Ending open defecation in India
A single gram of faeces contains millions of viruses, bacteria and parasitic cysts, and contributed to nearly 100,000 diarrhoeal deaths of children under five years in India. Sick children, through the repeated damage to their stomach lining and subsequent ability to absorb nutrients, therefore become susceptible to malnutrition, stunted growth and opportunistic infections such as pneumonia. In addition to being a serious health risk, open defecation and the subsequent diarrheal illnesses severely impact a child’s ability to receive an education. Poor sanitation also negatively impacts the lives of women and children by crippling national development, which leads to workers living shorter lives, producing and earning less.
Open defecation amounts to tonnes of faeces introduced daily into the environment, which regularly exposed India’s children to excrement through direct contact. The risk of spreading diarrheal and waterborne diseases is compounded by the lack of regular handwashing and microbial contamination of water in their homes and communities.
Since 2014, the Government of India, in partnership with UNICEF, has made remarkable strides in reaching the Open Defecation Free targets. 36 states and union territories, 706 districts and over 603,175 villages have been declared open defecation free as of Jan 2020.
(Source: SBM Dashboard)
Even with these impressive figures, it is vital that social and behavioural change communication approaches keep pace with the service delivery to ensure that families receiving toilets continue to use them regularly. The practice is deeply ingrained from early childhood and a taboo topic for discussion, which makes behaviour change a challenge.
Changing behaviour, beliefs and myths around toilets is key to ensuring sustained open defecation free status in all communities across India.
India has made rapid progress in ending open defecation across the Country which is having a huge impact on improving water, sanitation and hygiene (WASH). The Swachh Bharat Mission (SBM) has changed the behaviour of hundreds of millions of people with respect to toilet access and usage. 500 million people have stopped defecating in the open since 2014, down from 550 million to less than 50 million today. A tremendous achievement, only possible because of the Swacch Bharat Mission (SBM) (Clean India Campaign), led by the Prime Minister. UNICEF has been a proud partner of the Swacch Bharat Mission.
Whether in the cities or the countryside, open defecation has historically been most prevalent among the poorest citizens because many of them are unable to afford toilet construction or are living in rented homes without toilets. Even where toilets have been built some people still prefer to openly defecate.
Even if the economically disadvantaged could afford to install a toilet, most people view this as a governmental responsibility with little benefit to their social standing, status, or well-being. Also, close to seven per cent of people in crowded urban areas defecate in the open. Open defecation in urban areas is driven by several factors, including lack of space, tenants unwilling to invest in toilets, and landlords unwilling to provide them.
The Government of India, with help from partners like UNICEF, has demonstrated an unprecedented commitment to making India ‘Open Defecation Free’ by 2019. To achieve this target and support multiple SDGs, the Government launched the Swachh Bharat Mission in 2014. While the priority of the Campaign is to ensure all households construct and use a toilet, it is now also focused on ensuring the availability of clean water and preventing faecal waste from flowing into fields and contaminating crops.
UNICEF, as a critical Government partner, provides technical support in over 192 districts across 16 states in developing district-wide ODF plans and implementation models.
District ODF Plans incorporate behaviour change messaging supporting toilet use, safely managed water supplies and handwashing with soap. Importantly, UNICEF ensures that these models adopt a strong equity dimension to prioritize the most vulnerable communities and are risk-informed in disaster-prone districts and districts affected by civil strife.
UNICEF also supports monitoring and evaluation, including conducting third-party verification and spot checks to help authenticate the real-time monitoring and information dashboard hosted by the Ministry Jal Shakti.
UNICEF promotes joint programming between the SBM and nutrition missions, by articulating sanitation’s impact on nutrition and vice versa. UNICEF stimulates demand for adequate water, sanitation and hygiene facilities and promotes life-saving practices like handwashing with soap.
Efforts are also focused on harnessing social movements to create new social norms for ending open defecation while challenging deeply entrenched practices of caste, gender inequity and social exclusion. Advocacy promotes the installation of mass handwashing stations in schools and preschools to allow for daily handwashing exercises to teach good hygiene habits.
We have started expanding our programme from rural areas to urban areas, where the urban poor are often left out of the sanitation equation.