• GGI

India's Sanitation Crisis: An Unequal Gender access in rural India



The Government of India ventured on a journey to make the country open defecation free through the Swachh Bharat Mission in 2014. If India is indeed ODF is still a matter of scrutiny and utmost concern.



1. Abstract


Despite both the rural and urban areas being declared as 100% ODF by the government at the end of the first phase of SBM, it is found that there are gaps in the implementation of ODF status. The National Annual Rural Sanitation Survey (NARSS)-(2019-20), a survey conducted by an Independent Verification Agency (IVA) under the World Bank support project to the Swachh Bharat Mission Gramin (SBM-G) for measuring the performance of each states’ rural areas, shows that only 85% of the rural population is using toilets that are safe, functional & hygienic and only 90% of the villages have been able to sustain their ODF status which in fact a marginal reduction from the last round of the survey while only about half the rural population was found to be practising solid & liquid waste management which is a 10 percentage point reduction from the previous round of the survey.


The objective of this white paper is on SBM -Gramin and aims to identify the reasons for current gaps in ODF implementation and accordingly provide useful recommendations by identifying areas that demand attention to help bridge the existing gaps for an open defecation free India. The construction of toilets through Swachh Bharat Mission has given a push to the dream of open defecation free India, but there are issues in functioning and maintenance of these toilets, problems related to access rooted in caste and gender though there has been positive behavior change to use the toilets after the first phase of SBM. The paper takes into account best practices from the states that have been able to fare better than others as well as draws on relevant international practices.


2. Swachh Bharat Mission- Challenge to sustain the ODF status


At the start of the Swachh Bharat Mission in 2014, about 600 million people in India defecated in the open, of which 550 million were in rural areas[1]. To accelerate the efforts to achieve universal sanitation coverage and to put focus on safe sanitation, the Prime Minister of India launched the Swachh Bharat Mission on 2nd October, 2014, under which 9.5 crore toilets were constructed in India from 2014-2019 in order to achieve Open Defecation Free status in all states/UTs by October 2, 2019.


The focus of SBM-G[2] phase 1 was on the creation of toilets , creating complete ODF villages whereas with phase 2 since 2020, the focus has now shifted to sustain the ODF status and to improve the levels of cleanliness in rural areas through solid and liquid waste management activities, making villages ODF Plus. The government now acknowledges that constructing toilets is only the first step in its vision to achieve an ODF India and now the challenge is to sustain the ODF status.


3. Research Methodology


The research methodology entails thinking from first principles in identifying the reasons/drivers for current gaps in ODF implementation. For each of the drivers identified, a hypothesis is formulated, and an attempt is made to either accept or refute the hypothesis based on data analysis. The four disbursement linked indicators that NARSS Report(2019-20) mentions are-


  1. Poor maintenance of toilets has contributed to gaps in OD

  2. Difficulty in access is specific to problems of gender and caste

  3. Resistance to change and lack of awareness contributes to the problem of OD

  4. The funds allocated for the exercise are insufficient and the amount of incentive provided for the construction of toilets is inadequate




Out of these 4 disbursement linked indicators, we are relying on the first three, due to lack of state wise data on the 4th disbursement linked indicator for coming up with the list of best and worst performing states. The paper relies on secondary research to draw conclusions on the extent of the problem. An attempt has been made to identify certain measurable key performance indicators for each of accessibility, usage, maintenance of toilets and on SLWM practices in order to quantify the problem.


Since at the start of the SBM 92% of the problem of OD was in rural India, we have limited the scope of our research to rural areas. Further in our analysis of data, we are concentrating upon household and public toilets as they comprise the major share of overall toilet usage.

Through a quantitative analysis of indicators as identified for each of the drivers, it is sought to identify the current gaps in OD while mentioning the learnings from the best performing states. Suitable recommendations have then been made specific to the problems as identified by benchmarking to best practices.


4. States wise Ranking according to the calculation based on 3 DLIs


The disbursement linked indicators were based on the various parameters of sanitation, which helped in setting a benchmark for the distribution of financial incentives to states and UTs. The financial incentives were directly proportional to the actual DLI performance of the states and UTs[3].



Best & Worst Performers based on rankings



5. Analyzing the Supply side issues:


1. Maintenance of Toilets

Without basic sanitation services, people have no choice but to use inadequate communal latrines or to practise open defecation, posing a risk to health and livelihoods. Even in communities with toilets, waste containment may not be adequate. If toilets are difficult to clean or not designed or maintained to safely contain, transport and treat excreta, slippage from Open Defecation Free (ODF) status is inevitable. Hence, maintenance of toilets becomes fundamental towards sustaining ODF statuses achieved by various states. Maintenance of toilets can be studied under three aspects. They are:


· Functionality of the toilets

· Availability of water

· Solid and Liquid Waste Management


A) Functionality of Toilets


The functional status of the toilet can be determined by observing four components. Such as:


I. pan/seat is not completely broken

II. pan is not completely choked

III. pits/tanks are completely covered

IV. pipes are not completely broken or open.

A toilet is considered non-functional if any of the parameters stated above, is found to be compromised.


