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Important to sell the idea of toilets better

Vidya Balan in the government ad for promoting toilets

Important to sell the idea of toilets better

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SANTOSH MEHROTRA

MACRO VIEW

The ad on TV features Vidya Balan, the Bollywood star and ambassador of the Government of India (GoI) programme for building toilets in homes. She asks the mother-in-law, who is lengthening her bahu’s ghunghat at her son’s wedding, “Do you have a toilet at home for your daughter-in-law?” Mum-in-law replies: “No.” Balan retorts: “Then why are you extending your bahu’s ghunghat if you can’t provide her a toilet at home?” 

It is the smartest ad for toilets — smarter than any other sarkari ad you might see on TV. But is the message getting through?

India leads the world in open-air defecation with about 600 million people defecating outdoors every day. This is 60 percent of the total open defecation (OD) in the world. It is more than the OD in all of sub-Saharan Africa.

Women and children are the most affected. Close to 300 million women and young girls sit out in the open in the heat, cold and rain, and under constant threat of being watched, molested and raped.

This is not only a national shame. It is a human tragedy. Open defecation is a cause of under-nutrition due to poor absorption, and of illness, stunting and poor school performance. It damages immune systems and impairs mental development, reducing future earnings and human capital.  

It results in stunting: half to two-thirds of stunting is because of open defecation, most of all where OD and populations are both dense, as in the Hindi belt. School midday meals are eaten up by intestinal worms, or lost in diarrhoea or in fighting a host of sicknesses. The 2,12,000 children who die of diarrhoea each year are only the tip of the iceberg. The costs (6.4 percent of GDP estimated in a 2010 World Bank study) and suffering are immense.

A recent survey in North India found the belief widespread that OD is healthier than having a toilet in or near a dwelling. More than half the people with a government-constructed toilet defecate in the open. Constructing toilets is no solution. Only a revolutionary change in collective behaviour can achieve a Swachh Bharat.

Past mistakes

How did earlier programmes fare? The Central Rural Sanitation Programme (CRSP) of 1986-1999, the Total Sanitation Campaign (TSC) of 1999-2012, and the Nirmal Bharat Abhiyan (NBA) of 2012-14 failed. The TSC, started by the previous NDA government, had 2012 as the target date for a Nirmal Bharat.  Instead, with population increase, eight million more rural households were defecating in the open in 2011 than in 2001 (Census data). The share of rural households with toilets increased from 21 to 31 percent between the two Censuses. At this snail’s pace, it will take nearly 70 more years for India to become free of OD.

This situation, 70 years after independence and three decades after the first programme started, indicates basic design weaknesses in the approach. The focus on individual financial subsidies to build toilets has continued. As in many other countries,  the policy of individual toilet subsidies/incentives has failed. Previous governments have successively increased the subsidy/incentive.

Corruption is compounded by misreporting. The Ministry of Rural Development reported that the government built toilets for 68 percent of households. But Census 2011 found that 60 million toilets reportedly constructed weren’t found on the ground in 2011. Disbursements were taken as a proxy for construction.

The information, education and communication (IEC) component of the TSC/NBA (of the Vidya Balan ad variety) has failed to trigger behaviour change. Research evidence is that people defecate in the open because they do not see a reason to change their centuries-old behaviour. But bureaucrats actually believe that villagers don’t build and use toilets because they are too poor. So then how come Census 2011 reported that a higher proportion of households own TVs rather
than toilets?

Poverty is not the issue. Open defecation is rampant even in Haryana and Punjab where most well-off farmers defecate in the open. The great majority could build toilets for themselves if they really wanted to. Crores of people have mobile phones rather than toilets. All community members have to want to end open defecation.  

Not radical enough

With Swachh Bharat there was indeed a radical revision of policy at the GoI level during the design of the new national sanitation programme. 

Its key elements were:

  • Appointment of youth, including girls, to be ‘triggers’ (Swachhata Doot) of collective behaviour change. This requires training of youth to trigger behaviour change in each village. Instead of the government constructing toilets, households would construct and then use their own toilets, monitored by the triggers.
  • Giving rewards to credibly OD-free habitations, gram panchayats, blocks and districts following independent verification and certification of the actual use of toilets (not the mere building of toilets).

Evaluations until 2014 had shown that a few months after the President of India gave a village a Nirmal Gram Puraskar for achieving ODF (Open Defecation-Free) status, the village was back to defecating in the open as there was no genuine behaviour change. It was all done to win the financial reward.

Similarly, the significant ramp-up in spending on sanitation through the Swachh Bharat Abhiyan is also going to create more work in rural areas in the building of toilets.

There have been four transformations, thanks to the Swachh Bharat Abhiyan, in the nation’s 40-year-old programme to create villages without open defecation.

  • Rural sanitation is on the national agenda as the PM himself has focused on it and speaks on the subject regularly.
  • A campaign or movement on sanitation is visible in each state. Thus, many Collectors are emerging as champions.
  • Counting toilets is stopping. This is a hugely important development as the earlier focus under the Nirmal Bharat Abhiyaan (the UPA programme) was very much on simply building toilets, and the administrative machinery focused on reporting the number of toilets built. That is not the same goal as creating communities who are counted as being free of open defecation, are proud of that status and can sustain that status. Simply building a toilet in households that did not have one does not lead to whole communities actually becoming ODF. Now, the Government MIS system is counting ODF communities — villages, blocks, districts — not merely the number of toilets built.
  • The focus is on behaviour change through appropriate information, education and communication strategies.

 At the same time, the status today with regard to toilet construction is as follows:

  • Increase in percentage of households with toilets since 2 October 2014 is 10.31 percent.
  • Percentage of households with toilets is 52.44 percent.
  • Number of ODF villages is 61,850.

This is again thanks to the increase in financial allocation since 2014, as compared to the period before that. Thus, expenditure on the Nirmal Bharat Abhiyan was Rs 2,250 crore in 2013-14. It had increased to Rs 2,850 crore in the first year of the Swachh Bharat Abhiyan but jumped to Rs 6,524 crore in 2015-16. The allocation for the financial year 2016-17 is `9,000 crore.

There are contradictory elements in the Swachh Bharat Mission (SBM). International evidence strongly indicates that giving individual subsidies to households to construct toilets does not encourage toilet use, which has been corroborated in India. Yet the SBM continues with such subsidies. At the same time, the SBM does recognise, finally, the need to trigger behaviour change at community level through interpersonal communication. One can only hope that the money set aside for such IEC and “triggering” does not remain unutilised, while the money for construction is absorbed rapidly — as happens so often in government programmes.  

Santosh Mehrotra is Professor of Economics at Jawaharlal Nehru University and the author of Seizing the Demographic Dividend: Policies to Achieve Inclusive Growth.