1. Understanding Rural Sanitation
Definitions, Progress, Issues and Challenges
J.V.R. Murty
International Development Consultant
August 2015

2. Part-1
Understanding Sanitation and Historical Evolution in India

3. What is Sanitation?
Discussions…..

4. What is Sanitation?
Sanitation is the collection, transport, treatment, disposal and/or reuse of human excreta, domestic waste water , solid waste and associated promotion of hygiene
Basic sanitation is the process of safe disposal of human excreta to prevent disease and safe guard human privacy and dignity.
Source: United Nations

5. Steps in Sanitation?
User interface: a household latrine or a public latrine
Collection: in sanitary pits or septic tanks
Conveyance: through sewer systems or vacuum suction tanks
Treatment: through appropriate technologies , and
Disposal and reuse: through appropriate means

6. Why is Sanitation Important?
Public health
Convenience
Privacy
Dignity
Economic benefits

7. Impacts of Poor Sanitation
Open defecation is one of the main causes of diarrhoea, which results in the deaths of more than750,000 children under age 5 every year.
Every 20 seconds a child dies as a result of poor sanitation.
80 per cent of diseases in developing countries are caused by unsafe water and poor sanitation, including inadequate sanitation facilities.
Access to sanitation, the practice of good hygiene, and a safe water supply could save 1.5 million children a year.
Poor sanitation and water supply result in economic losses estimated at $260 billion annually in developing countries
Doing nothing is costly. Every US $1 spent on sanitation brings a $5.50 return by keeping people healthy and productive.
Source: United Nations

8. Global Sanitation Coverage- 2012

9. Historical Evolution of Sanitation-1
During Vedic period there seems to be some evidence of good sanitation and hygiene practices in India through references made in Manu Smriti etc (kumar Alok)
Indus valley civilization remains (Harappa, Mohanjadaro) also point to existence of good sanitary practices – bathrooms, latrines, drains etc
Not much is known in between periods

10. Historical Evolution of Sanitation-2
Much is known about bad sanitation during British period and attempts to address several facets of Sanitation, related to:
: Royal Commission recommended setting up of Sanitary Commissioners to protect health of British Army.
Bhangi Mukti Movement launched by Mahatma Gandhi during freedom struggle
Post Independence sanitation was introduced in first 5 year plan in 1954 under the health sector and focus was on mostly on Bhangi Mukti.

11. Historical Evolution of Sanitation-3
Pace started picking up from 1980s due to International Decade of Sanitation ( )
Key programs were:
National Guinea Worm Eradication Program –
Central Rural Sanitation program (CRSP)
Minimum Needs Program (MNP) – 1980s-1990s
Total Sanitation Campaign (TSC)
Nirmal Gram Puraskar (NGP) – 2005 onwards
Nirmal Bharat Abhiyan (NBA)
Swach Bharat Abhiyan –Grameen- (SBM-G) 2014 onwards
+ various state sponsored programs in different states.

12. Historical Evolution of Sanitation-4
Tow important international goals also shaped the discussions on sanitation issues.
: Millennium Development Goals (MDG) T
The Millennium Declaration-’every individual has dignity; and hence, the right to freedom, equality, a basic standard of living that includes freedom from hunger and violence and encourages tolerance and solidarity’. 8 goals were adopted.
Target 7C: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation
: Sustainable Development Goals (SDS):  2030 Agenda for Sustainable Development, includes a set of 17 Sustainable Development Goals (SDGs) to end poverty, fight inequality and injustice, and tackle climate change by 2030.
Goal 6 is clean water and sanitation to ensure water and sanitation for all.

