Who’s the cleanest of them all? Sanitation scores in Indian cities

Abstract

Urban India is struggling to provide adequate water and sanitation services to its citizens. Open defecation, insufficient wastewater treatment, and mixing of untreated wastewater with stormwater and drinking water supplies are contributing to a severe health and economic crisis. Recent government measures such as the Jawaharlal Nehru National Urban Renewal Mission and National Urban Sanitation Policy (NUSP) are steps in the right direction. We draw on sanitation scores awarded to 421 cities under NUSP to identify factors that explain the heterogeneity in city-level scores. Our estimates suggest the higher scores are partly a result of city location. Population is non-linearly associated with sanitation score. Consistent with recent literature, we show that increased presence of household toilets does not impact city-level sanitation outcomes. Further, smaller cities perform differently than medium and large cities, pointing to a need for customized policy prescriptions for different classes of cities, preferably designed by municipal governments.