Sanitation in Rural India: Exploring the Associations between Dwelling Space and Household Latrine Ownership.

Anoop Jain,Lia Fernald,S.V Subramanian,Kirk Smith

doi:10.3390/ijerph16050734

Abstract

In 2017, the Joint Monitoring Programme estimated that 520 million people in India were defecating in the open every day. This is despite efforts made by the government, Non-Governmental Organizations (NGOs), and multilaterals to improve latrine coverage throughout India. We hypothesize that this might be because current interventions focus mostly on individual-level determinants, such as attitudes and beliefs, instead of considering all possible social determinants of latrine ownership. Given this, we ask two questions: what is the association between the amount of dwelling space owned by households in rural India and their likelihood of toilet ownership and what proportion of the variation in household latrine ownership is attributable to villages and states? We used multilevel modeling and found significant associations between the amount of household dwelling space and the likelihood of latrine ownership. Furthermore, considerable variation in latrine ownership is attributable to villages and states, suggesting that additional research is required to elucidate the contextual effects of villages and states on household latrine ownership. Thus, sanitation interventions should consider household dwelling space and village and state context as important social determinants of latrine ownership in rural India. Doing so could bolster progress towards Sustainable Development Goal (SDG) 6.

Highlights

In 2010, the UN General Assembly established access to safe drinking water and toilets as basic rights as they are essential for the “full enjoyment of life and all human rights” [1]
Despite decades of government-led sanitation interventions, approximately 520 million people continue defecating in the open throughout India [9]
That there exists a significant association between the amount of dwelling space owned by a family and the odds of latrine ownership, could explain why rates of latrine ownership remain low in India, where the average rural household owns less than 500 ft2

Summary

Introduction

In 2010, the UN General Assembly established access to safe drinking water and toilets as basic rights as they are essential for the “full enjoyment of life and all human rights” [1]. This resolution was adopted because inadequate access to toilets can lead to open defecation, resulting in the spread of fecal contamination throughout the environment. Inadequate access to sanitation exposes women and girls to unsafe, and sometimes violent, situations [5], while making menstrual hygiene management extremely difficult.

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