IHHL:

State-wise data analysis shows 98 percent of household toilets at national level were functional.


Focus states having dysfunctional household toilets:


Out of the 6013 toilets surveyed in Bihar 18% of toilets were found to be dysfunctional. Likewise, 15.8% of 3704 toilets surveyed were found to be dysfunctional in Odisha.With the available data, we could interpret that people do not prefer to use toilets in Bihar because pipes were completely broken in 17.7% of the toilets, pit tanks were left uncovered in 0.5% of the toilets, pans were completely choked in 0.6% of the toilets and pans were completely broken in 0.2 % of the toilets.Likewise, in Odisha toilet pipes were completely broken in 13.8% of the toilets, 0.4% of toilets had their pits uncovere[4]d, 2.7% of toilets had their pans choked and 1.6% of toilets had their pans broken.


Historical trend shows that the percentage of households with functional toilets decreased from 98.6 percent in NARSS Round-32-2 (2018- 19) to 96.4 percent in NARSS Round-3 (2019-20).


PT/CT:

Sate-wise data shows that 98.6% of the public toilets.[5] community toilets at the national level were functional.

Focus states having dysfunctional public/ community toilets:


Historical trend shows that the percentage of PT/CT with functional toilets decreased from 99 percent in NARSS Round-2 (2018- 19) to 98.6 percent in NARSS Round-3 (2019-20).

B) Availability of Water

Availability of any one of the following sources was checked to declare status.

  1. piped water supply in the toilet, or

  2. small water turf/tank next to the toilet, or

  3. bucket of water kept next to the toilet, or

  4. presence of well or hand-pump in the house premises, or

  5. presence of any other water sources.

IHHL:

Sate-wise data shows that 99.6% of the public toilets/ community toilets at the national level had access to water.

Focus states having no access to water:


Historical trend shows that the percentage of households with adequate water supply has remained unchanged at 99.6% in NARSS Round-2 (2018- 19) and NARSS Round-3 (2019-20).


PT/CT:

State-wise data analysis shows that 99.6% percent of public toilets/ community toilets at a national level has availability of water.

Focus states having inadequate supply of water:


None of the segregated worst performing states have inadequate supply of water. Hence, water is available for sanitary purposes. However, it is important to understand that as explained in other sections, the shortfall in compliance to functionality and hygienicity could directly influence the water usage in select states.


Historical trend shows that the percentage of PT/CT with an adequate supply of water has increased from 94.4 percent in NARSS Round-2 (2018- 19) to 99.6 percent in NARSS Round-3 (2019-20).


C) Hygienic Toilets:


The criteria of the toilet to become hygienic includes[6]

I. Toilet is connected to a tank/pit or a sewer system

II. Availability of fly proof seal (Water trap/lid/other) in the toilet and

III. The presence of no visible human excreta in the squatting area.

IHHLs:

State-wise analysis of data shows that the household toilets at the national level were reported to have more 96.3% percent hygienic toilets.

Focus states having unhygienic household toilets:



With the available data we interpret that in states like Bihar, the entire 18.1% of surveyed toilets attributes to majorly one problem which is human excreta being visible in the squatting area Odisha, on the other hand, observed unhygienic practices due to human excreta being visible (18.2%), fly-proof seal unavailable (0.3%), and toilets not connected to sewer systems(0.3%).


Historical trend shows that the percentage of households with hygienic toilets increased from 95.0 percent in 2018-19 to 96.3 percent in 2019-20.

PT/CTs:


Safe technology for disposal of human excreta includes the options of a septic tank with no overflow /discharge to surface / open drain; and/or with Soak pit, single leach pit, double leach pit, a closed drain with the sewer system, and closed pit. If a toilet was reported with any one of the disposal options stated above, it has been considered as having safe disposal


Focus states having unhygienic public toilets:



At an all-India level, 99.9% of the villages practice safe disposal of excreta. The only state which has not yet achieved a 100% hygienic public toilet status is Madhya Pradesh (96.4%).


Historical trend shows that the percentage of households with hygienic toilets increased from 99.2 percent in 2018-19 to 99.9 percent in 2019-20


D) Solid & Liquid Waste Management


Solid Wastes:

Solid waste management process could be studied as follows:

I. Indiscriminate (there is no formal arrangement)

II. Safely disposed within the household

III. Disposed outside to common system.

The country-wise data shows that 97.5% of households had no evidence of solid waste within the premises.

Worst performing state where solid wastes are visible within the premises of the household includes Mizoram (86.1%) and Punjab (99.8%) is one of the best performing states.


Focus states practicing unsafe disposal of solid wastes:


J&K, Jharkhand, Puducherry and Odisha are among the states which has lowest levels of households with a formal arrangement to dispose off solid waste although they have very low to zero levels of solid waste visibility within the premises. Hence, we could understand that a significant percentage of households preferring cleanliness of their premises do not practice safe disposal of solid wastes.


