A recent research paper, “Changes in open defecation in rural north India: 2014 -2018”, by Aashish Gupta, Nazar Khalid, Devashish Deshpande, Payal Hathi, Avani Kapur, Nikhil Srivastav, Sangita Vyas, Dean Spears, and Diane Coffey, published by the Research Institute for Compassionate Economics (RICE), seeks to assess the efficacy of the Swachh Bharat Mission (SBM) on the basis of results from a late 2018 survey that revisited households from the 2014 survey in four states, Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh. Excerpts:
Although rural latrine ownership increased considerably over this period, open defecation remains very common in these four states. Different statistical methods produce slightly different numbers, but a wide range of approaches agree that approximately 40 to 50% of rural people in these states defecated in the open in late 2018. This is reduced from about 70% of rural people in the 2014 survey. Much of the reduction in open defecation is a result of new latrine construction: nearly six in 10 households that did not own a latrine in 2014 acquired one by the 2018 survey. However, the fraction of people who own a latrine, but who nevertheless defecate in the open, did not change between 2014 and 2018: it was about 23% in both years.
In 2018, at the state level, open defecation ranged from 25% in Madhya Pradesh to 60% in Bihar. These results contrast with government claims that these states are entirely or largely provided with latrines and open defecation free. Nevertheless, we find important reductions in open defecation. In the region as a whole, open defecation declined from approximately 70% of people over two years old in 2014, to approximately 44% of people over two years old in 2018.
This 26 percentage point reduction in individual open defecation over a four year period (more than six percentage points per year) was rapid compared to the likely rate of decline in prior years.
Nearly the entire change in open defecation between 2014 and 2018 comes from increases in latrine ownership, rather than from changes in behaviour (that is, differences in the proportion of owners and non-owners who defecate in the open).
This active engagement of government officials with the SBM typically stopped at latrine construction; it focused little on latrine use. Officials said the goal of the SBM was to make the village “open defecation free.” Despite the fact that the literal meaning of these words is something quite different, officials explained that this phrase refers to latrine coverage in a village. Many elected leaders and village secretaries readily stated that block and district officials expected them to fill out the paperwork claiming “open defecation free” status when about 80% of the households owned latrines. Given this focus, it is not surprising that the analyses find little difference in use among latrine owners in 2014 and 2018.
If sustained, the estimated reduction in open defecation of approximately 26 percentage points over four years of the SBM could imply important improvements for child health and economic prosperity. But it came at a social cost: coercion and threats by local officials were commonplace. Violence and bullying sometimes occurred.
Forms of coercion vary both in how ethical or unethical they are, and in whether or not they can be lawfully used. Although coercion was primarily used to convince people to build latrines, in Madhya Pradesh, and to a certain extent in Uttar Pradesh, it was sometimes also used to convince people who owned latrines to use them.
More than half of households in the focus states are aware of some form of coercion in their village. This coerciveness is at odds with the SBM’s claims that switching to latrine use occurred through a bottom-up “true people’s movement”. Especially troubling is that about one in four households said that they had heard of government benefits being withdrawn from those that did not have latrines.
Coercion followed familiar patterns of social disadvantage. Both among latrine owners and among latrine non-owners, Dalit and Adivasi households were more likely than households from other social groups to report that they personally experienced one of these three forms of coercion. Among households that own a latrine, Dalits are over twice as likely as others to report that their own household received one of these three forms of coercion and Adivasis were almost three times as likely.
The coerciveness of the SBM varied across villages. Village-level coerciveness of the SBM is an important predictor of latrine ownership, and, through its effect on latrine ownership, of reported open defecation.
Coercion was central to what the SBM did in practice. Indeed, although many local SBM implementers said that they had been trained on talking points about benefits of latrine use, they were also familiar with a variety of coercion tactics, which were routinely shared and encouraged through meetings and WhatsApp groups. Very few local officials expressed the view that such tactics were inappropriate or extreme. The use of coercion and threats, rather than sustained persuasion and outreach, were relied upon heavily and that village officials were pressured by block, district, and state officials to achieve toilet construction targets in unreasonably short periods of time.
These findings raise uncertainty about whether latrine use among new latrine owners will be sustained when the environment of enforcement and coercion diminishes. Only 45% of people in households where the primary reason for building a latrine was pressure from village officials used it, compared with about 80% latrine use among people in households where convenience or lack of open spaces was the primary cause for construction.
These findings suggest the need for transparent, fact-based public dialogue about the SBM: its costs and benefits, its accomplishments and means. Reducing open defecation offers a benefit for the health of children and others who would be otherwise exposed to faecal germs. Through improvements in health, reduction in open defecation will also likely improve long-run economic prosperity. Subsidized provision of latrines also benefit people who would like to use a latrine but who are not able to build one for themselves – especially older and disabled people.
2018 survey documents that open defecation declined more rapidly over the past five years than it did before the SBM. This is because more latrines were built: latrine use among latrine owners is similarly common as it was five years ago. However, SBM latrine construction was far from universal in Uttar Pradesh and Bihar, two states which, due to their population sizes, are quantitatively influential in determining India’s overall open defecation rate. Further, latrine construction was often accomplished through coercion. It remains to be seen whether latrine use achieved through coercion will be sustained.
Despite claims to the contrary, open defecation unfortunately is still a pressing problem in rural India. The health of children is still threatened by the germs in the faeces around them, so it matters enormously what rural sanitation policies are tried next. A wide literature now documents the roots of rural north India’s open defecation in casteism and untouchability, and especially in the implications of these social ideas for latrine pit emptying and use. In our new data, we can see that well-studied predictors and patterns of latrine use which reflect these causes remain intact and that relatively few households have built the sorts of latrines that allow faecal sludge to be managed safely and sustainably.
*Download full research paper HERE