For verification of this paper, please visit on http://www.socialresearchfoundation.com/remarking.php#8

The World Health Organization(WHO) defines Sanitation as the provision of facilities and services for the safe disposal of human urine and faeces. It also refers to the maintenance of hygienic conditions through services such as garbage collection and waste water disposal. The need for safe, convenient and sustainable access to sanitation arise from the fact that a natural and private process like sanitation if not accessible can lead to various consequences and pose many threats related to health and nutrition. The consequences of improper and unhygienic sanitation conditions not only affect the human population and their wellbeing but also impact the economy and the environment at large. The ill effects are even far-reaching for girls and women leaving them vulnerable to physical and sexual violence. This is why; proper access to sanitation is seen as an essential component of Right to Life directly affecting one’s sense of privacy, dignity and safety. According to WHO, over 1.7 billion people still do not have basic sanitation services such as private toilets. In 2020 only 54% of global population used a safely managed sanitation service. WHO states that Open Defecation perpetuates a vicious cycle of disease and poverty. The countries where open defection is most widespread have the highest number of deaths of children aged under 5 years as well as the highest levels of malnutrition and poverty, and big disparities of wealth. WHO in it’s various reports and studies done across the world point to the need of proper access to sanitation and highlight the effects of lack of it with it’s special focus on girls and women. SDG 6(Sustainable Development Goal), set out by the United Nations to be achieved by 2030, states ‘Ensure availability and sustainable management of water and sanitation for all.’ UN studies further state that at current rates in 2030 around 2.8 billion people will lack safely managed sanitation and about 1.6 billion people will lack safely managed drinking water. Looking at the present scenario, UN estimates that meeting drinking water, sanitation and hygiene (WASH) targets by 2030 require 4 times increase in the pace of progress. India with it’s rich history and culture, from early civilization to modern times have emphasised on the need of cleanliness and it’s relation to health. Despite this knowledge, sanitation coverage was less than 1% at the time of independence and was only 2% in 1982, this led to many government backed schemes aiming to improve the situation with respect to cleanliness and sanitation. Keeping the same mission of cleanliness, hygiene, universal sanitation coverage and access in mind Swachh Bharat Mission was launched as a successor to earlier programmes on 2nd Oct 2014 on the birth anniversary Mahatma Gandhi drawing inspiration from his ideals of cleanliness and hygiene.

VerKuilen, Anna, et al., 2023 in the article “Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review” did systematic review of studies assessing impact of Swachh Bharat Mission on Open Defecation. The review also focused on identifying success and flaws of the mission and suggests recommendations to reduce open defecation in India. It found ODF claims by government to be overrepresented and variation among studies reporting rates of OD and latrine coverage in India.  Poverty and lack of finance identified as key impediments. It suggested need for research that look at social determinants of latrine uptake, improve infrastructure, provide education and use of community motivation and incentives to reduce /eliminate OD in India.

Behera, Manas Ranjan, et al., 2021 in the research paper “Achievements and challenges of India’s sanitation campaign under clean India mission: A commentary” examined achievements of SBM-G and highlight the challenges impeding the mission. It mentioned lack of water supply as key challenge. Other challenges include improper solid liquid waste management, toilet technology and inadequate human resource. It recommended to address the reasons for non usage of toilets and a credible monitoring process to be put in place to assess sanitation progress in the country.

Jangra, Babita, J. P. Majra, and Mahavir Singh.,2016 in the article “Swachh Bharat Abhiyan (clean India mission): SWOT analysis”  did a situational analysis of SBM highlighting strong points as well as weaknesses followed by suggestions with respect to sanitation improvement in India. It enlisted funding provisions, flexibility to the states and technological innovation as strengths whereas identified toilet construction without demand, social factors like caste, maintenance of toilets built and other factors as weaknesses. It also highlighted threats to the sanitation program like sustainability, change in leadership and will, solid liquid waste management and change in mindset of people.

Das, Priyam, and Julia Crowley., 2018 in the research article “Sanitation for all: a Panglossian perspective?” examined the factors that affect toilet ownership and use versus open defecation in India.  The study was done in three cities of Madhya Pradesh- Gwalior, Indore and Jabalpur. The findings highlighted that the factors that affect sanitation in urban areas are not similar to rural areas. It recommended focus on motivating households to build toilets, encourage toilet use by providing water and sanitation services, proper solid liquid waste management and the role of Public Private Partnership with respect to sanitation facilities. It also highlighted that many factors affect sanitation behaviour and it varies according to sociocultural context.

