India has made progress in increasing access to water and sanitation but still faces challenges. Strengths include policies promoting access, financing from central and state governments, and programs like Swachh Bharat Mission and Jal Jeevan Mission. Interventions in various states led to outcomes like increased school enrollment and ended open defecation. However, issues remain around sustainability, governance, and fully achieving targets. A SWOT analysis can help identify how to strengthen programs and address weaknesses.

1. WASH PROGRAM: SWOT ANALYSIS
Dr. Smriti Madhusikta
PG
Guided by: Prof (Dr) Sonali
Kar
16/12/2021 1

2. Learning Objectives
• Introduction to the program
• Problem statement
• WaSH interventions
• Consequences of WaSH interventions
• Outcomes, impacts and barriers of WaSH interventions
• WaSH in India
• SWOT analysis in India
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3. Introduction
• WaSH: safe drinking water, sanitation and Hygiene: fundamental to
improved standard of living
• Strategy in response to 2030 agenda for sustainable development and its
goals (SDGs).
• WHO vision for WASH: “to substantially improve health through the safe
management of water, sanitation and hygiene services in all settings.”
• In 1990: 76% of global population – access to improved drinking water
54% - access to safe sanitation
(WHO & UNICEF 2015b)
• MDG: achieved drinking water target in 2010;
9% points short of achieving the sanitation target.
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4. Problem Statement
Globally*:
• Global prevalance of handwashing with soap after contact with excreta is 19%.
• Rates of prevalance of handwashing much lower# - Sub Saharan Africa (14%)
- South East Asia (17%)
* WHO & UNICEF 2015b
# Freeman & Others 2014
1990 2015
Improved drinking water sources 76% 91%
Use of improved sanitation 54% 68%
Proportion of population practicing open defecation 24% 13%
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5. Problem Statement (cont)
In 2017, 96 countries had estimates for safely managed sanitation
Figure: Proportion of population using safely managed sanitation services ,
2017(%)
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(JMP 2019 full report)

6. Problem Statement (cont)
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JMP 2021 full report

7. Problem Statement (cont)
Figure: Proportion of population with basic handwashing facilities at home, 2017(%) & 2021
(JMP 2019 & 2021 full report)
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8. Problem Statement (cont)
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JMP 2021 full report

9. WaSH interventions
• WASH interventions mostly targets populations affected by cholera, Ebola virus disease (hereafter
‘Ebola’), hepatitis E, hepatitis A, typhoid, acute watery diarrhoea and bacillary shigellosis (dysentery).
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Source: Yates, T., Allen, J., Leandre Joseph, M. and Lantagne, D. (2017). WASH interventions in disease outbreak response. Humanitarian Evidence Programme.
Oxford: Oxfam GB

10. WaSH interventions (cont)
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1. Well disinfection - Disinfecting a contaminated well with chlorine
• Shock chlorination
• Pot chlorination
2. Source-based water treatment - water treatment that occurs at the source itself
• Chlorine dispensers
• Bucket chlorination
3. Household water treatment (HWT) – chlorine-based products
• Chlorine tablets : small tablets of 7-167mg sodium
dichloroisocyanurate used to treat 1-20L of water
• Liquid chlorine: a small bottle of 1-1.25 percent sodium
hypochlorite, sized so 1 cap is used to treat 20L of water

11. WaSH interventions (cont)
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4. HWT – other products – non chlorine HWT interventions
• Filters
• SODIS : Solar disinfection
• Safe water storage
• Boiling
5. Community-driven sanitation – Community – driven approaches focus on specific
promotion to ‘trigger’ the community to address its sanitation needs with local
materials.
• Community-Led Total Sanitation (CLTS)
• Community Approach to Total Sanitation (CATS)
• Participatory Hygiene and Sanitation Transformation (PHAST)

