The following presentation was made as part of the NITI-CPR seminar on Open Defecation Free Communities by Shubhagato Dasgupta, Senior Fellow at CPR

1. 1st NITI Aayog – Centre for Policy Research:
Open Seminar Series
Framing the ODF measurement question
Shubhagato Dasgupta, Senior Fellow

2. Background: India's sanitation challenge
India
Indonesia
Pakistan
Nigeria
Ethiopia
Sudan
Niger
Nepal
China
Mozambique
Burkina
Faso
Madagascar
Cambodia
South
Sudan
Rest
of
the
world
59%,
605.3
million
persons
Source
:
JMP
2014

3. Background: the evolution of Sanitation Policy
‘47
International Water & Sanitation
Decade
‘80 ‘86 ‘90 ‘93 ‘95 2000 ‘01 ‘03 ’04 ‘05 ‘07 ‘08 ‘10 ‘12 ‘14 ‘15
ILCS-­‐
Integrated
Low-­‐cost
SanitaJon,
CRSP-­‐
Central
Rural
SanitaJon
Programme,
GAP-­‐
Ganga
AcJon
Plan,
NRCP-­‐
NaJonal
River
ConservaJon
Programme,
TSC-­‐
Total
SanitaJon
Campaign,
NGP-­‐
Nirmal
Gram
Puraskar,
JNNURM-­‐
Jawaharlal
Nehru
NaJonal
Urban
Renewal
Mission,
NUSP-­‐
NaJonal
Urban
SanitaJon
Policy
,
SBM
–
Swachh
Bharat
Mission,
NUDM
–
NaJonal
Urban
Development
Mission
Millennium Summit & MDG
International Year of Sanitation.
Part of Water for Life Decade
SDGs
ILCS CRSP
GAP
Manual Scavenging
Act 1993
NRCP
GAP subsumed
into NRCP
NGP
Pune Decl.
JNNURM, GOI financing for
urban sanitation sector
started to increase
NUSP
released
SBM AMRUT
Smart Cities
TSC
‘95 ‘16 ‘17 ‘18 ‘19 ‘20 ‘21 ‘22
Goal of
an ODF
India!

4. Background: Genealogy of the term “Open
Defecation Free”
“100%
sani8zed
village”
-­‐
Mosmoil
N a 8 o n a l
Focus
on
1 0 0 %
sani8zed
village
/
ODF
TSC
Sant
Gadge
Baba
Swatchata
Abhiyan
ODF
in
SBM
G
2000 ‘01 ’04 ‘05 ‘07 ‘08 ‘10 ‘12 ‘14 ‘15 ‘16 ‘17 ‘18 ‘19‘02 ‘03
SDG
WDR
2004
TSC/NBA
ODF
1999
INDIA
ODF
India
target
Global
ODF
elimina8on
target
GLOBAL
BANGLADESH
Nirmal
Gram
Puraskar
From
78%
to
3
%
OD
SACOSAN
(T
2022)
‘30
OTHER
COUNTRIES

5. Background: Why has the “Open Defecation Free
Community” concept received so much purchase? : Some
explanations
• Clear recognition of the publicgoodaspect of sanitation
• Recognition that partialcoverageanduseoftoilets leads to
unsatisfactory public health outcomes from sanitation
• Clarifies the role of the community in sanitation
• Sets up a clear identifiable stage in the sanitationimprovemetmatrix
aimed at safely containing human excreta thereby breaking the
faecal oral route of transmission of disease
• Helps raise awarenessacrosscommunities
• Has induced innovativecommunity approaches and participation
• In a number of situations lead to rapid scalingupofabsorptionof
improved sanitation practices

