Toilet drive won't help unless people use latrines: scientists

The NDA government’s large-scale toilet building exercise is unlikely to clean up the country unless the government spends more money to educate people on the importance of using these latrines, health researchers have found.

Since Prime Minister Narendra Modi’s Independence Day address two years ago, the Central government spent large sums to construct toilets aiming to stop the common practice of open defecation. The corporate sector and the state governments have also been encouraged to pitch in.
A group of public health researchers have estimated that without adequate spending to inform and educate the masses, the clean-up objective is unlikely to bear the fruits.

“Without stronger and more frequent educational campaigns, it is difficult to bridge the gap between the number of people having access to toilets and the ones using them. It is estimated that a universal coverage of latrines will not make any difference in large states such as Bihar, Uttar Pradesh, and Rajasthan. Due to lack of knowledge about the benefits of use of toilets, most people in these states will continue to defecate in the open,” said Ramanan Laxminarayan, director at the Centre for Disease Dynamics, Economics and Policy at Washington DC.

The estimate is part of a fresh study on how better access to toilet, piped water and sanitation can help reduce diarrhoeal deaths of children and out of pocket expenditure on health in India. Access to toilets may not necessarily imply that the households are using them. Lack of knowledge and hard-to-change behavioural patterns could hinder the use of toilet facilities.

In a recent UNICEF study in Tamil Nadu, almost 90% of respondents reported they were habituated to open defecation, and 50% considered it a cleaner practice than using toilets. Another survey in Bihar, Haryana, Madhya Pradesh, Rajasthan and Uttar Pradesh has found, among households which have access to a latrine, 40% reported at least one member to be defecating in the open.

Two other studies pointed out that access to sanitation may have a lower-than expected effect on childhood diarrhoea rates due to lack of use. In the 2015-16 Budget, more than Rs 3,500 crore was allocated for Swachh Bharat mission but only 8% of the money is meant for communication.

“Construction of toilets is not enough. People need to be convinced to use it. There is a social aspect to this problem that needs to be addressed,” Laxminarayan told DH. India accounts for a fifth of the global deaths of children under the age of five years and more than 3,00,000 children under five in the country die from diarrhoeal diseases each year.