Historical trend shows that the percentage of households where solid waste is not visible remained unchanged at 97.5 percent from NARSS Round-2 (2018-19) to NARSS Round-3 (2019-20).


Liquid Waste :

Liquid waste management process could be studied as follows:

I. Indiscriminate disposal

II. Flows into a common system

III. Kitchen garden

IV. Soak Pit

The countrywide data shows 12.8% of unsafe disposal of wastewater, which is a thwarting increase from the previous survey.


Focus states that practice unsafe disposal:


Although practicing indiscriminate disposal, it is found that households in Jharkhand and J&K among other states seem to have very limited or even no evidence of wastewater in their premises. This essentially means apart from those who practice indiscriminate disposal, people do extensively use other methods of safe disposal as well. Other states that do not perform well in terms of evidence of wastewater within the household premises include Mizoram, Karnataka, Andhra Pradesh and D&N Haveli. Since majority of these states do not practice significant levels of indiscriminate disposal, it is ideal that the focus must be placed on other methods of safe disposal as well.


Historical trend shows that the percentage of households where liquid waste is not visible increased from 96.3 percent in NARSS Round2 (2018-19) to 97.4 percent in NARSS Round-3 (2019-20).[7]


E) Benchmarking Regions:


Best practices:


Sikkim:

· The convergence of IAY/CMRHM/MGREGA/SBM

· State Government benefits linked with Toilets (Carrot & Stick Policy)

· Toilets Mandatory to contest GP Elections

· Cost-Effective construction - Use of local materials (abundantly available Ekra bamboo) and contribution from beneficiaries

· Local masons employed.

· Saved an average of Rs. 10,000/- (ten thousand rupees) per toilet

· Every Friday Field Day: Visit villages by the District Collector and line departments to ensure beneficiaries welfare.


Tamil Nadu:

Namma Toilet is an initiative by the Commissionerate of Municipal Administration, Tamil Nadu along with participation of Urbane Industries Ltd to eradicate open defecation in the State. The mandate was to design and develop a user-friendly universal toilet which will be sustainable and should be successfully used by the people across all socio-economic spectrum. The first set of toilets were installed in Tambaram, a suburb of Chennai. Everyday about 1200 people use four toilets installed there

Distinctive features:

· International quality surface finish for ease of maintenance, anti-graffiti and also this surface prevents smell generating bacteria from surviving on the inner wall surfaces.

· Smell free toilets due to abundant louvers for easy passage of fresh air at all times from the door to the top most positioned louvers

· Modular design to fit various site sizes, shapes and user requirement

· Modules made of composite materials for ease of installation at a very short period even in hilly terrain and remote places

· Concealed plumbing with independent water tank and a room under the water tank for the maintenance staff and the material used for maintenance

· Rounded edges to prevent accumulation of dirt and grime and also for easy cleaning

· Flushing system in all the stalls with a five-litre capacity tank to ensure proper cleaning of the pan after the use

· Universal and standard signage with logo for common identification and uniformity across the whole country

With all the necessary fittings and additions, the per seat cost appears higher but in the end when we take the life cycle costs (i.e 25 years or more) and facilities provided as compared to regular toilets the costs are very much comparable and also the purpose for which it is built is served, which is of the most importance.

F) Worst performing region:

Bihar:


As mentioned above, Bihar has not been performing well in most of the parameters of[8] functionality for both IHHL and PT, availability of water in IHHLs, and hygienic toilets in IHHLs. It seems to be topping the list of worst-performing states as per the NARSS Report 2019-2020.

Gaps identified:

· It is found in Bihar that a village called Navdiha, Naubatpur block, Patna has recorded 23.93% ODF coverage has not witnessed even a single toilet construction in the past two years.

· There are instances where households haven’t been able to use the toilets as they weren't able to complete construction due to the lethargic process of payment of grants.

· Contractor-built latrines were generally of poorer quality.In Bihar, 49% of their latrines constructed, were used whereas only 19% of the toilets constructed with the government’s support were used.

· It is also found that households are disinterested in proper sanitation as it was not only difficult but also impossible to build a toilet with the government grant of Rs.12000 as the actuals approximately counts to Rs.20,000 per toilet.

· Coercive treatment leads to compromise on quality because the citizens are forced to construct toilets and if not done so, they are denied of government benefits, imposed fine and deployed by government staff or members of community vigilance group. 56% of people surveyed in rural Madhya Pradesh, Rajasthan, Bihar, and Uttar Pradesh reported being aware of at least one of three coercive practices

· In terms of unavailability of space to construct toilets at home, one of the Swachh Bharat officials said, “Space is a huge issue in the state as houses here are small and there are limitations in terms of connecting sewage pipelines to the toilets or even installing a twin-pit toilet. Because of these limitations, people don’t prefer constructing toilets at home.”

