Defecation In India Research Articles

Gender composition of children and sanitation behavior in India

Open defecation has been linked to various environmental and public health issues and has gained significant policy attention. Investing in better sanitation has also been advocated to provide women with privacy and protection from harassment. Nonetheless, previous research has shown that because of son-biased preferences, households in India underinvest in outcomes for their female children. Linking the gender composition of children to the sanitation behavior in Indian households, I find that households increase toilet ownership in the presence of female children by 5% in urban and 2.5% in rural areas, respectively. These results are robust to various empirical specifications, falsification tests, and bounding analysis to test for omitted-variable bias. Various heterogeneity analyses suggest that the decline in open defecation in response to having a female child is driven by households living in regions with a higher prevalence gender-based harassment and weaker law and order. These findings provide new evidence that differences in the gender composition of households create differential incentives to adopt toilets, which can be harnessed to reduce open defecation in India.

Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage. Reasons for households’ continued OD practice include financial constraints, lack of water supply, governmental mistrust, cultural beliefs, and personal preference. Community incentives and penalties have been used to encourage proper sanitation practices with varying success. Overarching strategies and approaches that have worked well across study districts to reduce OD include high involvement of district leadership and innovative behavior-change and local community mobilization campaigns.

Spatial clustering and drivers of open defecation practice in India: Findings from the fifth round of National Family Health Survey (2019-21)

BackgroundIndia implemented a basket of public health developmental packages to achieve the Sustainable Development Goal (SDG) 6—providing access to clean water and adequate sanitation for all by 2030. Though the country is getting closer to being free of open defecation, the pace of progress varies spatially. Therefore, the current study is relevant to explore determinants of practicing open defecation at the small area level in India. MethodsThe present study included the latest National Family and Health Survey (2019–21) and applied both non-spatial (bivariate statistics with ꭔ2 test and multivariate logistic regression) and spatial analyses (Univariate and bivariate LISA Moran I, OLS, SLM, and SEM) to assess the national level predictors and spatially auto-correlated determinants of practicing open defecation. ResultsIn India, almost one-fifth of households practiced open defecation, mainly clustered in the Middle Ganges Plain, central, and eastern region. A significant rural-urban and poor-rich gap in open defecation practice was also observed. The spatial clusters of lower-educated individuals, poorest wealth quintile, backward social groups, and rural residence were found to be prone to open defecation practice. Housing condition and water supply with the house were also significantly auto-correlated with open defecation practice. ConclusionOpen defecation remains a public health challenge in India, particularly in the north and central parts, among rural populations, and in socioeconomically deprived areas. It is crucial to focus on small area-level program implementation and assessment approaches to eliminate open defecation in India by 2030.

Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

Geography matters for sanitation! Spatial heterogeneity of the district‐level correlates of open defecation in India

This paper quantitatively analyzes the spatial heterogeneity of district‐level correlates of open defecation in rural India. We employ standard non‐spatial regression, spatially explicit regressions and multi‐scale geographically weighted regression to compare the stability of measurable correlates of open defecation across these different methods as well as across analyzed spatial units. Attributes like ownership of household assets, drinking water inaccessibility and prevalent literacy rates were identified as the most stable district‐level correlates of open defecation. Our results also demonstrated the relevance of our hypotheses about (a) possible negative sanitation externalities stemming from the co‐concentration of Scheduled Caste communities and other communities in densely populated rural districts, and (b) possible positive sanitation externalities stemming from the co‐concentration of Muslim and non‐Muslim communities in densely populated districts. Overall, however, our analyses demonstrate notable spatial clustering and significant spatial non‐stationarity of examined variables. Therefore, in our opinion, research findings that ignore spatial heterogeneity of sanitation drivers provide incomplete information for policy development and implementation.

