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


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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.

To inform this technical assistance program, a review of the World Bank’s Water and Sanitation Program (WSP)’s previous engagement in India’s rural sanitation sector asked pertinent questions about how the technical assistance it provided could be scaled up to achieve the impact and sustainability required. Based on the key findings, a three-step pathway to scale and sustainability emerged and is now guiding the current programmatic assistance.

1. Further increasing political will and administrative commitment by identifying and creating local sanitation champions at the district level – for example, through exposure visits and evidence-based advocacy – and addressing key institutional bottlenecks such by supporting the state to formulate a state-specific sanitation policy.
2. Providing technical support to selected districts to demonstrate that sanitation can be delivered at the scale of a district and in a sustainable manner, and to develop district-wide approaches that are tailored to a particular state.
3. Supporting the strengthening of state governments’ institutional capacity to roll out the successful models to other districts, eventually covering the entire state.

The study covered WSP’s work in eight states (Bihar, Haryana, Himachal Pradesh, Jharkhand, Madhya Pradesh, Maharashtra, Meghalaya, and Rajasthan) between 2002 and 2013. This saw varying levels of success, with the experience in Rajasthan proving particularly pertinent in informing the three-step pathway.

As well as the creation of local champions, and government decision makers being willing to try something new, success factors included the ability to demonstrate progress by starting work in locations that were not the poorest, so households had some resources to invest in sanitation; and the sanitation sector in the state not being fragmented among multiple development actors. Further details about what we learned can be found in the newly-published learning note.

Rajasthan -  the three-step pathway in action
A large and mostly rural state, Rajasthan has historically lagged behind other states in sanitation: only 19.6 percent of rural households had a toilet in 2011. We invited ten of the state’s 32 district collectors – high-ranking officials, who are often relatively young and ambitious – on a study visit to Himachal Pradesh, which is much further advanced in rolling out sanitation.

During that visit, we observed that three of the ten collectors seemed especially enthused. We supported them to improve sanitation in their districts and showcased their successful experiences to the state government. The Chief Minister of Rajasthan declared sanitation as one of the state’s top development priorities, with a target of eliminating open defecation by 2018.

We gave the state government the technical assistance it needed to set out clear policies and guidelines and strengthen the responsible institutions: making processes more efficient, improving communications between state and district administrations, and reducing delays in implementation.

Prof. Partha Sarathi Datta
July 07, 2016

I appreciate the emphasis on behavioral change.
Perception Management and behavioral and mental attitude change is the greatest challenge!!!
The best way to deal with growing humanitarian needs is to address their root causes. Because, development is the best resilience-builder of all, the the scarce resources of official infrastructural development assistance should be used where it matters most—in situations of fragility. This requires a strong determination at the highest level of political leadership to prevent and resolve conflicts and to increase investment in risk reduction leading to disastrous situation by change in attitude and behavior of all the stakeholders.
Behavioral techniques (in this context) refer to any kind of approach that involves changing service users’ behavior to produce a certain outcome. Although there is overlap, behavioral techniques differ subtly from communication projects in the sense that rather than overtly informing customers behavioral techniques usually tap in to the power of social normative behavior.
It is desirable to focus on science for policy on three main areas:
• Providing and facilitating the participation of scientists in policy processes,scientific advice, coordinating.
• Providing advice on how policy processes should be created or modified to best utilize available scientific knowledge.
• Creating programs that will improve collaboration between scientists, policy-makers and all other stakeholders in the generation of scientific knowledge.

liaqat hayat
July 07, 2016

The important point in this aspect is to put some demonstration projects and let the people see for themselves the benefits after linking it with some economic benefits

liaqat hayat
July 08, 2016

i am interested to know what technical help in form of writeups or
handsketches provided to vilagers

liaqat hayat
July 08, 2016

what about other regional entities like pakistan or srilanka etc for similar programs

Hilda Winarta
July 12, 2016

Both Pakistan and Sri Lanka have their own proven successes in respectively reducing and eliminating open defecation practices. These could be studied for replication by the non or less performing areas in the respective country

Ismaila A. Hassan
July 09, 2016

Unhealthy social practices like defecation in the open are detrimental to attaining much needed global health coverage by the year 2030. Improving rural sanitation depends much on how defecation in the open is discouraged. It is the simplest way airborne diseases are spread with ease.

Meera HIra Smith
July 12, 2016

Yes indeed swach bharat by 2019 is the goal but that also means to monitor the construction of the toilets and their usage as mentioned above together with behavioural change. In some areas, as I have seen during the field visits, the external structure is constructed to obtain the fund without constructing the pit and many such toilets are used as store rooms. It is pertinent to setup mobile texting to report on such implementation. Project Well with local NGO, Aqua Welfare Society of WB, has a surveillance program developed with water projects in two districts of arsenic contaminated villages of West Bengal and now planning for honey-combed toilets in the same area. With the web-based monitoring and tracking system this program will definitely help in enhancing the health of the villagers. Proud of the field team who are dedicated to their work (http://www.projectwellusa.org/)

Nripendra Kumar Sarma
August 30, 2016

SBM needs to focus more on Behaviour Change with regard to safe WASH practices, rather than merely on eliminating Open Defecation. All efforts must have M&E as an attached component to highlight real sustained practices. Thanks and Regards