Even as the world is transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs), India is still lagging behind on the MDG goal related to sanitation. Nearly 50% of the Indian population continues to defecate in the open.
Following the launch of the Swachh Bharat Abhiyan last year, sanitation has come into the limelight and is being prioritized by a range of stakeholders. As part of the Mission, the Prime Minister announced a target of 120 million toilets to be constructed in rural India by 2019.
However, in order to achieve and sustain the open defecation free status, it is crucial that the following steps are taken to strengthen implementation of India's sanitation policies:
(1) Putting in place a comprehensive and actionable monitoring system
The fact that sanitation is as much about behaviour change as it is about infrastructure is being increasingly appreciated by many stakeholders. However, it is still not being reflected in target setting for many programs and schemes. Government programs and several corporate social responsibility initiatives continue to focus on the number of toilets constructed. The District Information System for Education, for instance, compiles data about the presence or absence of school toilets. However, it does not include indicators related to the functionality of constructed toilets, many of which are locked up or simply too dirty to use.
Another problem with setting high-level targets focused primarily on infrastructure creation is that other guideline components and quality related aspects can get less attention from those responsible for implementation. This can produce unintended results like rapid construction of toilets which are of unacceptable quality.
Until and unless success metrics are expanded to include functionality and usage of infrastructure and stakeholders at every level are held accountable to them, the reality on the ground will not change.
One of the reasons perhaps why monitoring often gets limited to measuring the number of toilets is because assessing behaviour change takes much longer and is far more complex. Additionally, a consistent definition of toilet functionality is needed.
Despite the measurement challenges, it is absolutely crucial to develop a more comprehensive and meaningful monitoring system because unless toilets are actually being maintained and used on a regular basis, there will be no positive impact on health or the environment. Periodic assessment of toilet functionality and usage can also help stakeholders to make course corrections in the design of sanitation programs based on feedback from local communities.
"In some cases, the holes of squatting toilets are too big and children are scared of falling into them."
(2) Better human resource management
Enhancing the knowledge levels and management skills of Government officials with respect to sanitation policies is also critical. For instance, Public Health Engineering Department staff who oversee toilet construction in villages and schools need to be sensitized so that they are also cognizant of the quality of construction. In some cases, the holes of squatting toilets are too big and children are scared of falling into them. Toilet doors in schools often do not have latches, which is a safety concern, especially for girls.
Additionally, sanitation-related government grants need to come with guidance on deployment. For instance, schools often get lump sum grants but whether they should be spent on furniture or soap is left to the discretion of principals. Similarly, health workers get untied funds which could be spent on sanitation and cleanliness but in the absence of guidance, the money accumulates in their bank accounts.
(3) Incentives for implementing guidelines
In addition to training, incentives are also needed for motivating villages and schools to implement sanitation programs and adhere to quality standards. West Bengal, for instance, implements a reward system for schools to inculcate greater ownership and generate demand from communities for water and sanitation initiatives. Although the prize money is modest, it has become a matter of prestige for schools. Teachers who retire from awarded schools mentor other schools. Children from winning schools influence their communities to become open defecation free.
"I have met women from slum communities who say that they are so accustomed to defecating in the open that it simply does not bother them anymore."
(4) Greater focus on appreciating and changing existing sanitation practices
Cultural and social norms are important barriers to achieving sanitation related goals. These include the widespread practice of open defecation and the influence of the caste system (e.g. toilet cleaning is often delegated to people from lower castes). Varied beliefs are especially challenging in a decentralized Government system where dependence on local stakeholders for implementation is very high. Habits do not change easily or quickly, especially when they have persisted for years. For instance, it is natural to assume that women are the most concerned about having a toilet in their homes for greater convenience, privacy and safety. While this is true in a majority of cases, I have met women from slum communities who say that they are so accustomed to defecating in the open that it simply does not bother them anymore. Others prefer open defecation over using a closed toilet which makes them feel claustrophobic. Adequate time, therefore, needs to be invested in understanding the widely varying sanitation practices in India and devising effective strategies to change them.
(5) Cultivation of local champions and change agents
Women, children, and other stakeholders have the potential to become change agents by championing the cause of sanitation in their local communities. In school, for instance, if the principal and teachers are motivated they often take steps to facilitate implementation of sanitation related initiatives despite funding or other limitations. Similarly, children who are adequately trained about sanitation and hygiene practices in school can transfer those learnings to their families and communities.
Thus, while focusing on the Government's toilet construction related targets is important, even more important is strengthening the software aspects of sanitation programs. If India is able to achieve the target of 120 million toilets constructed by 2019, it will be a tremendous accomplishment, however, real impact will only be achieved if the toilets are used and the problem of sanitation is tackled holistically.