13. Part-2
Current Situation in India and Issues

14. Global Sanitation Status -2015
MDG 2015 Report- UNICEF&WHO

15. People Without Sanitation - 2012

16. People Practicing Open Defecation- 2012

17. Progress of Sanitation in Rural India
Source: WHO-UNICEF JMP Report 2013

18. Sanitation Non- Coverage in India – Census 2011
% of HHs without latrines
69.3% HHs in rural and 18.6% HHs in urban areas do not have access to sanitation

19. Reduction of Rural Open Defecation in South Asia (1995-2012)
Poor have benefited only in Bangladesh and to some extent in Nepal

22. What Was Done to Reach Here?
Four major programs:
CRSP ( ): 9 million toilets built
TSC ( ) + NBA ( ): 97 million toilets built
NGP from 2005 onwards:
SBM from 2014 onwards: Plans to build 100 mn toilets by 2019
Provided household subsides to both BPL and APL families (Rs 500 – Rs 12,000). Some states provided more.
Total estimated spend is about USD 3 billion ( roughly INR 618,000 crores)
Proposed spend on SBM is about USD 31 billion (1.9 lakh crores)

23. What Was Done to Reach Here?
Information, Education and Communications (IEC) from 1990s
Rural Sanitary Marts (material production centres) from 1990s
Provide household subsides/ incentives
Provided community incentives (Nirmal Gram Puraskar and variations in several states)
Community Led Total Sanitation (CLTS) from 2002 onwards
Other approaches like: Community Adopted Total Sanitation (CATS), Open Defecation Elimination Plan (ODEP), Behaviour Change Communications (BCC) etc.

24. Part-3
Policy Diagnosis

25. What is a Public Policy?
Public policy is the principled guide to action taken by the administrative executive branches of the state with regard to a class of issues in a manner consistent with law and institutional customs. The foundation of public policy is composed of national constitutional laws and regulations.
Courses of action, regulatory measures, laws, and funding priorities concerning a given topic promulgated by a governmental entity or its representatives.
Source: Wikipedia

26. Ingredients of a Public Policy
Adopted in the larger national interest, on a given subject.
Formulated through consultations.
Benefit to public of a country at large, especially the poor and vulnerable
Backed by constitution and/or other legal instruments
Transformed into actionable programs/ activities and backed with public financing
Set of institutions are put in place to implement, monitor and regulate the policy

27. Ingredients of a Sanitation Policy
Discussions

28. Ideal Governance Framework.
Unbundling of functions
Concerned ministry setting policy
Policy
Making
Citizen centric policies
CITIZEN
Oversight
Voice
Service
delivery
Accountability
Social audit committees
Higher tiers of govts
Financial audits
Rewards
Regulators
Local Governments
PHEDs
SPVs
Contracted operators

29. Current Institutional Structures.
State Water and Sanitation Mission (SWSM)
State Nodal Ministry/ Department
(Mostly PR and RD departments)
Water and Sanitation Support Organization (WSSO)
District Water and Sanitation Mission (DWSM)
District Program Unit (under a dedicated senior District officer)
Support Organizations
Block Resource Centre (BRC)
Under a senior block officer
Gram Panchayat/ Village Water and Sanitation Committee (VWSC)

30. Are the Institutions Strong?
Discussions

31. Outcome-1 Latrines Built..But are they being used??
Source: WSP, World Bank cartoons

32. Outcome-2 Did we Reach Poorest?
The programs have reached general households more than SC and ST households.
Souce: 2011 census data. Analysis done by JVR Murty

33. Outcome-3 IEC done..But did Behaviour Change??
Source: WSP, World Bank cartoons

34. Outcome-4 Are Institutions Capable?
Studies and experience indicate that last mile in the institutional chains are weak..
Source: A Decade of TSC – Rapid Assessment of Process and Outcomes at District Level, WSP, 2012

35. Key Challenges in Sanitation
Behaviour
Demand
SWM/ LWM
Institutional capacities of LGs
Markets
Equity

36. What Can Be Done?? Traditional Approach More Subsidy
More IEC/ Triggering
More Awards/ Rewards
Technology prescription
Innovative Approach
Don’t do anything?
Marketing approach?
Link with water supply?
Promote Micro Finance?
Choice of technology?