On the 29th of December 2016, the Ministry of Health and Family Welfare in collaboration with the Ministry of Drinking Water and Sanitation and Human Resource Development have launched a new initiative aimed at reducing open defecation in India.
The global prevalence of open defecation has decreased since 1990, yet India remains the country with the highest number of people still using this practice, an estimated 597 million (2014 estimate), roughly half of India’s population. Globally, out of the 2.5 billion of people who do not have access to sanitation facilities, about 1 billion people practice open defecation, with 82 percent of these living in 10 countries (India, Indonesia, Pakistan, Nigeria, Ethiopia, Sudan, Niger, Nepal, China and Mozambique).
The initiative named Swachh Swasth Sarvatra will focus on two main objectives. First, the government will facilitate the construction of infrastructure and facilities such as public toilets, and second, will aim to change behavioral factors through educational means. Through this new initiative, the Ministry of Health and Family Welfare will provide grants up to 1 million rupees to community health centers in order to help them achieve quality certification in hygiene and infection control which are rated under the Kayakalp system.
This initiative is not only in line with the WHO’s sustainable development goals, but is part of a national public health campaign Swachh Bharat Abhiyan (Clean India Mission) which Prime Minister Narendra Modi launched on October of 2014. This campaign has the ambition of making the nation free of open defecation by the year 2019 by building 12 million toilets across the country. Between April 2014 and January of 2015, over 3 million facilities have been built which represents about 25 percent of the total target. The cost in achieving this goal is projected to reach Rs 2 lakh crore.
The issue of open defecation does not only have a direct impact on health, but is an issue for woman as well as they are at a higher risk of being sexually assaulted. A famous case in 2014 where two girls were gang raped and hanged while they were on their way to the loo late at night sparked national outrage with the lack of sanitation being criticized.
Behavioral aspects are also at the center stage. According to a survey performed by the RICE institute in 2014, a preference to open defecation has been identified even though sanitation facilities were available. Over 40 percent of respondents in households with working latrines acknowledged that at least one member of their family practices open defecation, stating that the practice was more pleasurable then going to a bathroom. This study has sheds light on the fact the intensifying the construction of sanitation facilities will not alone suffice to substantially reduce the practice of open defecation, but that behavioral changes are critical as well.