· In some areas, most toilets are based on the single pit design, not the twin-pit ones that the government recommends. The twin-pit design allows the decomposition of faecal sludge in one pit while the other is being used, providing a safe way of emptying it. However, 48% of latrine owners with twin pits said that both the pits were used at the same time, defeating the idea of sustainable design. On the other hand, single pits require undecomposed sludge to be emptied manually or through expensive suction machines.

· 49% of people in Bihar used a single pit toilet, 16% used twin pit toilets and 30% used a containment chamber.Of the households using single pit latrines, only 1% of respondents said they emptied their toilet pits on their own, while 86% said they would call manual scavengers to empty their pits when required. About 13% either did not respond to the question or said they would revert to open defecation when such a time ca[9]me

2. Access to Toilets – Unequal access for women and Social Stigma


India tops the list for longest queue for toilets according to Water Aid. [10] The NARSS report says that accessibility to toilets is 77 percent in Non-ODF villages which means that 23% people in the Non -ODF villages still do not have access to toilets.




The NARSS data describes accessibility as access in terms of access to either a household toilet or shared toilet or even a community toilet . The findings of Research institute for compassionate economics (R.I.C.E) which suggests that 44% of people in rural Madhya Pradesh, Bihar, Uttar Pradesh and Rajasthan still defecate in the open[11] are even more worrisome. The successive rounds of the NARSS however does show a decrease in the percent of people practicing 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 households practicing open defecation was reported to be 24 percent .


Lack of Access forms a major driver leading to gaps in ODF. The gendered nature of relations and caste barriers leading to


social stigma play a big role in affecting access for certain segments of the population such as women and the so called lower castes as discussed below.


A) Gender Unequal access for women

The report by WaterAid points out that female biological needs make lack of toilets particularly harmful for women and girls.Women are forced to face the shame of Open Defecation due to the lack of consideration to their differential sanitation and privacy needs and poor access to toilet facilities.

[12]


Source - NARSS report 2019

Root cause - Gendered nature of relations in rural India -Lack of Women’s say in decision making in households and in the toilet design process at the community level.


In sanitation-related matters such as latrine building, it is the men who take crucial decisions like site identification, raw materials needed for construction, arranging masons for latrine building and investment.[13] Men who control the household budget, are many a time not keen to build it or prefer to keep it unfinished or nonfunctional and are often not sensitive to the needs of the women of the household. Although women who work as labourers are found to have some say in household decisions, they do not have lands to build latrines on because it is the men who are in charge of the economic resources.


Problems related to access to toilets for women

i) Lack of Prioritisation of Safety

● UNICEF reports that women pay the heaviest price for poor sanitation, and 50% of rapes in rural India occur when women defecate in the open. These concerns are magnified in the evenings and late nights.

● Even though according to a study done by UNICEF, Bill & Melinda Gates Foundation (BMGF) and Sambodhi Research and Communications Private Limited , which took into account a representative sample of 8290 households (interviews with 6993 women and 1297 men ) with a toilet constructed after 2017 interviewed across 320 villages of five states, found out that SBM – Gramin led to improvement in the safety of women (suraksha), with 93% of women reporting that they were no longer afraid of being hurt by someone or harmed by animals while defecating, yet this safety has in reality come at the cost of patriarchal assumptions. Improving the safety of women was cited as the primary reason for the construction of toilets by men[14] rather than seeing it as a much needed hygienic practice. Such an approach to sanitation neglects the role that unequal relationships of power play have in enabling or constraining access to health resources.


Lack of female caretakers in the public toilets which was also a reason identified by Greater Warangal Municipal Corporation (GWMC) in the state of Telangana, India when they tried to stop open defecation and urination in the city by providing public toilets in high population density areas.[15]


● There have been instances where women reported that men enter women's toilet blocks during power failures. Also, as toilet complexes often shut down when there is a power failure, women are forced to use open areas for defecation which leaves them vulnerable to further harassment.[16]


ii) Menstrual Hygiene management- least prioritised element in SBM -G


Menstrual Hygiene Management (MHM) is tucked neatly in the Swachh Bharat Mission Guidelines. Point 5.9.2 of the Swachh Bharat Mission Guidelines states, “Issues relating to women’s personal hygiene namely menstrual hygiene are to be focused under the SBM (Gramin). Girls and women have hygiene and sanitation needs linked to their menstrual cycle. Women suffer in the absence of knowledge about safe practices on Menstrual Hygiene Management (MHM)[17]Yet, MHM is still recognised as one of the least prioritized components of SBM-G.

