A World Bank Report on the Progress on Sanitation in Rural India

The full title of this report is ” Progress on Sanitation in Rural India: Reconciling Diverse Evidence”.

Here’s the first paragraph of the concluding section in its entirety:

Some of the public discourse surrounding the performance of SBM-G has been dominated by contested claims about the extent of progress achieved in reducing open defecation in rural India. The controversy appears related to the use of different, competing data sources, methodologies, measurement and definitions of sanitation outcomes. To bring some order to these debates, this paper assembles multiple independent data sources – combining both government and non-governmental data – along with harmonization of measures across surveys, to paint the most comprehensive, reliable picture to date of the progress in sanitation in rural India in the past decade, covering the period before and after SBM-G implementation

https://documents1.worldbank.org/curated/en/099092923121532756/pdf/P176229130c733b010a59143531b8a716c7d31f859e8.pdf, pp 28

So which sources have been used?

ibid, pp 5

Students unfamiliar with these surveys may want to read the brief description that follows this table in the PDF, to get a sense of who conducts these surveys, and how. This report is worth reading for multiple reasons, but students of economics and statistics will especially enjoy reading this, for it is a good exercise to learn how to reconcile information across different surveys. Section 3, which details the methodology used in preparing this report, is especially useful reading. Pay careful attention to Tables 4,5 and 6 in particular.

Four key results emerge from this report:

  1. Enormous expansion in toilet access, with near-universal coverage of rural sanitation infrastructure
  2. Substantial increase in regular toilet use, especially for the poor and socially disadvantaged groups
  3. Wide variation in progress of regular toilet use across and within states
  4. The impressive gains in regular toilet use are slowing or reversing, sustainability is a key challenge

Each of these are important, and noteworthy. The report speaks about how the Swachh Bharat Mission – Gramin (SBM-G) builds on earlier programs – The Central Rural Sanitation Program (1986-1999) and the Total Sanitation Campaign (1999-2012, rebranded as Nirmal Bharat Abhiyan from 2012-2014), and mentions how the scale that this particular program achieved was truly noteworthy:

We find clear evidence of remarkable progress in the provision of sanitation infrastructure, which has now extended toilet access to almost everyone in rural India. This achievement is apparent in both the government data and in independent survey data. Building over 100 million toilets to provide sanitation access to the rural poor is a breathtaking administrative achievement. There is recent research that sheds light on the processes and delivery mechanisms by the which the Indian government was able to deploy resources so quickly, efficiently and widely (Boudet et al 2023). Other developing country governments could learn from that experience, not only in the sanitation sector, but for other development sectors as well.

https://documents1.worldbank.org/curated/en/099092923121532756/pdf/P176229130c733b010a59143531b8a716c7d31f859e8.pdf, pp 28

Second, the improvement in regular toilet use is encouraging, and the biggest improvements come from the poorest states, and the most disadvantaged communities:

pp 16
pp 15

But most worrisome is this:

By 2018-19, 87 percent of India’s rural population was regularly using any toilet (unimproved or improved) – a jump of 41 percentage points in just three years (Figure 7). Even the regular usage of “own, improved toilets” doubled during this period from 37 to 74 percent. By historical standards, this represents extraordinary progress achieved within a short period of time. However, that progress has not sustained. Since 2018-19, regular use of any toilet has actually decreased by 12 percentage points. This backsliding implies that a full quarter of the country’s rural population was not regularly using toilets by 2021. When imposing the JMP metric of own, improved toilets, usage falls to 65%.

https://documents1.worldbank.org/curated/en/099092923121532756/pdf/P176229130c733b010a59143531b8a716c7d31f859e8.pdf (pp 17) Emphasis added

Toilet usage is as much a hardware problem as it is a software problem. I no longer remember where I heard this line in this context, but it is a line that has stuck with me. If you would like this to be said in the language of the economist, supplying toilets (hardware) is only half the story. Well, less than half the story. As this report puts it: “Sustaining regular toilet use remains a critical challenge, and results from randomized controlled trials conducted by social scientists in several developing countries offer insights on how to sustainably increase sanitation demand.”

There is much more to read and analyze in this report, and it is a report that should be widely read (to give you just one example re: more needs to be analyzed, consider the fact that Gujarat and Tamil Nadu rank below Uttar Pradesh and Rajasthan in regular toilet use among the rural population).

We have achieved remarkable progress when it comes to open defecation, and much more remains to be done. We live in times where all of us are willing to acknowledge only one half of the previous sentence, and heap abuse on folks who dare utter the other half – but both things are true at the same time, and both need to be acknowledged.

Also see this earlier EFE post on Where India Goes.

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