12. WaSH interventions (cont)
6. Hygiene promotion – sharing of personal and environmental hygiene-related
information to educate populations with the goal of reinforcing or changing behaviour.
• Hygiene education
7. Social mobilization – describes strategies for involving or engaging communities in the
outbreak response, with responders facilitating communities to address identified
risks with local solutions.
8. Hygiene kit distribution – Non Food Items (NFIs) like HWT products, soap and safe
water storage containers most commonly included.
9. Environmental hygiene – efforts aim to protect populations by reducing environmental
transmission of disease
• Jerry can disinfection
• Household disinfection
• Environmental clean-up
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13. WaSH interventions (cont)
10. WASH package – WASH interventions are regularly implemented in combination by
responders to address multiple possible transmission routes and provide comprehensive
protection to beneficiaries. Package includes
• Well rehabilitation
• Water trucking
• New borehole
• Latrine construction
• Sanitation promotion
• Hygiene promotion
• NFI distribution
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14. Consequences of WaSH interventions
• Health consequences
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15. Consequences of WaSH interventions (cont)
• Diarrhea can be prevented - and the lives of 525,000 children annually be saved (estimate
for 2017) - by improved sanitation, clean drinking water, and hand washing with soap.1
• Numerous studies have shown that improvements in drinking water and sanitation (WASH)
lead to decreased risks of diarrhea.2
• Water, sanitation and hygiene interventions help to prevent many neglected tropical
diseases (NTDs), for example soil-transmitted helminthiasis.3
• A randomized control trial in India concluded that the provision of chlorine tablets for
improving water quality led to a 75% decrease in incidences of cholera among the study
population.4
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1."Diarrhoeal disease Fact sheet". World Health Organization. 2 May 2017. Retrieved 12 December 2021.
2. Wolf, Jennyfer; Prüss-Ustün, Annette; Cumming, Oliver; Bartram, Jamie; Bonjour, Sophie; Cairncross, Sandy; Clasen, Thomas; Colford, John M.; Curtis, Valerie; De France, Jennifer; Fewtrell,
Lorna; Freeman, Matthew C.; Gordon, Bruce; Hunter, Paul R.; Jeandron, Aurelie; Johnston, Richard B.; Mäusezahl, Daniel; Mathers, Colin; Neira, Maria; Higgins, Julian P.T. (August
2014). "Systematic review: Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-
regression" (PDF). Tropical Medicine & International Health. 19 (8): 928–42. doi:10.1111/tmi.12331. PMID 24811732. S2CID 22903164
3. Johnston, E. Anna; Teague, Jordan; Graham, Jay P (2015). "Challenges and opportunities associated with neglected tropical disease and water, sanitation and hygiene intersectoral
integration programs". BMC Public Health. 15: 547. doi:10.1186/s12889-015-1838-7. PMC 4464235. PMID 26062691)
4. Taylor, Dawn L; Kahawita, Tanya M; Cairncross, Sandy; Ensink, Jeroen H. J (2015). "The Impact of Water, Sanitation and Hygiene Interventions to Control Cholera: A Systematic
Review". PLOS ONE. 10 (8): e0135676.doi:10.1371/journal.pone.0135676. PMC 4540465. PMID 26284367

16. Consequences of WaSH interventions (cont)
Social welfare consequences:
• Improved water supply and sanitation provide individuals with increased comfort,
safety, dignity, status, and convenience, and also have broader effects on the living
environment
• Facilities In or Near Homes :
– Water supply in or adjacent to homes provides greater comfort to household
members; water sources closer to home, especially piped water, are associated
with increased use (Howard and Bartram 2003; Olajuyigbe 2010)
– Individuals with access to on-plot sanitation benefit from greater privacy,
comfort, and convenience.
– Privacy, comfort, and convenience benefits are magnified for vulnerable groups,
such as the elderly or persons living with disabilities or debilitating chronic
illness.
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17. Consequences of WaSH interventions (cont)
Social welfare consequences (cont):
• School and workplaces:
– Access to improved WASH services in schools and workplaces contributes to school
attendance, school performance, and choice of where to work, especially for girls and
women.
– A study from India shows that a national government program to build toilets in schools
led to an 8 percent increase in enrollment among pubescent-age boys and girls and a 12
percent increase among younger children of both genders (Adukia 2014).
• Menstrual hygiene:
– Improved WaSH services improves menstrual hygiene management.
– Separate toilets for boys and girls and proper MHM decreases absenteeism and
improves retention of girls in schools
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18. Consequences of WaSH interventions
Environmental consequences:
• Major environmental consequences of poor WASH practices:
1. excessive extraction of water to meet population needs
2. pollution caused by poorly managed human excreta.
• Proper implementation of sanitation practices like usage of toilets reduces open
defaecation thereby reducing the pollution caused by human excreta
• Safe hygiene practices decreases WaSH related disease transmission improving the
standard of living.
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19. Outcomes, impacts and barriers of WaSH
interventions
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Causal chain intervention evidence.
Source: Yates, T., Allen, J., Leandre Joseph, M. and Lantagne, D. (2017). WASH interventions in disease
outbreak response. Humanitarian Evidence Programme. Oxford: Oxfam GB.