Development, Sanitation and Personal Hygiene in India

The fact that many Indian rural dwellings lack toilets and that, therefore, a significant proportion of India’s rural population is forced to defecate in the open has, by facilitating the spread of bacterial infections, profound consequences for public health. Compounding this is the fact that open defecation means that people carry limited amounts of water with them and so, by default, post-defecation handwashing is cursory. This paper, using data from the Indian Human Development Survey, examines the demand for toilets in India and the quality of post-defecation personal hygiene. Income, education, and ancillary facilities in the dwelling—like kitchens, and proper roofs and floors—were the strongest influences on demand. However, ceteris paribus households in more developed villages were more likely to have a toilet than those in less developed villages. This suggests that, over and above specific factors, households’ toilet demand also depended on their social environment In setting out these results, the paper rejects the idea, put forward in several academic papers, that the problem of open defecation in India exists because considerations caste and ritual pollution lead rural Indians to prefer open defecation to toilet use.

Bias in the perceived prevalence of open defecation: Evidence from Bihar, India.

People often form perceptions about how prevalent a behavior is in a social group. However, these perceptions can be inaccurate and biased. While persistent undesirable practices in low-income countries have drawn global attention, evidence regarding people's perception of how prevalent these practices are is scarce. Among those harmful practices, open defecation in India remains a significant public health concern, where it perpetuates the vicious cycle of disease and poverty. In this study, we focus on measuring the perceived prevalence of open defecation among respondents in Bihar, India. We examined the bias in perceived prevalence, which is defined as a pattern of deviation from the actual prevalence of open defecation. Results showed that respondents who defecate in the open overestimate the prevalence of open defecation, whereas those who consistently use toilets underestimate it. This finding suggests a false consensus bias in the perceived prevalence of open defecation. Scholars, policymakers, and program implementers who seek to correct misperceptions about open defecation by broadcasting real prevalence should be aware of biases in the perceived prevalence and address them in behavior change interventions.

Examining the linkage between open defecation and child malnutrition in India

Nutritional status of children is a key to track the development progress and a precursor to human well-being. It is not possible to realize sustainable development in the absence of nutritional well-being. One of the factors affecting nutritional status in developing countries is open defecation. India accounts for 90 percent of open defecation cases in South-Asia annually. Open defecation enables the absorption of fecal pathogens that leads to intestinal worms, diarrhoea, and environmental enteric malfunction. This leads to loss of appetite, lessening the body's immunity, disturbing the absorption of nutrients, and eventually leading to malnutrition. As there is not much scholarship on the relation between open defecation and malnutrition in the context of India, this study examines the linkages between open defecation and malnutrition among the under-five children in India. The examination is performed using data from the National Family Health Survey 2015–16, and assessing the nutritional status of children through stunting and underweight. The analysis clearly shows higher chances of being stunted and underweight with an increase in the prevalence of open defecation. Multivariate findings reveal that the chances of stunting and underweight are 13% and 28%, respectively, more among the population defecating in the open compared to those defecating in an improved toilet facility. Awareness and state’s financial help in improving sanitation facilities are keys to reducing the level of open defecation in India. A multi-sector approach should be adopted to overcome the challenges of malnutrition resulting through open defecation.

