Statista

Quote of the Week: Raghuram Rajan

Sina Odugbemi's picture

Central bankers have had enormous responsibilities thrust on them to compensate, essentially, for the failings of the political system. And my worry is we don’t have sufficient tools to do that, but we’re not willing to say it. And, as a result, we push as hard as we can on the existing tools, and they may create more risk in the system.” 

- Raghuram Rajan, Governor of the Reserve Bank of India since 4 September 2013. Prior to his post at the Reserve Bank of India, Rajan was chief economic adviser to India's Ministry of Finance in 2012 and chief economist at the International Monetary Fund from 2003 to 2007.
 

Sanitation For All: Ignore Quality at Your Own Peril

Suvojit Chattopadhyay's picture

The excellently named Research Institute for Compassionate Economics (R.I.C.E) recently published an equally excellently named survey – the SQUAT (Sanitation Quality, Use, Access and Trends) survey. Based on the findings of this survey conducted in five north Indian states, R.I.C.E calls for a latrine use revolution - since the bottleneck is not the non-availability of a latrine (since even those with a government latrine are not using them), nor is it lack of funds (since far poorer countries and communities have built and used latrine). It is an issue of messaging around hygiene, towards which we need to set our firm focus.

My first job in the development sector was with an NGO, Gram Vikas in Odisha and my experience there has shaped many of my core beliefs about working in this sector. At the core of Gram Vikas' work was the conviction that the 'poor can and will pay for quality services'. So when I think toilets (not latrines – and there is a key difference in the definition), I often use the 'quality' lens and make the argument about how the usage of physical facilities installed by projects has a direct link with what community perception of what counts as good quality. This also has a strong link with the extent to which they feel a sense of ownership for the facility.

Delivery Challenges for India’s National Food Security Act 2013

Abhilaksh Likhi's picture

The recently enacted National Food Security Act, 2013 (NFSA) is being described as a ‘game changer’ to strengthen food and nutritional security in the country. It goes without saying that, be it basic staples (wheat and rice) or other foods (edible oil, pulses, fruits, vegetables, milk and milk products, egg, meat, fish etc), India has been quite successful in ensuring their ample availability to its population. But in addition to food availability, there are two more critical factors in ensuring food security to the citizen’s - access to food and its absorption for better nourishment.

Despite robust economic growth in recent years, one-third of India’s population, i.e. more than 376 million people in 2010 still lived below the poverty line, as per World Bank’s definition of $1.25 a day. Besides, the National Family Health Survey (NFHS-3) of 2005-06 highlighted that amongst children under five years, 20% were acutely and 48% chronically undernourished. The above facts definitely underline the continued relevance for safety net targeting that makes the poor and vulnerable food secure in terms of nutrition, dietary needs and changing food preferences.
 

The Need to Improve Administrative Data

Suvojit Chattopadhyay's picture
While we debate poverty estimates and methodologies, the humble administrative data continues to be ignored
 
A key aspect of good governance is the generation and use of data—good quality data, produced through reliable means that can inform policy-making and implementation. The importance of official data need not be underlined—state and national-level poverty statistics are fodder for academic as well as political debates. We know that this is mainly because the headline figures reflect the achievements of the governments in power.

However, in the same universe, administrative data is often ignored. Administrative data is the data collected primarily for (or as part of) implementation of specific interventions or functions. Within the government, this may refer to data as varied as that of birth and death registries; cooking gas cylinders issued; teachers’ attendance or mid-day meals served. It is easy to see how such administrative data can be used in monitoring implementation—better data can help identify and plug leakages; ensure better targeting and delivery; and maintain a high quality of service delivery, among others. In fact, the quality of data is both a contributing factor as well as outcome of the quality of governance. Better data, made public in easily digestible formats can also enable citizens to hold governments to account.

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