After SBM, due to the availability of toilets in their household, 77% of women reported feeling stress-free about changing absorbent material when required as opposed to 27% when they did not own a toilet. However, on the Lok Sabha question of allocation of funds to the MHM component of SBM-G, the Ministry of Drinking Water and Sanitation answered that they do not release component-wise funds and do not have any monitoring mechanism in place (Lok Sabha 2017). Ground reports show that knowledge of proper menstrual hygiene practices is still lacking. Girls have access to sanitary napkins as long as they are provided with the same from the school and later, stop using them because of non-affordability or non-availability. Even though ASHA workers continue to raise awareness yet 80% of women and girls in villages continue to practice unhygienic MHM (101 Reporters 2019). [18]


iii) Geography , Distance and Time problems


Improvement in Swachh Barat Mission


Despite the improvements with the SBM, the issues affecting access to toilets are -


Lack of access to piped water- Access to piped water from a treated source is very poor in the villages. For example in mountainous regions like Uttarakhand, the villages have been reported to have shortage of water supply. Since it is the women who as a result of deeply gendered relations have the burden of maintaining the toilets at home if it is constructed ,or emptying the pit if it is a single pit toilet , it increases the burden on women which is also one factor affecting the access of women to toilets.[19] Similar is the case in Rajasthan , in villages with difficult terrains where women have reported that fetching water for toilets at home has increased their drudgery[20]



Going to Community toilets- a time consuming task

Women often avoid community toilets as they have to travel long distance to access them and then further there are crowded which makes going to a toilet one time at least into a half an hour affair (USAID) [21]which is not possible for women in their busy day where they already have a lot of responsibilities. [22]Also, Because of the lack of women-only public sanitation facilities women often avoid using constructed toilets and have to wait until after dark to relieve themselves and defecate in the open. This leads to too many health-related concerns such as bladder and urinary tract infections directly caused by prolonged periods of not being able to urinate and dispense with other bodily wastes.[23]


B) Caste– Social Stigma Still Prevails



According to the NARSS Survey, households which belong to the other backward castes have less access as compared to the general caste. Even though the difference may not seem stark when data is seen there lies deeper problems.



Problem with the single pit

Open defecation in rural India is not entirely attributable to relative material or educational deprivation, but also to beliefs, values, and norms about purity, pollution, caste, and untouchability . The single pit is the most widely used sanitation structure (40%). Issues associated with this structure comes from its ineffective waste disposal system, that is that the pit has to be manually emptied. The cleaning of human waste has traditionally been linked to the caste hierarchy in India, whereby it is the Dalit communities who are often relegated to tasks considered too degrading and menial for higher caste individuals.[24] Often the notions of untouchability that stem from India’s caste hierarchy deter people from using their pit latrines as they do not want to clean them out when they fill up[25].

Accountability Initiative’s (AI) 2017 survey found that 86% of households which owned latrines employed manual scavengers to empty the structures. This further highlights the prevalence of the practice of Manual Scavenging, which is otherwise banned by the Government of India[26].Furthermore, the majority of manual scavengers are women, highlighting the double jeopardy of caste and gender these women face.


R.I.C.E in its study found in four states Bihar, Madhya Pradesh, Rajasthan and UP that when government officials used coercive measures to stop open defecation, Dalit households were twice as likely, and Adivasi households thrice, to face coercive practices compared to other social groups. They were more likely to face threats irrespective of whether or not they owned a latrine[27].


C) Learning from the Best States


● In Sikkim, contrary to the common belief that it would have been easier to achieve 100% access to toilets because it is a small state, culture has rather played a more important role . People in Sikkim have been more conscious about privacy rather than hygiene , so even before the government started its programme, villagers used locally-made bamboo structures as toilets.”[28]



Kerala is another state with high access, and the success mantra lies in that the state made most of the toilets by adopting changes suiting local conditions in hilly and tribal areas and mass youth involvement led the way forward. For the increasing access to toilets in tribal areas, NCC cadets, NSS volunteers and students of engineering colleges were involved who not just created awareness but even built the toilets.[29]


● The open defecation free status of Mizoram was possible because of the hard work of its district officials, who went from village to village to tell people about the importance of cleanliness. In villages where terrains proved to be difficult for the construction of conventional toilets, district officials helped locals use bamboo to construct strong and durable toilets.[30]


Strong will of the district officers to reach to the marginal areas , using terrain specific alternatives to single pit toilets, and mobilising the youth to create awareness are some steps that worst performing states like Bihar and Odisha can learn from the best performing states to increase access to constructed toilets.


3. Funding for SBM & Construction of Toilets


A) Allocations

1. Till FY 2021-22, GOI allocations for SBM -G stand at 75,691 crores – out of which 56,391(91%) had been spent by states (5th December 2019)


2. 5,99,963 villages declared ODF till 2 October 2019, 97 percent of villages had undergone the first level of ODF verification, and 25 percent had undergone the second level of verification.[31]

3. In September 2019, DDWS released a new ten-year rural sanitation strategy, till 2029, with a focus on Open Defecation Free (ODF) Plus – SBM phase 2


4.Between FY 2020-21 Revised Estimates (REs) – 17, 023 crore and FY 2021-22 Budget

Estimates (BEs) – 60,030 crores, allocations for DDWS increased by 252 per cent[32]


5. In FY 2020-21 REs, GOI allocated 6000 crores to SBM-G –a 26% less than the REs for FY 2019-20


6. In FY 2021-22 BEs, GOI allocated 9994 crores to SBM-G –a 66% increase than the REs for FY 2020-21



The analysis shows that adequate funds are being deployed by the central government for the mission. States receive funds from DDWS by a proper procedure as discussed in the next section and they can spend the funds allotted on different sanitation activities as per their discretion.


