By Dr. Arijita Dutta, Department of Economics, University of Calcutta,
Gitanjali Hajra, PhD research scholar, Department of Economics, University of Calcutta,
For Citation: SITE4society Brief No. 7-2018
Related to: #SDG3 (Good Health and Well Being) #SDG6 (Clean Water and Sanitation) #SBM (Swachh Bharat Mission) #TSC(Total Sanitation Campaign)
SITE Focus: Infrastructure, Environment, Governance
The context: Evidence-based research on medical and social science has confirmed without doubt that improved sanitation has a crucial positive impact on human health and development. According to the World Bank, the economic cost of inadequate sanitation in India amounts to a loss of INR 2,180 (US$ 48) per person, which is equivalent to 4% of GDP. This is why, India, like other developing countries, has implemented national programs to reduce open defecation (OD) through installation of toilets and inducing behavioural change. For instance, sanitation coverage has increased continuously from 1997, especially after the ‘Total Sanitation Campaign’ (TSC) in 1999, that evolved into the Swachh Bharat Mission (SBM) in 2014. Households living below poverty line are fully subsidized to construct the toilet, while the households above poverty line are motivated by information and education campaigns to construct them with funds out of their own pocket. But, these programs are supply-driven, with a top-down approach, assuming that building of toilets will automatically lead to their usage. However, Census 2011 highlighted that half of the population in India still defecated in the open. Moreover, Swachhta Status, MOSPI 2016-17, indicates that the percentage of open defecation (or OD) still stands at 52.1% and 7.5% at individual level for rural and urban areas respectively. Thus, building toilets has clearly not made OD vanish in India.
- Does OD occur by necessity or by choice?
- For those with toilets, what are the factors, across and within households that determine OD?
Motivation for Research Questions: OD can occur due to lack of access to a functioning toilet or due to other socio-economic and cultural features. While the former is self-evident, the latter is a puzzle. To date, scholars have noted that cultural beliefs, poor knowledge and foul smell from toilets can lead to non-usage. For instance, there is an belief in Uganda that the use of latrines could affect womens’ fertility and cause miscarriage. Another study on Orissa showed that people defecated openly on and beside the road connecting the area to Bhubaneshwar, because of their belief that, God resides at home. However, there are pockets of results and no systematic study has been conducted on toilet usage or non-usage, when they are available at home.
Methodology: We collected primary data during the month of August-September, 2014 on 300 households on information related to socio-economic status of the households, access and usage of toilet facilities, sources of drinking water, hygiene behavior and awareness, morbidity profile among the all members in households from four selected
villages of Jalpaiguri district of West Bengal. For collection of data, we used three stages stratified random sampling: at the first stage two blocks were chosen according to literacy rate, namely Nagrakata with lowest literacy rate and Jalpaiguri with highest literacy rate, then at the second stage two big villages from each block were chosen according to highest concentration of Scheduled Tribe (ST) population. The chosen villages were Gatia Tea Garden and Grassmore Tea Garden (with share of ST population being 79.4% and 72.39% respectively) from Nagrakata block and Barpatina Nutanbus (ST share 27.19%) and Patkata (ST share 24.82%) from Jalpaiguri. Finally we selected 75 households from each of the two villages randomly to run the survey.
Ordered Logistic Regression was run on 1425 individuals (above one year of age who are able to use toilets) residing in 300 households with the dependent variable being the usage of toilets divided in four categories: No access to sanitation and always OD; Having access to toilet and always OD, Having access to toilet and mixed use (using both home toilet and OD) and Having access to toilet and using only Home toilet exclusively. These categories are ordered from the worst to better to best practice of defecation: from no toilet and OD to having toilet and always using it. Ordered logistic model is a special case of binary limited dependent regression model, where the dependent variable has more than two categories and they can clearly be ordered in a sequence gradually.
- Out of 300 households only 45% households had toilet within their house.
- In the 55% of households with toilets:
- Only in 11% of households all the adult members use home toilet exclusively.
- Exclusive use of household toilet is higher than average in Scheduled Tribes being 25%.
- 5% practice only OD, despite having a toilet, i.e. the toilet is not used by any member of the household. Exclusive OD with toilet is higher among poor households compared to non-poor and in households having pit latrines.
- With respect to individuals in the 55% of households with toilets:
- nearly 27% use home toilet exclusively, 16% choose mixed type (both home toilet and OD) and 5% openly defecate in spite of having toilets at home.
- According to our empirical model, the significant drivers of OD for individuals in households without a toilet are:
- Religion: Other factors being similar, the odds of better sanitation behavior (i.e. mixed practice or exclusive toilet) vis-a-vis exclusive OD due to no access is 0.43 times lower for Muslims.
- Gender: females have 5.48 time higher probability than male in choosing higher sanitation preferences, that is avoiding OD.
- According to our empirical model, the significant driver of OD for individuals in households with a toilet is the physical condition and functioning of a toilet. Non-functioning toilets or those with physical defect trigger OD.
- Building toilets is necessary but not sufficient to reduce OD.
- Toilets should be structurally and functionally sound and long lasting.
- Education and Motivation campaigns to promote toilet usage have to be inclusive across income groups and social groups. In particular non-Muslims and males may need more accompaniments.
- Media campaigns should avoid gender stereotyping as males need more motivation than females. Initially, campaigns such as the famous Vidya Balan advertisement, exhorted investment in toilets to protect daughters and daughters-in-law from the shame and risks of OD. However, the campaign left the message that toilets are for women only, thus creating a serious gender bias in the entire issue. Even in the much acclaimed movie ‘Toilet Ek Prem Katha’ the trigger for toilet construction is to protect women’s convenience and dignity. However, this is also changing and becoming more inclusive (see Darwaza Band – or close the door campaign).