Water, sanitation, and hygiene are basic needs and rights for all people. Unfortunately, even seven decades after Independence, India still struggles to ensure equal access to safe drinking water and sanitation for more than half of its population. One of the most significant challenges in achieving the ‘Clean India’ target is the country’s unacceptable state of open defecation. According to UNICEF, India has the largest population practising open defecation. Only 48.4% of Indian households have access to sanitation facilities (National Family Health Survey IV). 

The lack of proper sanitation facilities has taken a severe toll on the country. According to the World Bank, as cited in The Economist in September 2017, one in ten deaths in India is due to poor sanitation. The World Health Organisation estimates that 117,000 Indian children under the age of five died in 2015 from diarrhoeal diseases caused by inadequate sanitation and hygiene. Furthermore, women and girls face shame, loss of dignity, and safety risks when there are no toilets at their homes, communities, or schools. Dasra’s report Spot On highlights that 66% of girls in India manage their periods outside or in open fields due to the absence of household toilets, while 23% of girls drop out of school for the same reason. 

According to the Ministry of Drinking Water and Sanitation, approximately 590,930,000 toilets have been built so far under the Swachh Bharat Mission. Over 307,349 villages have been declared Open Defecation Free (ODF). While these figures are commendable, concerns remain regarding how many people actually use their new toilets. Simply building toilets is not enough to ensure their use. Behavioural change at the individual, household, and community levels is essential to achieve a truly open defecation-free status. Communities must be mobilised not only to use toilets but also to maintain and clean them. 

Here is an example of the benefits of mobilising communities. Even after bio-toilets were installed in Badam Basha village, Bokaro, most villagers continued to defecate in open fields. A WASH Committee, formed by World Vision India, visited homes to educate people about the health risks associated with the unhygienic practice of outdoor defecation. The committee, led by 20-year-old ‘Toilet Minister’ Sandhya, even went so far as to clean and maintain the toilets for villagers, who were initially reluctant to take on the responsibility of maintaining their own toilets. When asked if the entire village had stopped defecating in the open, Sandhya smiled and said, “Yes, 99%.” 

World Vision India’s Water, Sanitation, and Hygiene (WASH) initiatives focus on the Community-Led Total Sanitation (CLTS) approach, which aims to generate demand, change behaviour, promote self-action, and integrate with the Clean India initiative. A recent study conducted among 384 households in 30 ODF villages covered under World Vision India’s Area Development Programme (ADP) in Narsinghpur, Madhya Pradesh, evaluated the behaviour change generated through community-based processes. 

According to the study, 93% of households reported that all family members use the toilet every time they need to defecate. Around 99% of households clean their toilets at regular intervals, which indicates toilet use. The study also found that 91% of toilets are available and used at the household level, while 9% of households use community toilets, which can be reached within 30 minutes. About 51% of toilets were reported to have water connectivity, and 93% of toilets have a facility for handwashing after defecation. Additionally, 98% of households reported the availability of soap for washing. 

Encouragingly, all households covered in the study are aware of the benefits of using a toilet, such as safety for women, dignity, respect, time efficiency, and cleanliness. Approximately 99% of households feel that there is no harm in using a toilet. Less than 1% felt that using a toilet could pollute water sources. The responses indicate that behaviour change regarding toilet use is clearly visible at the community level. 

By leveraging resources and opportunities created under the Clean India Mission, World Vision India is making significant contributions by engaging communities, building local capacities, changing behaviours, and encouraging rural communities to become open defecation free. 

The study also identified various constraints preventing people from using toilets. Around 13% of households reported lack of water, 12% cited bad odour, and 12% mentioned limited space as challenges in using their toilets. Around 53% of households reported other constraints related to social customs, the need for more users at one time, and a lack of assistance required for using the toilet.  

All the limitations of the current system must be addressed for communities to truly enjoy the benefits of being open defecation free. Sustaining the achieved ODF status will also become challenging in the long run. It is at this point that the resources and expertise of organisations like World Vision India, which engage and capacitate communities while building links with government service provisions, become invaluable. 

Labels: #behaviourchange #blog #CLTS #india #ODF #opendefecation #swachhbharath #toilets #worldvisionindia WASH