Comparison of the costs and benefits of the Clean India Mission

Abstract Background The Swachh Bharat (Clean India) Mission (SBM) launched in October 2014 is the world’s largest sanitation campaign. Our aim was to estimate and compare major economic costs and benefits associated with sanitation improvement achieved during three years of SBM from households’ financial and economic perspectives and a broader societal perspective. Methods Cost-benefit model inputs were obtained from household surveys in the twelve Indian states that once contributed to over 90 percent of open defecation in India, published literature and secondary data. Monetized costs included household financial and time investments in building and maintaining toilets, and government’s investments on subsidies and campaign activities. Monetized benefits included reductions in medical costs and mortality associated with diarrheal diseases, productive time saved from fewer diarrhoea cases and accessing outside defecation options, and increase in the property value of having a toilet. Probabilistic uncertainty analysis assessed the combined effect of key modelling assumptions and sampling errors in the inputs to the cost-benefit model. Findings Investment costs average US$ 396 per latrine and average annual operational costs are US$ 37 (financial) and US$ 94 (time costs) 1 . Annual benefits of US$ 727 per household are mainly from savings associated with reduced diarrhoea incidence (55%) and from sanitation access time savings (45%). The estimated Benefit-Cost Ratios (BCRs) are 1.7 (household financial perspective), 4.5 (household economic perspective) and 4.0 (societal perspective) under Open Defecation Free (ODF, corresponding to 100% toilet coverage and usage) scenario. However, under partial-ODF scenario with 85 percent toilet use rate, the BCRs are 1.1, 3.3 and 3.0, respectively. Probabilistic uncertainty analysis shows that the financial BCRs under the partial-ODF scenario can reduce to 0.7, but societal BCR will remain above 2. Interpretation This study shows the sanitation improvements under the SBM are highly cost-beneficial, more when communities are free of open defecation with all households using private improved sanitation facilities. Future SBM investments must ensure not only sustaining the universal toilet coverage and usage, but also ensure safe faecal waste management so that households continue to enjoy full benefits of sanitation.

Measuring open defecation in India using survey questions: evidence from a randomised survey experiment

ObjectivesTo investigate differences in reported open defecation between a question about latrine use or open defecation for every household member and a household-level question.SettingRural India is home to most of...

“Sacred nudging” and sanitation decisions in India

ABSTRACTSanitation policies in India have primarily focused on infrastructure development, through building latrines and toilets. Given the persistence of open defecation in India despite such efforts, emphases on behavioral change interventions are crucial. We explore why and how the dual nature of purity and degradation in public and private spaces is relevant to such problems. In the context of sanitation and health policies in India, we propose an intervention that exploits social norms associated with purity via the use of religious imagery in public spaces as a deterrent for unhygienic sanitation behaviors. This intervention falls within the framework of nudging, which has received great emphasis in recent policy discussions. In the absence of empirical data on the intervention, this paper takes into account considerations of ethics, implications, cost, and scalability; suggestions on implementing the intervention at various levels of government are provided keeping in mind India’s socio-cultural context.

A Dialectical and Dialogical Approach to Health Policies and Programs: The Case of Open Defecation in India

ABSTRACTA multi-pronged approach to health policy and programs related to open defecation (OD) is proposed via a qualitative study conducted in rural India. A dialogic and dialectic perspective is employed to interpret the key findings from nine focus groups, highlighting the dialectical views toward OD and latrines. Findings indicate that current policy may be too narrow as it does not fully deal with the multiple reasons, including social communication as well as gender, cultural, health and work identity issues, for OD. The results suggest that OD is more complicated than it appears and a multi-pronged, poly-vocal approach to health communication campaigns and policy should be considered.

Study to assess considerations in selection of specific toilet design in rural Raipur, Chhattisgarh

The practice of open defecation in India has been a riddle to date and numerous efforts are being made to decode the reasons behind it. Studies spearheaded by Diane Coffey, Dean Spears, and their team, point out the deeply rooted caste-based norms in Indian society as a basic reason for non-acceptance of toilets in the day-to-day life of the rural population. The SQUAT survey indicates that in most parts of India, the idea of purity/impurity associated with toilet maintenance obstructs people from selecting affordable twin pit toilets. However, while implementing Swach Bharat Mission Gramin (SBM) in rural parts of Chhattisgarh, the authors of this paper observed that caste-based inhibitions are not very significant among local communities. Instead, there are other social conditioning processes which obstruct people from selecting the twin pit-based toilet design. Accordingly, a dedicated strategy is employed to convince people about the benefits of twin pit-based toilets. As a result, it is found that the...

