#WorldToiletDay: Is building toilets enough?
J-PAL South Asia
J-PAL South Asia at IFMR. J-PAL's mission is to reduce poverty by ensuring policy is informed by scientific evidence.
This #WorldToiletDay , we explore evidence on behavioral changes that may boost toilet use, combat open defecation & improve child health.
One of the largest rural sanitation programmes in the world, India's Total Sanitation Campaign (ICTS) had aimed to improve access to sanitation by building individual toilets & reducing open defecation rates in rural India.?
However, is increased access to sanitation facilities enough to improve child health?
A study by J-PAL affiliated professors assessed whether expanding access to individual toilets in rural areas could decrease open defecation, and subsequently improve child health outcomes.
This program included:??
?? changing social norms & behaviors around open defecation through school sanitation & hygiene education.
??providing technical & financial support to build toilets
?? providing subsidies for building individual household latrines.
Researchers found that this intervention led to increased access to individual toilets for households and a significant drop in open defecation rates.?
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However, this did not lead to improved child health outcomes. Why?
The study found that more than 70% of the population that received the program continued to defecate in the open and an estimated 41% households with improved sanitation facilities defecated in the open daily. A follow-up survey found that this was due to
??Culture
??Habit
??Preference?
??And inadequate water availability.
Evidence-based approaches that aim to change behaviors around toilet use may hold the answer. For example, an evaluation in Bangladesh found that in addition to promoting toilet construction, financial subsidies were effective in decreasing open defecation rates.
In India, however, “... the efforts to improve toilet usage should also address the role of caste and misinformation about latrine models...”
Taken together,?impacting behavior change by employing evidence from such programs could help close the gap between toilet construction, and make India open defecation-free.