6. Measurement : MDGs to SDGs:
from access to improved sanitation facilities to ending Open Defecation
MDGs (2000-2015)
GOAL
Halve, by 2015, the proportion of
people withoutsustainableaccess to
safe drinking water and basic
sanitation
TARGET
Halve by 2015, the proportion of
population withoutsustainableaccessto
safe drinking water & basic sanitation
INDICATORS
• The proportion of the population that
use an improved drinking water
source
• The proportion of the population that
use animprovedsanitationfacility
SDGs: 2015-2030GOAL:
Ensure availabilityandsustainable
managementof water & sanitation for
all
TARGET
(6.2) By 2030 achieve access to
adequate&equitable sanitation &
hygiene for all, and endopen
defecation, paying special attention to
the needs of women and girls
INDICATORS
• % of all population using safely
managedsanitationservices
[progressive elimination of
inequalities in access]
• Population with a hand-washing
facility with soap & water in the
household [progressive elimination
of inequalities in access
Measured
by
the
Joint
Monitoring
Program
(JMP)
of
the
WHO
&
UNICEF
(Dependent
on
naJonal
household
surveys
/
census)

7. Open Defecation (JMP) Census 2011 NSSO 69th Round
Open defecation: when human faeces are
disposed of in fields,forests,bushes,open
bodies of water,beaches,or other open
spaces,or disposed off with solid waste
No
latrine
within
premises
–
Public
latrine
-­‐
Open
• Access
to
latrine
–
no
latrine
-­‐
OD
• Type
of
latrine
–
not
used
-­‐
OD
• Whether
all
household
members
are
using
the
latrine
(male
/
female;
above/below
15
yrs)
&
Reason
Census 2011
Latrine within
premises?
Yes No
Flush / Pour flush
latrine :
Pit latrine:
Service latrine: Open
defecation
No
Public
latrine?
Measurement : JMP uses National Survey data from India
and elsewhere

8. Indonesia
(2012 DHS; 2010 Census)
Pakistan
(1998 Census; 2007 DHS)
Nigeria
(Census 2006)
Ethiopia
(Census 2007)
What type of toilet facility?
–No toilet
1. Latrine–no latrine
2. What kind of toilet
facility do members of
your household usually
use?–
o No facility / bush /
field
o Flush or pour flush
toilet: to somewhere
else; don't know
where
1. What type of toilet do
you use in this
household?-Nearby
(bush/beach/field)
2. What kind of toilet
facility do members of
your household usually
use?–No facility /
bush / field
What type of toilet facility
does the housing unit
have?–no toilet facility
Measurement : JMP uses National Survey data from India
and elsewhere

9. Measurement : Increasing engagement with ODF
measures in Indian programmes – NGP to NBA to SBM
§ Nirmal Gram
Puraskar 2005
§ Objective : To
incentivize PRIs to
make villages ODF
and to adopt Solid
& Liquid Waste
Management
(SLWM)
§ Detailed critrea : incl
Toilet usage by all
households,
migrant labour at
public places and
no open defecation
found in GP
§ Total Sanitation
Campeign 2011
§ Asks GPs for
“Plan of action to
attain ODF/Nirmal
Status”
§ Nirmal Bharat
Abhyan 2012
§ Additionally : “that
GPs will be
monitored for
‘Nirmal’ status”
§ Swachh Bharat
Abhiyan 2014
§ Objective 2.1(a):
“……eliminating open
defecation”
§ “community incentive,
if any, … released
after the village unit is
ODF for a significant
length of times”
§ Urban : “no
households engage
in the practice of OD”

10. India-NGP Nigeria Indonesia JMP CLTS PLAN
No OD found in the area ✓ ✓ ✓ ✓ ✓ ✓
100% presence of a functioning HH latrine ✓ ✓ ✓ ✓ ✓
> With superstructure ✓ ✓
>evidence of use ✓ ✓ ✓ ✓
>Latrines are well maintained ✓ ✓
Child stools are safely disposed of ✓ ✓ ✓
Safe containment of excreta ✓ ✓ ✓ ✓
Handwashing facilities are present ✓ ✓ ✓ ✓
>above with soap ✓ ✓ ✓ ✓
IEC activities ✓ ✓
>use of sanctions ✓
>existence of a monitoring system ✓ ✓
School sanitation ✓ ✓ ✓
>with handwashing facilities ✓ ✓
Aanganwadi sanitation ✓
Community toilets ✓ ✓
Health centre sanitation ✓
No manual scavenging ✓
Access to water ✓
Solid waste management ✓
Liquid waste management ✓ ✓
Time for certification (months) 24 3 NA NA 3-6 24
Source: WaterAid Policy Note – “Open Defecation Free”
Measurement : ODF indicators used across programmes