Curtis, Val., 2019 in the research article “Explaining the outcomes of the ’Clean India’ campaign: institutional behaviour and sanitation transformation in India” aimed to understand how Indian Government affected the sanitation transformation.  The study is based on interview with actors related to SBM program across the capital and four states. It found that high level political support and leadership changed the psychology of district officials which led to behaviour change for the program. Success of flagship districts acted as a booster whereas involvement of young professionals gave energy and ideas. Media informed and motivated the public. Despite challenges this drive could help attain SDG of universal access to safe sanitation.

Murugan, G. 2021 in his commentary paper “SWACHH BHARAT-2019: WILL RURAL INDIA BE ODF/SWACHH?” tried to evaluate implementation of Swachh Bharat Mission in Rural India. It aimed to showcase the progress, successes and pitfalls of the mission. It concluded that the program is laudable in its approach. Mass Movement and Political willingness are its strengths. However, there are quite many pitfalls. Using Capabilities Approach of Amartya Sen as the paper’s theoretical base, it concluded that sanitation is one of the key determinants of reduction in child stunting, this highlights the importance of sanitation in human development.

Alexander, Kathryn, et al., 2016 in the report “Ending open defecation in India: Insights on implementation and behavior change for Swachh Bharat Abhiyan”  tried to identify drivers of open defecation in India and impact of social,  economic, geographical,  cultural and political factors on the practice of open defecation. The study found Poverty as not the only constraint. Culture and belief regarding purity /pollution, social groups, different regions, lack of administrative capacity of central, state and local level and lack of usable data to assess progress all impact the status of OD in India. It recommended further research, promotion of latrine use, administrative capacity building, and target on information, education and communication regarding ODF behaviour rather than merely building toilets.

Exum, Natalie G., et al., 2020 in the article “Evaluating the declarations of open defecation free status under the Swachh Bharat (‘Clean India’) Mission: repeated cross-sectional surveys in Rajasthan, India” aimed to evaluate ODF claims of Rajasthan by studying OD trends from 2016-18. The study is based on cross sectional survey of household’s water and sanitation data in Rajasthan.  The sample size is of 20485. It found open defecation practices decrease in Rajasthan from 63.3% to 45.8% in rural areas whereas 12.6% to 9.4% in urban areas between 2016-18. Water related stress revealed to be key factor behind open defecation. 

Figure 1:- Major Sanitation Programmes launched in India since Independence

SBM-G was launched in October 2014 with mission of making India Open Defecation Free (ODF) by 2^nd Oct 2019 as a tribute to Mahatma Gandhi on his 150^th birth anniversary. According to Ministry of Drinking Water and Sanitation, ODF would mean the termination of faeco-oral transmission defined by, a) no visible faeces found in environment/village and, b) every household as well as public/community institutions using safe technology option for disposal of faeces.

Vision /Objectives of the Mission:-        

a. Improve quality of life in rural areas by improving cleanliness and hygiene

b. Sanitation Coverage in rural areas

c. Sustainable Sanitation practices

d. Cost effective and ecological safe technology for sustainable sanitation

e. Develop community managed sanitation systems

f. Positive impact on gender and promote social inclusion  with respect to sanitation

Characteristics and Strategy of SBM-G:-

a. Massive Mass Movement

b. Time bound aim and it’s implementation

c. Political will and leadership

d. Use of modern technology- Integrated Management Information System(IMIS), Geo-tagging

e. Flexibility to states as sanitation is state subject

f. Emphasis on Behaviour Change Communication and Campaign by Information, Education and Communication(IEC) division of the mission

g. Army of foot soldiers known Swachhagrahis or Swachhta Doots

h. Participation from all across the society- women, youth,  children, private sector, media, social and religious organisations

i. Illustrative list of technology options with cost implications made available

j. Augmenting institutional capacity of districts to undertake behaviour change activities at grassroots level

k.Strengthen capacities of implementing agencies to roll out program in time bound manner and measure collective outcomes

l. Incentivize performance of state level institutions to implement behaviour change activities in communities

m. Incentive amount of Rs. 12000 made available for construction of individual household latrine units (IHHLs)

n. Monitoring mechanism  to measure progress of programme implementation with focus on sustainability

o. Verification of ODF communities

p. Sustaining ODF communities

q. Supporting and Financing sustainability

Impact of SBM-G:-

India achieved it’s herculean task of 100% sanitation coverage by declaring villages, gram panchayats and states open defecation free on 2^nd Oct 2019 realising the dream set 5 years ago and leaving behind generational practice of open defecation. A total of more than 10 crore toilets were built at the cost of 1.3 lakh crores across the states and union territories. The achievement is commendable in itself given sanitation coverage was as low as 39% till 2014.