B) Releases

1) Budgets for SBM-G are finalized through a process of negotiation between GOI and state governments and the basis are project proposals called Annual Implementation Plans (AIPs) which are supposed to be developed at the Gram Panchayat (GP) level and consolidated at district and state levels.


2) Final approval is given by DDWS, within the MJS. Funds are released based on approved budgets, in a consolidated manner for all components without any specific component-wise allocation.


3) In FY 2019-20 till 23 July 2019, ₹4,361 crore or 44 per cent of the allocations for the year had been released by GOI. This funding had been released to states as ‘Performance Incentive Grants’ under the World Bank grant to GOI for SBM-G31. While documenting this paper, Annual Report 2015-16, 2016-17, 2017-18, 2018-19 for the Ministry of Jal Shakti (erstwhile Ministry of Drinking Water and Sanitation).


C) Expenditures

Expenditure on toilet construction: - IHHL

1. Expenditure on construction of IHHLs accounts for the largest share of spending.


2. From FY 2015-16 to FY 2017-18, over 95 % of expenditure had been towards construction of IHHLs. In FY 2018-19, this proportion decreased to 91 percent31


3. The proportion of expenditure on IHHLs out of total expenditure from GOI funds further decreased to 67 per cent in FY 2019-20 (as on 3 July 2019).31


a.) Sikkim had incurred no expenditure on IHHL construction

b.) Arunachal Pradesh had incurred less than 1 per cent

c.) Mizoram (2%)

d.) Himachal Pradesh (5%)

e.) Meghalaya (17%)


4. States with highest spending on IHHLs Jharkhand > Chhattisgarh > West Bengal

Expenditure on toilet construction: - CSC


1. They are constructed in areas where there is lack of land or proper space is not available near households in the village for the construction of IHHLs, and the community residing there raises a specific demand for CSC. They can also be built in public spaces where a large number of people congregate or transit.

2. In FY 2018-19, total expenditure on CSCs was less than 1 per cent of the total expenditure, with 20 states and UTs reporting less than 1 percent of total expenditure on CSCs31.

3. In the period FY 2015-16 to FY 2018-19, Sikkim spent more than a quarter of its total expenditure on CSCs, the highest in the country. In FY 2019-20 (till 23 July 2019), only 1 per cent of the total expenditure out of GOI funds reported by states had been on CSCs31.

4. Trend: - While overall only 1 per cent of households were provided access to toilets through CSCs, Punjab had the highest number of households provided with toilet access through CSCs – more than 3 lakh or 13 percent. Despite Punjab having the highest proportion of households accessing CSCs and other non-IHHL toilets, the proportion of expenditure on CSCs out of total expenditure was less than 1 per cent from FY 2014-15 to FY 2018-19. On the other hand, Sikkim reported over 25 per cent of its total expenditure on CSCs, the highest in the country, yet no household was reported to have access to CSCs as per the SBM-G MIS data till 29 November 201931


D) Incentive


Subsidy Model for Latrine Construction is Inadequate


1. Rs 12,000 is insufficient for construction of a twin pit toilet in rural areas. Moreover, this is not the reimbursement of the cost of toilet which may be higher as well. If any additional requirement is there, it may be borne by the beneficiary.


2. If we look at the micro level, this is a major problem as the incentive/subsidy amount of Rs. 12,000 is not adequate for BPL and for some households APL for constructions of toilets. The government recommends twin-pit latrines for rural households, which families have to empty once they are full. As a result, many people want larger pits as they will not fill up quickly. A thousand bricks cost between Rs 7,000 and Rs 8,000. The sand that is needed costs between Rs 3,000 and Rs 3,500. At least five bags of cement are required: which cost a minimum of Rs 2,500. Similarly, Rs 3,000 will be spent on labour (one mason and two labourers for three days). In addition, a good amount will be spent on the door, plastic pipes and toilet seat. Therefore, the cost amounts to Rs. 20000


3. A report further suggests even for those households that were willing to cover the costs beyond the subsidy, SBA-G’s incentive-delivery method was not practical. For e.g. :-In Bihar, to receive the subsidy, people had to first pay for latrine construction out of pocket, and then submit a picture and forms to prove that they had done so


4. Given the SBA-G guidelines, states and districts do have the flexibility and discretion to delay the disbursement of reimbursements until a certain percentage of households in a village have constructed a latrine.


5. In reality, the incentive and subsidy provided by the government and the mechanism through which it is implemented is unsustainable and it is not devised keeping in mind the financial aspects of the rural poor.



