India’s sanitation story

The success of any government policy lies in its functional purpose, which is implementation.


As India steps into the 68th year of independence many challenges lie ahead of the country, of which the poor state of sanitation is one that is most glaring. Presently less than 50 percent of households in the country have access to sanitation facilities, only 30 percent of the generated wastewater and generated sewage gets treated before being let into rivers and streams. An estimated 4 lakh children die of diseases such as cholera, dysentery and suffer from stunted growth as a result of poor sanitation each year. During his maiden Independence Day speech the Prime Minister spoke about the urgency of the situation. He spoke about a nationwide program to clean up India and eliminate open defecation by 2019. But, several such programs have been in progress in the country for close to three decades. However, the achievements have been slow and disappointing.

Historically, the Indian society has often given high priority to sanitation. Excavations from the Indus Valley Civilisation and Harappa reveal ingenious solutions to facilitate waste water conveyance through underground drainage systems.  Sanitary engineering, as far as 5000 years ago, was at a developed stage. Such visions on improved sanitary practices continued across the reign of various dynasties – like the Mauryas, Guptas or the southern kingdom of Vijayanagara – that ruled the subcontinent. Even from an ideological point of view, various social reformers of India propagated the importance of sanitation. From Patanjali’s philosophy to writings of Vivekananda and the Gandhian concept of sanitation, the emphasis on sanitation was integral to India’s cultural foundation.

Though built on a history of understanding the relevance of sanitation, marginal concern was accorded to it among human settlements developed in the pre-independent period under British rule. Issues of governance were dealt through the lens of Britain’s experience in India. For instance, when rampant outbreaks of cholera and plague were affecting the health of the British Army personnel, it invoked the intervention of establishing improvement trusts to clean up cities, the first of which was the Bombay Improvement Trust in 1898. The trust was given an institutional mandate, which was  lost post Independence.

It was in 1986 that the government launched the Central Rural Sanitation Program (CRSP), the first nationwide sanitation program. Several other large sanitation programs have been launched since then such as the Nirmal Bharat Abhiyan (NBA) in rural India, and Basic Services for Urban Poor (BSUP) (under Jawaharlal Nehru National Urban Renewal Mission) and in urban India. Though sanitation was historically and culturally rooted in India even today 48 percent of country’s population defecates in the open. Open defecation is not rural phenomenon, considering India contributes to 46 percent of global open defecation in urban areas. Gender related issues exist with 70 percent of crimes against women occurring due to defecation in the open.

The negative implication of lack of sanitation is reiterated wisdom. A World Bank study estimates that inadequate sanitation accounts for a loss of $53.8 billion (as estimated for 2006) in India, which includes economic losses recorded from tourism, access time, water use and health related economic impacts. This implies a per capita annual loss of $48. India is also a signatory of the Millennium Development Goals, but is lagging severely in meeting its goal on sanitation i.e “halving the proportion of the population without sustainable access to safe drinking water and basic sanitation by 2015”.

The Government of India (GoI) has launched multiple sanitation policies across rural India. The Central Rural Sanitation Programme (CRSP) in 1986 was formulated with the objective of providing for 80 percent subsidy for construction of individual sanitary latrines for BPL households on demand basis. The CRSP was restructured in 1999, with a shift from a high subsidy to a low subsidy model. The supply driven approach was altered to a demand driven model with increased emphasis on public participation. In 2001 the CRSP was overhauled with the introduction of the Total Sanitation Campaign (TSC), which carried forward the demand driven approach focusing on awareness building. The programme costs in TSC were shared between Union (60 percent share), state governments (20 percent share) and the beneficiary (20 percent share). 

As a fillip to the TSC, the Nirmal Gram Puraskar (NGP) was launched, to recognise the achievements and efforts of Gram Panchyats towards full sanitation coverage. In 2007 TSC was renamed Nirmal Bharat Abhiyan (NBA). NBA envisages facilitating individual household toilets to the Below Poverty Line and Identified Above Poverty Line households and providing school and community level sanitation. The NBA has now been converged with the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) to facilitate the rural households with fund availability for creating their sanitation facilities. It was not until the inception of the National Urban Sanitation Policy (NUSP) in 2008, that urban sanitation has been allotted focused attention at the national level. The NUSP instated a framework for cities to prepare City Sanitation Plans under the scheme of a State Sanitation Strategy. Urban Sanitation awards and ratings were also introduced based on the benchmarking of sanitation services.

Centrally sponsored schemes such as JNNURM, Urban Infrastructure Development Scheme for Small and Medium Towns (UIDSSMT), Rajiv Awas Yojna, etc. provide funds for creation of sanitation assets like individual toilets, community toilet blocks and wastewater disposal and treatment facilities at the city level. The benchmarking initiative was an important recognition of the Ministry of Urban Development (MoUD) to increase accountability for service delivery, thus diverting – at least in principle – the focus of these centrally sponsored schemes on service delivery outcomes rather than on infrastructure creation. Even the 13th Finance Commission has endorsed the compliance with service level benchmarks as a necessary pre-condition for urban local bodies (ULBs) to obtain performance linked grants.

An analysis of India’s sanitation policies and programs thus far shows that their implementation has been purely government-led, infrastructure-centred, supply driven and subsidy-based. Our approach towards sanitation has been purely programmatic. This lack of a holistic overview has cost us very dearly; billions of rupees have been spent in building toilets that are not being used. Only 20 percent of the toilets constructed since 2001 were in place in 2011. The rest either had become unusable due to bad construction quality and lack of maintenance or were not just being used.

In survey conducted in rural Odisha, respondents reported that they felt no stigma associated with open defecation and preferred it over using a latrine as they felt using a latrine caused accumulation of faeces near the house. Case studies show that elimination of open defecation will require high degree of awareness creation and behavioural change for the population. Urban sanitation is faced with an additional challenge of multiple institutions in the form of water and sewerage boards and municipalities/municipal corporations, which creates a scenario of a lack of a clear mandate for institutions to govern urban sanitation services.

Sanitation Policies and Programs should facilitate participation of civil society (including women) in the design, implementation and monitoring of local priorities in rural and urban areas. The mistake of the programmatic paradigm adopted thus far has been the lack of localisation. This has led to a variety of issues like slow implementation, misplaced priorities of local government and complete dissatisfaction of the communities.

India also needs a very aggressive IEC program to influence people’s behaviour, preferences, and choices to make the country open defecation free. Strengthening of institutions, efficient monitoring and evaluation for improved accountability and innovations in design and implementation will have to mark the final sanitation journey that India is going to embark upon. No policy is bad by itself, in so far as it is not too specific or too broad in its functional scope. The success of any government policy lies in its functional purpose, which is implementation.

Photo: Overseas Development Institute