The National Family Health Survey- 5 2019-21 showed that 70.2% population having access to improved sanitation facilities as compared to 48.5% population in NFHS-4 2015-16. The survey also indicated a rural-urban divide with respect to population having access to improved sanitation facilities, where 81.5 % urban population has access to not shared and better sanitation facilities as compared to 64.9% of rural population. Improved sanitation facility is described as Flush to piped sewer system, flush to septic tank, flush to pit latrine, flush to don't know where, ventilated improved pit (VIP)/biogas latrine, pit latrine with slab, twin-pit/composting toilet, which is not shared with any other household.

Table 1:- Percentage Population living in households that use an Improved Sanitation Facility

Population living in households that use an Improved Sanitation Facility (%)
%Population	NFHS-5 (2019-21)			NFHS-4 (2015-16)
	Urban	Rural	Total	Total
	81.5	64.9	70.2	48.5

Source: - NFHS-5 2019-21

Figure 2:- Percentage Population living in households that use an Improved Sanitation Facility

 

Source: - NFHS-5 2019-21 

The National Sample Survey 78^th round 2020-21 showed 84.6% of households having access to latrines in all India as compared to 79.8% households in the NSS 76^th round 2018. In urban areas, 97.1% households have access to latrines as compared to 96.2 in 76^th round 2018; marginal increase can be seen from the earlier round. As for the rural areas, 78.7% households reported access to latrines in 78^th round as compared to 71.3% in 76^th round; here also slight increase can be seen but more than urban areas.

Table 2:- Percentage of households reported to have access to latrine

Percentage of households reported to have access to latrine
NSS rounds	Percentage of households
	Rural	Urban	All
78th round	78.7	97.1	84.6
76th round	71.3	96.2	79.8

Source: - NSS Round 78^th 2020-21

Figure 3:-Percentage of households reported to have access to latrine

 

Source: - NSS Round 78^th 2020-21

According to NARSS 2019-20, overall accessibility of the toilets for the households was found to be 94.4 percent at national level. The accessibility was reported to be was 98.0 percent in ODF villages while 77 percent in Non-ODF villages. Accessibility comprised of own toilet, shared toilet and public toilet access in total by the household. ODF & Non-ODF households relied on different set-up of toilet facilities depending on ownership status. Main type of toilet to which the ODF households got access to, is own toilet (81.5%), shared toilet (15.4%) and community Toilet (1.1%). In Non-ODF households, the trend of using the types of toilet is different, where the percent of Households with own toilet is accounted to 67.8 percent, shared toilet (9%) and community toilet (0.2%). Overall, 5.6 percent of households do not have access to toilet facilities, meaning they practice open defecation. Percentage of households practicing open defecation decreased from 6.7 percent in NARSS Round-2 (2018-19) to 5.6 percent in NARSS Round-3 (2019-20) at national level. In NARSS Round-1 (2017-18), the percentage of household practicing open defecation was reported to be 24 percent.

Figure 4:- Accessibility by types of toilet %

 

Source: - NARSS ROUND-3 2019-20

Figure 5:- Percentage of households practicing OD

 

Source: - NARSS ROUND—3 2019-20

As apparent from the above figures and tables, there has been a significant increase in the sanitation coverage after the launch of the mission in the country and open defecation has reduced by great amount. However the 100% open defecation free claim of the government stands questioned. Many reports, articles and studies have found 100% ODF claim to be overrepresented, either there is lack of sanitation coverage or relapse to open defecation. A Joint Monitoring Programme report for WASH by WHO and UNICEF released in 2021 stated that atleast 15% of total population defecated in open in India, 1% in urban areas and 22% of rural population defecates in open. The declaration of ODF status is a slippery issue as the rush to achieve targets has led to false claims in the past. Later field verifications carried out shows that in many villages that were declared to be ODF in the past 100 % coverage have not taken place, left over and re-emergence were very common in these ODF declared villages(Murugan, G 2021)

Roadblocks to ODF:-

In India the prevalence of open defecation is driven by various determinants and these diverse factors in turn affect the uptake and usage of toilets. The practice of open defecation in India is not only an infrastructural issue arising due to lack of toilet facilities rather is also determined by sociocultural, economic, geographical and psychological factors. The various factors are discussed below.

1. Access to water- availability of adequate water resource either within the household premises or at a reasonable distance from the dwelling units, is another problem or forms the main requirement affecting toilet use(Murugan, G 2021).