6. Analysing the Demand side Issues:

I. Behavioral Change- Sensitizing masses against Open Defecation


The success of the Swachh Bharat Mission is linked to the participation of the people. Participation includes people changing their attitudes towards cleanliness, constructing and using toilets along with maintaining personal hygiene. This reflects how a change in behaviour will help in breaking the existing norms and habits.


In the first phase of the Swachh Bharat Mission , the change management initiatives rolled out on various levels were crucial in order to induce the needed behaviour change regarding healthy sanitation practices while taking into account local cultures, practices, sensibilities and demands. IEC(Information Communication and Education) activities were carried out by five types of actors : 1.Ministry of Drinking Water and Sanitation (MDWS) & Associated State Departments 2. Other Ministries and State Departments 3. Development Partners, Philanthropy, and Civil Society (including faith based organisations) 4. Businesses 5. Media and Entertainment. The campaigns held around the country reached out to the masses regarding the use of toilets, in suitable communication formats like interpersonal communication (IPC), mass media,ambit media and digital media .


It’s important to adopt a decentralized approach towards bringing a change at scale. Thus every stakeholder should contribute to and understand the value of cleanliness, hygiene and sanitation. How effective have these campaigns been in influencing the rural population is indeed a matter of scrutiny.

The various approaches to inducing behaviour includes -


Behaviour-Centred Design (BCD) that offers both a theory of change of behaviour and a practical process for designing and evaluating interventions. It sets out a practical five-step process required to design an intervention to change specific behaviours- Assess, Build, Create, Deliver and Evaluate.

Behaviour Change Communication (BCC) is an approach to behavioural change which is ‘the strategic use of communication to promote positive health outcomes and models of behavioural change’.



The collaborative efforts of RB India and Jagran Pehel initiated a behavioural change initiative under the Dettol Banega Swachh India Programme . Impact assessment report highlights that using communication tools turned out to be effective in 200 villages of Uttar Pradesh and Bihar.[33]



Community-led Total Sanitation (CLTS) focuses on creating an enabling environment for the community-led approaches to be adopted as part of the main implementation strategy at the district and state levels.Successful campaigns such as Indore’s ‘Roko And Toko’ push initiated by Indore’s civic body created ‘Dibba gangs’ for roko and toko comprising of school children who beat metal boxes loudly and impose 100 rs fine if anyone is found defecating in the open . Members of the particular community are involved thus collective change is visible.


From Sholay’s Gabbar Singh telling Basanti to not defecate in the open to Deepika Padukone’s Shanti asking people about the value of clean toilets, students in Delhi in an innovative way spread the message of ‘swachhta’ through colourful Bollywood-inspired wall murals. These easily identified dialogues from iconic films have been given a swachh makeover and are a hit with the slum dwellers of Delhi’s Sultanpuri and Kirti Nagar areas.

Dalberg Advisors carried out a study to estimate the reach and value of the IEC-related activities of cross-sectoral actors under the Swachh Bharat Mission. It was then found that, A rural Indian was exposed to SBM related IEC messaging about 2,500-3,300 times in the last five years.


It was estimated that SBM was able to induce a cumulate investment equivalent to 6.5 times the cost. The total estimated equivalent investment in IEC activities conducted over the past five years is INR 22,000-26,000 Cr against a total cost incurred of INR 3,500-4,000 Cr; thus, resulting in a leverage between 6-6.5 times.[34]


The Swachh Survekshan[35] was launched nationally on August 14, 2019, one of its objectives being assessing the effectiveness of IEC/BCC interventions under SBM-G. R. Districts and states that were at the top of the heap overall were ,in descending order : among large states- Tamil Nadu, Haryana and Gujarat ;small states- Mizoram followed by Daman & Diu and Sikkim This indicates a positive correlation between the state’s ranking and its score in the category of the IEC activities indicating the contribution of the change management initiatives in preventing open defecation .


Additionally,these states rank high in usability of the toilets. This means that all those who have access to a toilet in the rural areas of the top ranking states are using it.Complementary to this, the NARSS statistics on toilet usage are also encouraging. It shows that 95.2% of the population who had access to household toilets in the rural areas of the country used them,while 100% of the surveyed public toilets were in regular use ,indicating that the Swachh Bharat Abhiyan’s efforts to change behaviour have reaped fruit..[36]


Swachh Survekshan Gramin 2019[37]



Inspiration for nudging the masses against open defecation can be drawn from Haryana that has scored the highest in the category for IEC activities conducted in its village.A report by Sustainable Development Goals Coordination Centre,Haryana mentions that the game changer for Haryana was to not view SBM as a mere toilet constructuction scheme but instead focus on bringing behaviour change.The entire machinery of the Government of Haryana, down to the PRIs,was sensitized and involve in the scheme’s implementation and monitoring. Being a community led initiative ,the scheme received widespread acceptance.



