Getting Swachh Bharat statistics right: Moving sanitation outcomes from access to use will represent true state

By Payal Seth

With the launch of the first phase of India’s National Family Health and Demographic Survey (NFHS-5) in December, we can estimate sanitation coverage improvement under the Swachh Bharat Mission (SBM). The data also equips us to compare the official SBM statistics and check the validity of the open defecation free (ODF) claim.

The NFHS-4 data collection commenced on January 20, 2015, ie, 2.5 months after the launch of the SBM. It ended in December 2016. Phase-one of the NFHS-5 data collection was conducted between June 2019 and February 2020. SBM concluded on October 2, 2016. Hence, estimates on sanitation improvement between the two survey rounds can be largely attributed to the SBM.

Phase 1 of NFHS-5 covered 17 states and five union territories. Besides a small decline in Sikkim, the percentage of households that reported using sanitation facilities has improved across the 22 states. Andhra Pradesh, Bihar, Jammu & Kashmir, Ladakh, Meghalaya, and Telangana have registered the highest improvements in sanitation (in the range of 20-25%). Overall, the states have reported a remarkable improvement in access to sanitation within the past 4-5 years. SBM was successful in achieving its objective of enhanced sanitation coverage in both rural and urban areas.

All the states on the SBM website have achieved the ODF status and 100% access to toilets in all the households. Exploring the extent of the disconnect between the official SBM statistics and the NFHS-5 data, we see that except Kerala and Lakshadweep, no other state is close to achieving universal sanitation. It is astounding to note that Ladakh and Bihar, states with the worst sanitation profile, have 50-60% less improved sanitation than is reported under SBM. For other states, the disconnect ranges between 5-35%.

Explaining the Disconnect
We need to be careful about the statistics as they represent answers to different questions. The SBM website provides numbers on access to toilets. Whereas, the NFHS-5 data asks the respondents to list the place where the household members usually defecate. As is mentioned in the NFHS-5 factsheet, the answers that correspond to “Flush to piped sewer system, flush to septic tank, flush to pit latrine, flush to don’t know where, ventilated improved pit (VIP)/biogas latrine, pit latrine with slab, twin pit/composting toilet, which is not shared with any other household” are categorised as improved sanitation facility. The NFHS does not verify the presence of toilets, so these statistics do not denote access to a toilet facility. Rather they capture a more precise measure of sanitation environment—use of facilities—by the respondent. This can partly explain the disconnect between the two datasets. The government must incorporate questions related to both access and use of toilets in future surveys that intend to capture the open defecation behaviour in India.

Declaration of India as an ODF nation was based solely on access to toilets. The outcome measured does not line up with the intent behind the launch of SBM—making India ODF, ie, no Indian resident practices OD and uses the toilets provided under the SBM scheme. The government guidelines also retained behaviour change activities as the core of SBM to bring about a change in the social attitudes of people and distinguished SBM as a demand-led sanitation program.
Therefore, measuring the use of toilets will convey the true success of the delivery of the SBM programme.

Moving the sanitation outcomes from access to use might push achieving the ODF target a little farther down the line, but will also represent the true state of the sanitation environment in India.

The author is Consultant at Tata-Cornell Institute, Cornell University, Ithaca, NY. PhD Scholar at Bennett University