2. Quality and type of toilet constructed- the type and quality of toilet built affected people’s attitude towards toilet use. Either the construction was substandard or inappropriate. Also villagers were dissatisfied because there thinking of an ideal toilet costs more than what was provided. Panchayat driven bulk purchase of materials and arrangement of construction (through masons and contractors) was widespread. Twin-leach pit technology was promoted, irrespective of the local conditions. Despite deeply embedded preferences for big septic tanks among households, they did not receive information regarding design options or materials. Many toilets were of substandard quality and had flawed designs(Abraham et al 2018). Another important aspect is the pit depth and misbelief among the beneficiaries or rather fears among them on pit filling. One reason for this pattern is that smaller pits are perceived to require frequent emptying, an activity which is associated with caste impurity on the one hand and the associated cost involved on the other. Large pits, in contrast, do not require emptying as frequently, and therefore their use does not invoke the same worries about contact with faeces or hiring a manual scavenger. Further, the excessively high cost of pit emptying also prompts the beneficiaries to construct large pits as they are completely ignorant of twin pit latrine technologies(Murugan, G 2021). Literature and studies carried out earlier suggest that in many cases the constructions cannot be made use of by the beneficiaries because of water logging, both inside the latrines as well as inside the pit. It is by and large a single pit in most of the states, excepting Rajasthan where the percentage is low. A large number of the villagers use containment chambers too. Both together constitute more than 70% of the newly constructed toilets. However in both cases there is a fear among the users on pit filling on shorter duration and there by the users may go for open defecation (Murugan, G 2021).

3. Geographical and Seasonal constraints- many areas of the country that experience seasonal variations either water scarcity due to droughts or water logging issues due to floods see relapse to open defecation and non usage of toilet.

4. Behavioural constraints- habit of open defecation and non usage of toilet either due to convenience or unawareness stood as major impediments in the way of promoting and ensuring toilet uptake and usage. Individuals opt for open defecation practices in spite of having sanitary larine at their premises and by analysing various reasons of open defecation practices, it was found that many opt for it due to their habits and others felt this practice very comfortable or convenient (Namdev Garima and Vinod Narkhede 2020).

5. Demand creation with regards to toilet ownership and usage- one of the most critical components of any public health program is to generate the demand among the community(Jangra B et al 2016), as merely construction of toilet infrastructure doesn’t help the purpose as habits outweigh the will to change.

6. Lack of technical guidance- technical guidance regarding toilet and pit design and construction appropriate and suitable to the area was lacking and there are not many trained personnel to work in the field. Masons are the technical experts available to the poor villagers, and they use their own judgments to prescribe technical specifications, faulty and defective in many circumstances as they are not updated with technologies(Murugan, G 2021).

7. Lack of staff at ground level- an impediment in the successful implementation of the program is its staffing in rural villages. Even though the SBM guidelines recommend a full-time sanitation officer for each block neither the block-level positions nor recommended district-level positions were found to be filled. In some states, the required man power is not available, whereas in some other places the bureaucracy does not give importance to these functionaries(Murugan, G 2021).

8. Lack of proper solid liquid waste management (SLWM)- lack of faecal waste management poses itself as both challenge and threat. As years pass on, the number of latrines, particularly the one with single pit and container chambers increase Sustainable Faecal Sludge Management practices is a question that needs to be addressed, failing which it could possibly have effects in contravention to what is desired. With the number of new toilets constructed, there will at least be a generation of 1, 00,000 tonnes of shit every day. The high density of pit latrines and poorly made and maintained septic tanks can render the shallow aquifer water, unfit for drinking because of nitrate and bacterial contamination. The deep pits do not need emptying but can contaminate groundwater if they are very deep. Moreover, in many areas, there may not be having an adequate lining of pits. The issue of dysfunctional toilets itself is because of the faulty single pit construction in the past.(Murugan, G 2021).

9. Cultural and religious beliefs- cultural and religious beliefs affect habits and practices of people. Beliefs such as toilet should not be within the household premise and purity/ pollution influence people’s willingness to build and use toilet. Cleaning of toilet, emptying toilet pits and scavenging all these activities are associated as work of some particular castes in the rural areas and with untouchability, this view also affects the mindset of people about sanitation and toilet use (Coffey, Diane, et al 2017).

Moving towards ODF-plus

In order to sustain and reinforce ODF behaviour and make solid liquid waste management (SLWM) accessible, the mission entered its second phase as SBM-G ODF-Plus

Objectives:-

a. Open defecation free behaviours are sustained and no one is left behind

b. Solid liquid waste management facilities are accessible and focus on providing interventions for safe management of solid and liquid waste in villages

c. To encourage cost effective and appropriate technologies for ecologically safe and sustainable sanitation

d. To develop wherever required community managed sanitation systems focusing on scientific solid liquid waste management for overall cleanliness in the rural areas

According to Department of Drinking Water and Sanitation, Ministry of Jal Shakti out of 5, 93,152 villages 3, 36,166 have declared themselves ODF-plus.