As the government ventures into the second phase of the mission,it asserts that the States/UTs will be allowed to utilise upto 3 % of the programme funds for IEC and Capacity Building as per the district and State plans in comparison to 8 % in the first phase of the mission .This shall include capacity strengthening of PRIs and ground functionaries and emphasised knowledge sharing. New initiatives will be chalked out that shall be inclined towards ODF sustainability and Solid and Liquid Waste Management . Hence, the change management initiatives will continue to complement the on ground efforts in tackling the issue of open defecation,customised as per objectives of the States.


7. The Way Ahead- Recommendations


A) Maintenance


To ensure functionality:

● Swachh Bharat Kosh Funds allocated for repair of dysfunctional toilets haven’t been used adequately (out of the INR 399.86 crores that have been released, only INR 129.41 crores have been utilised). Annual surveys could be conducted to locate dysfunctional toilets, ensure maintenance of the same and if need be, create a business model for technical support could help better utilization of funds.

● Recognizing that septic tanks are one of the key technologies to handle faecal waste, personnel constructing septic tanks have to be made aware of the Indian standard code of practice for installation of septic tanks (IS: 2470) - BIS (1986) and implemented by trained and certified masons

● The Panchayats need to be proactive and contract a person for maintenance and repair of CSCs at the time of construction rather than look for a person after the toilet becomes dysfunctional.

● For ensuring O&M of PT/CTs, the GPs could collaborate with NGOs to build revenue generation models for long term sustainability.

To ensure availability of water:

● Community Sanitary Complexes (CSCs) with proper infrastructure and maintenance could cater to the population with limited water supply.

● For the PT/CT, low water consumption methods like the twin-pit toilets and alternative methods need to be explored. Eg: Ecosan Toilets: Waterless toilet. The EcoSan toilets costs approximately Rs.11020 p.a which could be recovered in a span of approximately 3 years with the income from manure from faeces and urine. (Feasibility check in appendix)

● The states must look at site-specific and need-based technological solutions for toilets about choices for different pit types and sizes. It is best if the state gets the recommendations of a competent technical agency for the different site categories.



B) Access


1) Tracking gender outcomes -

There is a need for better data collection for understanding access. There needs to be a tracking system to check the usage of toilets by women in rural areas. Without proper quantitative data, effective solutions cannot be brought about. Right now there is not enough quantitative data to depict where the SBM -G policy stands on bridging the gender gap.[38]



2)Involving women in toilet design planning and construction


To address the needs of women, more female participation is required in the designing of toilets itself. Toilet design clinics in Kenya[39] are a good example which are meetings that locate the needs of women and girls at the Centre of sanitation infrastructure planning and design. Design clinics have also been extended to consider toilet design in households and public spaces that meet the needs of women, people with disabilities, the elderly. Such meetings can be conducted in rural India as well to make toilet designs more inclusive, safe and within safe distance in the vicinity.


Toilet design dialogues can also help to come up with modifications or alternatives in accordance with the geography. One size fits all approach does not apply to all terrains. For example compost toilets might be beneficial where there is a problem of water supply.[40]


Involving women not only in the planning but even in the construction of gender sensitive toilets can help a lot , by addressing needs of women as well as providing them with employment, economically empowering them. The state of Jharkhand started with a programme to train women as rani mistri (female masons).The programme not only helped Jharkhand become open defecation free, but also empowered over 55,000 women who are now using their economic freedom to lift up the next generation of girls. Some of these rani mistris also started weekly discussions on menstrual hygiene management[41].


3) Redesigning existing community toilets to include gender sensitive toilet design elements


These can include the following-


● Spacious cubicle to allow change of clothes.

● Interiors and surrounding areas to be well lit especially when facilities are open at night. CCTV cameras can be installed outside the community complexes.

● Robust doors and structure that can be bolted from inside.

● Including sanitary napkin vending machines.

● Adequate training of male and female attendants on cleaning, waste disposal, operating napkin vending machines/ incinerator; and being sensitive and responsive to users.[42]



4) Involving more men in sanitation dialogues

The narrative unfortunately that has got established in the public sphere is that toilets need to be built for women in the rural areas for ensuring their safety. This narrative needs to be countered by the narrative of ‘Toilets for all’.


This can be done by mobilising young girls from rural households to persuade the male members in their families to attend these dialogues. The Swachhagrahis and the ASHA workers can mobilise them.The self help groups can be mobilised to create more awareness on toilets as primarily needed for hygiene rather than the safety of women. Also the need for gender sensitive design elements needed in toilets can be emphasised through these dialogues. Incentives can be provided to the men who spread awareness on ‘Toilets for all’ by honouring those who are able to bring about positive change as ‘equality heros’.



4) Alternatives to single pit toilets to be encouraged by government to eliminate the need of manual scavenging

Awareness needs to be created for using twin -pit toilets than the single pit ones which eliminate the need for any kind of manual scavenging. The two-pit system is supposed to take care of itself in that by the time the second pit fills up, excreta in the first should have become manure, making its removal non-defiling