20. WaSH in INDIA
Indian statistics:
As per 76th NSS reports (July 2018 – December 2018)
• Improved source of drinking water – about 94.5% households in rural areas
- about 97.4% households in urban areas
• Access to bathroom – 56.6% households in rural areas
- 91.2% households in urban areas
• Between 2014 and 2019, Indian Government claims to have built around 108 million toilets
all across India. (https://sbm.gov.in/sbmdashboard/)
• basic sanitation coverage went up from 38.7% in October 2014 to 93.3% in 2019.
(https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=.WS_PPL_S-
ALB..&startPeriod=2014&endPeriod=2019)
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21. WaSH in INDIA (cont)
Odisha statistics:
• The rural sanitation coverage of Odisha as of august 2011 was only 55.19% (as per
the Report of the Working Group on Rural Domestic Water and Sanitation )
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22. 16/12/2021 22
Source: 76th NSS reports (July 2018 – December 2018)

23. Important Drinking water supply programs and
policies in India
1969 – National rural drinking water supply program launched with technical support
from UNICEF.
1972-73 – Accelerated Rural Water Supply Program (ARWSP) introduced
1986 – The National Drinking Water Mission (NDWM) launched
1987 – 1st National Water policy was drafted
1999 – separate Dept of Drinking Water Supply in the Ministry of Rural development
formed
2005 – Bharat Nirman Program launched
2009 – National Rural Drinking Water Programme launched on 1/4/2009
2011 - Department of Drinking Water and Sanitation upgraded as separate Ministry of
Drinking Water and Sanitation
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24. Interventions and immediate consequences in
terms of implementation in India
According to a case study by Plan India curated by The Indian sanitation
Coalition from 2014-2016, few Implementations and results are as follows:
• As part of the Support My School campaign implemented by Plan India, separate toilets
were built, safe drinking water was made available and sports facilities were also provided.
Since then, the number of children enrolled in Class I has increased and retention has gone
up from 51% to 80%.
• As part of the ‘Swachh Vidyalaya Swachh Bache’ campaign, 73 schools with more than 700
children, parents and teachers each were taught on cleanliness of schools and personal
hygiene.
• Special focus was given on promoting Village Water Safety and Security as part of their
WASH interventions. Several villages in remote and hard to reach locations were supported
through participatory techniques and government linkages, to access potable water, clean
toilets and learn good practices on environmental hygiene and community sanitation.
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25. Interventions and immediate consequences in
terms of implementation in India (cont)
• In Odisha, 750 tribal people ended open defecation because of toilets constructed and
3,400 persons oriented on hand washing and personal hygiene on Global Hand washing Day.
• In Jharkhand 500 household toilets built through Swachh Bharat Abhiyan funds and 1,135+
children benefited through the Support my School project.
• In Uttar Pradesh, Over 1,000 adolescent girls who participated in the activities were able to
influence 126 families to construct domestic latrines bringing an end to open defecation.
• In Rajasthan, 3,257 families with poor financial backgrounds supported through
construction of household toilets and 1,500+ adolescent girls trained on menstrual hygiene
practices, safe disposal of sanitary napkins.
• In Delhi, 6,600 children benefited from improved sanitation facilities including disabled
friendly facilities in schools ; 5,500 households had access to clean drinking water.
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26. Newer inititative in Odisha
Drink from Tap Mission:
• Initiative of Govt of Odisha to reach everyone with 24/7 safe drinking water
from a tap on premise in urban localities
• All houses connected to provide 24x7 piped water supply of drink from tap
quality water with 100% metering
• WATCO implementing the programme with technical support from UNICEF &
IRC
• Successfully implemented at selected locations in BMC & Puri Town
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27. WASH: SWOT ANALYSIS in India
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28. STRENGTHS
Policies:
• Launch of National Urban Sanitation Policy in November 2008 with the goal of
creating "totally sanitized cities" i.e open-defecation free, safely collect and treat all
their wastewater, eliminate manual scavenging and collect and dispose solid waste
safely.
• Introduction of Nirmal Shahar Purashkar to the best sanitation performing city
• Promotion of efficient use and water management, recycling and reuse of
wastewater, water supply and sanitation, and efficient water pricing by initiatives
like National Water Policy 2012
• Encouraging private sector participation, contracting out operations and
management to private companies to reduce non-revenue water in urban areas
• Transferring the responsibility for service provision from State Water Boards
and district governments to Panchayati Raj Institutions (PRI) at the block or village
level.
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29. Investment and Financing:
• The investments in domestic Water and Sanitation in the 11th five year plan (2007 –
2012) : 40150 (Rs in crores) by centre & 49000 (Rs in Crores) by states
• Sub groups formed for depth analysis of different aspects of the program
SubGroup Subjects allocated
1 Appropriate technology
2 Issues of Governance, Sustainability of sources and schemes
3 Capacity building and IEC in water and sanitation
4 Right to water and equity issues
5 Incentives and subsidy in Domestic Water and sanitation
6 Coverage of Rural domestic water and sanitation
7 Approach to sustainability – Water
8 Water quality – Monitoring and mitigation
9 Nirmal Gram puraskar
10 Approach to sustainability - Sanitation
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30. Institutions and approaches:
• The Jawaharlal Nehru National Urban Renewal Mission (2005-2014) replaced by
the Atal Mission for Rejuvenation and Urban Transformationn (AMRUT) plays an
important role in financing urban water supply and sanitation through central
government grants.
• Initiation of Total Sanitation Campaign to eradicate the practice of open
defecation by 2017
• Launching of the Swachh Bharat Mission on 2nd October 2014; Funding and
technical support for Swachh Bharat Abhiyaan from the World Bank
• Schemes under Jal Jeevan Mission:
– In-village water supply (PWS) infrastructure for tap water connection to every household
– Reliable drinking water source development/ augmentation of existing sources
– Transfer of water (multi-village scheme; where quantity & quality issues are there in the local
water sources)
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31. – Technological intervention for treatment to make water potable (where water quality is an issue,
but quantity is sufficient)
– Retrofitting of completed and ongoing piped water supply schemes to provide FHTC and raise the
service level
– Grey water management
– Capacity building of various stakeholders and support activities to facilitate the implementation.
• Initiation of Har Ghar Jal scheme by the Government of India in 2019 with the aim
to provide tap water to every rural household by 2024
• Set up of ‘World’s first mobile water from air kiosk’- MEGHDOOT in
Vishakhapatnam
External cooperation:
• Financial and technological aid from international banks like World Bank, Asian
Development Bank
• Technical expertise from countries like Japan, Israel and Germany.
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32. (WHO results report programme budget 2018-2019)
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33. WEAKNESS
• The indicators for global monitoring not simple for feasibility and cost. Countries,
organizations and programs often monitor different aspects of service performance.
(Roaf, Khalfan and Langford 2005)
• The definitions in existing monitoring systems have several limitations.
• Proxy indicators for handwashing practice from nationally representative surveys are
not reliable and tend to over report hygiene practices. (Biran & others 2008)
• WaSH interventions are better in developed countries than underdeveloped and
poorly developed countries
• Low or uneven demand has limited growth opportunities for small scale onsite
sanitation service providers
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34. WEAKNESS (cont)
• Cost recovery and operating and maintenance costs of utilities in some cities was
60% (according to a 2007 study) https://www.adb.org/publications/2007-benchmarking-and-data-book-water-utilities-india
• Improper or inadequate water metering of all the cities creates hinderance in
regulation and cost recovery of utilities. Malfunctioning of meters at various places
leads to flat charging of customers.
• Health systems and provisions are more skewed towards urban facilities and there
is decreased focus on rural facilities
• Higher financial costs, inadequate technical training for operations and
maintenance, poor use of new facilities and taught behaviors, and a lack of
community participation and ownership.
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35. WEAKNESS (cont)
• Access to WASH services varies internally within nations depending on socio-
economic status, political power, and level of urbanization.
• Unequal focus on WaSH components: more emphasis on drinking water which is
provider centric; decreased focus on hygiene practices i.e community driven
• Lack of community participation, ownership and sustainability.
• Lack of provisions or too expensive option in hard to reach areas.
• Only focus on human excreta and hygiene practice; lack of attention on the pollution
caused by others like handling, bathing and defaecation by domestic animals
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36. (UNC ‐ the Water Institute, 2020)
(UNICEF, 2020)
• 30‐50% of WASH projects
fail after 2‐5 years
– good: technical aspect
– Lack of: good governance
:enabling environment;
:accountability.
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37. OPPORTUNITY
• The service range can be widened and include
– Micro and small-scale independent water resellers, network operators, well and pit
diggers, public toilet operators etc
– Medium scale sanitation markets or sanimarts
• Microfinance or microcredit can help poor households facing liquidity constraints to
invest in water supply and sanitation
• Intersectoral convergence between govt and pvt sectors in the form of coalitions or
partnerships to achieve higher efficiency, quality, coverage and effectiveness.
• Implementation of more cost effective interventions like usage of sanitisers where
there is scarcity of water (esp. in Covid times)
• Improved, loud and wider campaining across the country to create awareness
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38. OPPORTUNITY (cont)
• Increased and active reasearch on these areas like door to door survey will help in
generating a good data and increase relevance on clinical side.
• Adequate sanitation facility should be provided at schools with more focus in rural
areas
• Encouraging water harvesting by giving incentives.
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39. THREATS
• Economic divide: the economic difference between developed and underdeveloped
countries brings about a major difference in the implementation of program
• Different countries and areas have different priorities which may put WaSH at backhand for
them
• Social divide: Inequalities in the system based on caste, gender and religion have a major
impact on WaSH both in urban and rural areas
• Strong cultural taboos around menstruation, which are present in many societies, coupled
with a lack of Menstrual Hygiene Management services in schools
• Climate change contributing to water scarcity
– Increased demand due to low rainfall
– Heavy rainfall and flooding causing damage to water sources
• Political interests prevent tariffs to be increased slightly even if users are willing to pay
16/12/2021 39