Figure 6:- Percentage of ODF+ Villages in the States

Source: - SBM-G Dashboard

Figure 7:- Number of ODF-Plus Villages

Source: - SBM-G Dashboard

Figure 8:- ODF+ Indicators

Source: - SBM-G Dashboard 

The research paper is based on Secondary Sources of data. The Sources include official website of SBM-G, WHO, UN-SDG and others, reports of NSS, NFHS, NARSS and studies, research articles, papers related to the topic. The research paper is Descriptive in nature.

1. Abraham, Mary, et al. "Using immersive research to understand rural sanitation: lessons from the Swachh Bharat Mission in India." (2018). 2. Alexander, Kathryn, et al. "Ending open defecation in India: Insights on implementation and behavior change for Swachh Bharat Abhiyan." (2016). 3. Alexander, Kathryn, et al. “Ending open defecation in India: Insights on implementation and behavior change for Swachh Bharat Abhiyan.” (2016). 4. Coffey, Diane, et al. “Understanding open defecation in rural India: Untouchability, pollution, and latrine pits.” Economic and Political Weekly 52.1 (2017): 59-66. 5. Curtis, Val. "Explaining the outcomes of the’ Clean India’ campaign: institutional behaviour and sanitation transformation in India." BMJ global health 4.5 (2019): e001892. 6. Das, Priyam, and Julia Crowley. “Sanitation for all: a Panglossian perspective?” Journal of Water, Sanitation and Hygiene for Development 8.4 (2018): 718-729. 7. Exum, Natalie G., et al. "Evaluating the declarations of open defecation free status under the Swachh Bharat (‘Clean India’) Mission: repeated cross-sectional surveys in Rajasthan, India." BMJ Global Health 5.3 (2020): e002277. 8. Government of India, NARSS Round-3 2019-20,Ministry of Jal Shakti, 2019-20 https://swachhbharatmission.gov.in/sbmcms/writereaddata/Portal/Images/pdf/NARSS_2019-20_Report.pdf 9. Government of India, NFHS-5,Ministry of Health and Family Welfare, 2020-21 https://main.mohfw.gov.in/sites/default/files/NFHS-5_Phase-II_0.pdf 10. Government of India, NSS-78TH, Ministry of Statistics and Programme Implementation, 2020-21 https://mospi.gov.in/download-reports?main_cat=NzIy&cat=All&sub_category=All 11. Government of India, Swachh Bharat Mission Grameen - Report Card, Department of Drinking Water and Sanitation, Ministry of Jal Shakti, 2019 https://swachhbharatmission.gov.in/sbmcms/writereaddata/Portal/Images/pdf/SBMG_Report_Card.pdf 12. Government of India, Swachh Bharat Mission: About SBM https://swachhbharatmission.gov.in/SBMCMS/about-us.htm 13. https://static.pib.gov.in › PDF SWACHH BHARAT MISSION – GRAMEEN 14. Jangra, Babita, J. P. Majra, and Mahavir Singh. “Swachh bharat abhiyan (clean India mission): SWOT analysis.” International Journal of Community Medicine and Public Health 3.12 (2016): 3285-3290. 15. Ministry of Drinking Water and Sanitation. "Guidelines for Swachh Bharat Mission (Gramin)." (2017). https://swachhbharatmission.gov.in/sbmcms/writereaddata/images/pdf/Guidelines/Complete-set-guidelines.pdf 16. Murugan, G. “SWACHH BHARAT-2019: WILL RURAL INDIA BE ODF/SWACHH?” (2021). 17. Namdev, Garima, and Vinod Narkhede. “Reasons of Open Defecation Behavior in Rural Households of Bhopal, Madhya Pradesh, India.” National Journal of Community Medicine 11.03 (2020): 103-106. 18. Swachhata Sanskriti, https://swachhbharatmission.gov.in/sbmcms/writereaddata/Portal/Images/pdf/Swachhata-Sanskriti-Draft-G2-Small-Review-Copy.pdf 19. United Nations, Sustainable Development Goal-6 https://sdgs.un.org/goals/goal6 20. VerKuilen, Anna, et al. “Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review.” Frontiers in Environmental Science 11 (2023): 565. 21. WHO and UNICEF, Joint Monitoring Programme WASH 2021 22. WHO Factsheets on Sanitation https://www.who.int/news-room/fact-sheets/detail/sanitation