11. Source:
Ministry
of
Drinking
Water
and
SanitaJon,
Government
of
India
(2011)
ZPs
awarded
in
that
State
Measurement and Results : NGP awarded GPs (2012) by
state in percentage

12. 10.58
33.2
60.9
111.47
55.8
0
20
40
60
80
100
120
Census
TSC
Expon.
(1991-­‐2001
Growth
rate)
Linear
(1991-­‐2001
Growth)
(10%)
(23%)
(34%)
Million
HHs
Source:
Ministry
of
Drinking
Water
and
SanitaJon,
Government
of
India
(2012);
Census
1991,2001,2011
Measurement and Results : TSC and Census 2011 compared

13. Measurement and Results : Some questions and explanations for
the Slip back
SLIP BACK STATUS : NGP Impact Assessment Study
• 80.8% HHs from NGP had access to latrines at the time of the study
• 26% HHs had fully functional latrines
• 67% HHs all members used latrines
• Similar findings from UNICEF-TARU and Arghyam Surveys
Some issues identified by the NGP Impact Assessment Study – WHY?
Source:
Assessment
Study
of
Impact
and
Sustainability
of
Nirmal
Gram
Puraskar
(GoI
2011)

14. Measurement and Results : Some questions and explanations
of the complexity of behavioral issues involved
Sanitation Quality, Use, Access and Trends (SQUAT) Survey, 2014 in 5 North
Indian states
• A preference for open defecation:
– over 40% of HHs with a working latrine have at least one member who
defecates in the open – Why?
• Psychology of the “un-clean” – create distance, build high capacity pits…
• Feedback on benefits to defecating in the open:
– 47% of those that defecate in the open say they do so because it is pleasant,
comfortable, or convenient – Why?
• Rural households in India do not build inexpensive latrines like the ones in
countries in the region or Southeast Asia, and sub-Saharan Africa – WHY?
• Most people who own a government-constructed latrine continue to defecate
in the open - this is mentioned as a choice – Why?
Source:
hfp://squatreport.in/about-­‐the-­‐survey/
(3,235 adults on defecation practices and individual level latrine use data for 22,787
household members)

15. Randomized Control Trials
(RCTs)
• London School of Hygiene &
Tropical Medicine- Helminths
infection
• Sanitation and stunting in
I n d o n e s i a , O r i s s a ,
Maharashtra
• TSC, defecation behaviours
and health
Hand washing and habit formation
Higher
intensity
Lower intensity
Government
driven ODF
surveys
eg. NGP surveys
NSSO surveys
Non-
governmental
sample surveys
Census
household
survey
Programme
evaluations eg.
NGP scheme,
JNNURM
Sanitation
Baseline surveys
100%
Surveys
Sample
Surveys
Aggregator
Surveys
What we have learnt on ODF communities and its
measurement

16. What we have learnt on ODF communities and its
measurement
1. India is among a few countries that have a significant toilet
(output) subsidy program
2. It is the only country that has an incentive and reward scheme for
sanitation
• Others have recognition schemes / awards etc.
3. Slip back, is highly probable, so social mobilisation innovations
and special efforts needed for maintaining and improving status
4. One time measurement and declaration of ODF status has not
worked well enough
• ODF status needs to be confirmed only after few years of
consistent ODF results
5. Sanitation advances cannot be achieved and improvements
maintained as a one time effort but need ongoing programmes
6. Program Survey and aggregator biases difficult to control, so an
independent ongoing measurement system is needed, to monitor

17. Some ideas going forward on measuring ODF
communities
• There is a need for an non-program linked annual survey on a
Sanitation Matrix
• Possibly conducted by the NSSO and NITI Aayog?
• With the objective to gauge the sanitation situation from the
perspective of the extent to which waste (human excreta, liquid
and solid waste) is disposed of safely so that there are no
adverse effects on health
• Possibly understand where different states of the country rank
on a sanitation index (constructed through the survey) so that
the efficacy of their sanitation efforts can be reflected upon
• THANK YOU