Demand for household sanitation in India using NFHS-3 data

India has the highest number of people defecating in the open, and the Indian Government is trying to eradicate by constructing toilets for its citizens. This paper is about whether the government is likely to succeed in its cleanliness drive mission by a supply-side policy. We examine the household preference and other the factors leading to open defecation in India. We examine preference for having a toilet in the household over the preference of other household durable goods. Our results suggest toilets get a lower preference—ranked 12, out of 21 different types of consumer durables we investigate. The results also indicate a strong case for imparting education and public awareness, especially, among the female cohort. We find the odds of having toilets in a household with an educated woman (18 years of schooling) is 3.1 times more than a household with illiterate or preschool educated women. Among other factors households living in urban areas are 19 times more likely to have toilets in comparison with their rural counterparts.

Exploring “The Remote” and “The Rural”: Open Defecation and Latrine Use in Uttarakhand, India

Summary Open defecation is a major global health problem. The number of open defecators in India dwarfs that of other states, and most live in rural places. Open defecation is often approached as a problem scaled at the site of the individual, who makes a choice not to build and/or use a toilet. Attempts to end rural open defecation by targeting individuals, like social marketing or behavior change approaches, often ignore the structural inequalities that shape rural residents’ everyday lives. Our study explores the question, “What is the role of remoteness in sustaining open defecation in rural India?” We deploy the concept of remoteness as an analytical tool that can capture everyday practices of open defecation as a function of physical and social distance. Using ethnographic methods, we interviewed and observed 70 participants in four villages in Uttarakhand, India over a three-month period in 2013. We find that remoteness in general, and its lived nuances, form a context for prevalent open defecation. Structural inequalities across space will need to be addressed to make latrine building and usage viable in remote places.

EDITORIAL: Special Issue on “Recent Advances in Biodegradation, Sanitation, and Bioremediation”

Currently, India is considered as one of the fastest developing countries with impressive macroeconomic statistics. Waste generation and its con-sequences is invariably linked with the develop-mental activities, health related issues and industrial progress. According to UNICEF, almost half the population of India (around 595 million people), defecate in the open. India accounts for 90 per cent of the people in South Asia and 59 per cent of the 1.1 billion people in the world who practise open defecation and thereby contributing nearly 65,000 tonnes of faeces into the environment each day (http://unicef.in/Whatwedo/11/Eliminate-Open-Defecation). Open defecation in India, poses a very serious threat to the health and hygiene issues, especially to the children.Keeping in view the need for looking into the scientific and technical advancements in the field of biodegrada-tion and sanitation, in 16-17 December 2014, DRL organized a national conference on “Recent Advances in Biodegradation of Human Wastes”. Sub-sequently, it was decided to bring some of the high quality technical papers presented during the conference, into a form of proceedings as a journal special issue. This issue contains a total of twelve articles.The editors take this opportunity to convey their sincere thanks to all the contributors for submitting their exciting research or review work for bringing the conference proceedings as special journal is-sue. The financial support provided by the DRDO and the DBT, Govt of India is also gratefully acknowledged. We sincerely believe that this syn-thesis of scientific information on biodegradation, sanitation and bioremediation shall be useful for the researchers and policy makers associated with solid waste management.

Open Defecation in India: A Major Health Hazard and Hurdle in Infection Control.

Open Defecation in India: A Major Health Hazard and Hurdle in Infection Control.

The cultural politics of shit: class, gender and public space in India

In this article we seek to interrogate the cultural, political and economic conditions that generate the crisis of sanitation in India, with its severe implications for the poor and the marginalized. The key question we ask is how to interpret and explain the spectre of ‘open defecation’ in India's countryside and its booming urban centres. The discussion is divided into three parts. Part one examines the cultural interpretation of ‘shitting’ as symbolic action underpinned by ideas of purity, pollution and ‘the body politic’. Part two takes the political economic approach to gain further insights into contemporary discourse, performance and cultural politics surrounding toilets and open defecation in India. Part three examines civil society activities, state campaigns and media accounts of open defecation to explore the disruptive potency of everyday toilet activities, and how these interplay with issues of class, caste, and gender. Drawing on interviews and a review of ethnographic work, we seek to interrogate the idiom of modern sanitation, with its emphasis on cleanliness, progress and dreams of technology, as a constitutive idea and an explanatory force in Indian modernity.