40. THREATS (cont)
• Overcrowding due to migrating population may poses a threat for sanitation
infrastructures that were not originally designed to serve so many households.
• Natural calamities like cyclones, floods, drought etc may cause damage to water
sources and may start point source epidemic
• Spread of Pandemics like COVID-19 due to inadequate knowledge, practice and
facilities.
• Exploitation of urban people not having a piped connection by the Water Mafia by
supplying compromised quality of water at a very high rate
(https://foreignpolicy.com/2015/07/17/at-the-mercy-of-the-water-mafia-india-delhi-tanker-gang-scarcity/)
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41. STRENGTH
1. Launch of policies like NUSP, Nirmal shahar puraskar,
national water policy
2. USAID partnership with GoI to improve safe water
services
3. Leveraging the private sector to access to safe
drinking water
4. GoI initiatives like:
• Swachh Bharat Mission
• AMRUT
• Jal jeevan
• Har ghar jal
WEAKNESS
1. Definitions in existing monitoring systems have
several limitations
2. Discrepancy between studies and actual practice
3. No uniformity in monitoring different aspects of
service performance
4. Unequal focus on WaSH components
5. Lack of public support
6. Delay in implementation of govt. schemes
OPPORTUNITY
1. Reduced heirarchy in sanction of funds and
implementation of policies
2. Improved IEC
3. Inclusion of latest and sustainable technology
4. PPP model with NGOs
5. Sanitation facilities at school
6. Incentive for harvesting and other community based
activities
THREATS
1. Caste and gender based inequality
2. Climate change
3. Natural calamity
4. Epidemics and pandemics
5. Overcrowding
6. Water mafia
7. Distorting accountability
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42. References
• Mock C, Nugent R, Kobusingye O, Smith K, Medina-Mora M. Disease Control Priorities, Third Edition
(Volume 7). 3rd ed.
• Progress on household drinking water, sanitation and hygiene 2000-2017. Special focus on inequalities.
New York: United Nations Children’s Fund (UNICEF) and World Health Organization, 2019.
• Progress on household drinking water, sanitation and hygiene 2000-2020: Five years into the SDGs.
Geneva: World Health
• Organization (WHO) and the United Nations Children’s Fund (UNICEF), 2021. Licence: CC BY-NC-SA 3.0 IGO.
• Government of India. Drinking Water, Sanitation, Hygiene and Housing Condition in India [Internet]. 2018.
Available from: http://mospi.nic.in/sites/default/files/NSS7612dws/Report_584_final.pdf
• World Health Organisation. WHO Results Report Programme Budget 2018-2019 [Internet]. WHO; 2019 p.
131. Available from: https://www.who.int/publications/i/item/who-result-report-programme-budget-
2018-2019
• UNC – the Water Institute, 2020. The WASH Performance Index Report. Available at:
waterinstitute.unc.edu/wash‐performance‐index‐report/ Last accessed: 28/10/2021/
• UNICEF, 2020. Water, Sanitation and Hygiene. Available at: www.unicef.org/wash/ Last accessed:
15/10/2020
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43. References (cont)
• Seetharam, K. E.. 2007. 2007 Benchmarking and Data Book of Water Utilities in India. ©
Asian Development Bank. http://hdl.handle.net/11540/222. License: CC BY 3.0 IGO
• Yates, T., Allen, J., Leandre Joseph, M. and Lantagne, D. (2017). WASH interventions in
disease outbreak response. Humanitarian Evidence Programme. Oxford: Oxfam GB.
• India sanitation coalition. PLAN INDIA – WASH INITIATIVES [Internet]. Available from:
https://www.indiasanitationcoalition.org/resources/Case%20Study%20-
%20Plan%20India.pdf
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44. THANK YOU
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