Given these achievements, it is hardly surprising that India just hosted ministers of sanitation, heads of various multilateral organisations, led by the secretary general of the UN, and other field experts from around the world at the Mahatma Gandhi International Sanitation Convention to showcase how this dramatic transformation was brought about. No surprise, therefore, that other countries such as China and Pakistan have similar campaigns now. Without a doubt, then, the SBA is a highly commendable initiative and improvements in India’s sanitation and health metrics, which have been an embarrassment, were urgently required.
However, this rosy picture contrasts with some of the independent assessments of the SBA. For instance, the ODF data, which has become synonymous with the SBA, has been questioned by researchers. Nikhil Srivastav of the University of Texas and Payal Hathi of the University of California, Berkeley have characterised the findings of the National Annual Rural Sanitation Survey (NARSS) data — showing that open defecation is being eliminated from rural India — as “unfortunately premature”. They have pointed out that, in practice, this survey was designed to agree with government claims, which, in turn, are based on MIS (management information system) reports. The trouble is that MIS reports take into account only toilet construction, not toilet use. Moreover, given the political weight behind the scheme, there is tremendous pressure among officials at village level to overstate the success of the initiative.
Indeed, there are other results that suggest government claims may have been overstated. For instance, the findings of the latest round of the National Family Health Survey (NFHS-4), which is a high-quality, internationally comparable survey, contrast sharply with that of the NARSS. Both were conducted within months of each other. Moreover, beyond the ODF targets, the SBA success has been middling on other parameters such as management of liquid and solid waste. For instance, of the 62 billion litres of sewage generated in our cities daily, only 23 billion litres gets treated, contributing to the demise of several rivers. Similarly, only 37 per cent of the municipal waste gets treated. The other challenge is to sustain the changed rural sanitation behaviour and to ensure that the toilets that have been built are used. While over 450,000 grassroots motivators are dealing with the task in rural areas, clearly, there is a long way to go.