Abstract
Swachh Bharat Abhiyan, India’s flagship sanitation intervention, set out to end open defecation by October 2019. While the program improved toilet coverage nationally, large regional disparities in construction and use remain. Our study used ethnographic methods to explore perspectives on open defecation and latrine use, and the socio-economic and political reasons for these perspectives, in rural Bihar. We draw on insights from social epidemiology and political ecology to explore the structural determinants of latrine ownership and use. Though researchers have often pointed to rural residents’ preference for open defecation, we found that people were aware of its many risks. We also found that (i) while sanitation research and “behavior change” campaigns often conflate the reluctance to adopt latrines with a preference for open defecation, this is an erroneous conflation; (ii) a subsidy can help (some) households to construct latrines but the amount of the subsidy and the manner of its disbursement are key to its usefulness; and (iii) widespread resentment towards what many rural residents view as a development bias against rural areas reinforces distrust towards the government overall and its Swachh Bharat Abhiyan-funded latrines in particular. These social-structural explanations for the slow uptake of sanitation in rural Bihar (and potentially elsewhere) deserve more attention in sanitation research and promotion efforts.
Highlights
In 2015, the United Nations General Assembly announced 17 Sustainable Development Goals (SDGs) to be met by 2030
We present an exploratory study of perspectives on open defecation and latrine use, and the socio-economic and political reasons for these perspectives, in rural Bihar, one of the worst-performing states under SBA-G
Our first result challenges the widespread notion that low rates of latrine ownership and use are a function of a preference for open defecation; this may be the case for some regions, but low latrine adoption cannot be conflated with a preference for OD
Summary
In 2015, the United Nations General Assembly announced 17 Sustainable Development Goals (SDGs) to be met by 2030. One of these goals, SDG 6, calls on the global community to “ensure availability and sustainable management of water and sanitation for all” [1]. OD results in the spread of untreated fecal matter throughout the environment and is associated with a variety of negative health outcomes. Fecal contamination is associated with diarrheal diseases, trachoma and schistosomiasis [3,4]. OD, and inadequate sanitation more generally, is associated with psychosocial stress [6]. There is widespread consensus among health researchers that adequate sanitation and hygiene are key determinants of health [7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
