How is Swachh Bharat Mission succeeding?

In 2014, the Prime Minister announced a goal of eliminating open defecation by 2019. Doing so would have required the slow pace of decline in open defecation to have accelerated, starting in 2014, by more than a multiple of 12.

This would have been three times as fast as the fastest five-year decline in open defecation ever recorded in any country. (That record decline, which some experts believe is overestimated, goes to the 17-percentage-point decline in Ethiopia, a country with a much smaller population than India’s, and which still has not eliminated open defecation altogether)

So, we should not be surprised that, now almost two-thirds of the way through the Swachh Bharat Mission (SBM), it appears very unlikely that open defecation will be eliminated by 2019. This was not a realistic goal in the first place.

But this does not necessarily imply that we should be disappointed. The diseases spread by open defecation in densely populated rural India are so threatening to the survival, health, and development of children that even a modest acceleration in decline of open defecation could represent a substantial improvement in well-being.

In fact, the best rural sanitation policy probably is not one that pretends an unachievable goal is achievable. A better policy would make serious plans that are both ambitious and realistic, strategising pragmatically to turn resources into feasible progress towards a hard problem.

Is that what we have? Has the SBM made meaningful progress towards accelerating the decline of open defecation? Nobody knows. SBM is not measuring open defecation. Nobody knows because there is no credible, independent survey that can offer a useful nationally representative estimate of the fraction of rural persons defecating in the open.

Indeed, there is not even a cross-sectional estimate for a point in time after the start of the SBM, let alone a consistently measured data series to assess the pace of decline. This is not to say that the government is not putting out numbers about sanitation. Indeed, data are collected, tabulated, and presented, but the resulting numbers do not teach us about the decline of open defecation.

One reason is that the government’s monitoring system does not track open defecation it tracks funds spent on latrine construction. For reasons we describe in our book, few people in villages want the pit latrines provided by the government, so in many cases funds spent on latrines do not result in functional latrines. Pits may never be dug and superstructures may turn into storage sheds or bathing areas.

Another reason why tracking funds spent on latrine construction tells us little about progress towards reducing open defecation is that even where funds translate into functional latrines, latrine ownership does not imply latrine use. In earlier research, we found high rates of open defecation among people who own government latrines (Coffey et al. 2014).

Other studies have found the same (Barnard et al. 2013, Clasen et al. 2014, Coffey et al. 2017). If measuring open defecation is the goal, the government should be asking people carefully worded and respectfully posed survey questions about what they do.

Asking the right question

The government could launch a survey to measure open defecation. Indeed, many small-scale surveys done by independent research teams have measured open defecation in different parts of the country. What we have learned is that asking rural people where they defecate – and getting accurate answers has its challenges. But it is nevertheless feasible, and not particularly costly.

A first step towards measuring open defecation is asking the right question. Our analysis of several sanitation surveys reveals some general principles on question wording. We recommend a question that has:

Balance: A good survey question explicitly permits both open defecation and latrine use as answers.
Disaggregation by person: A good survey question asks about each person individually, in the order they are listed on a household roster.
Specific, recent time frame: A good survey question refers to a short-term, specific time frame. People may feel more comfortable admitting to open defecation if saying ‘yes’ for now is not admitting to ‘yes’ for always.

An example of a question which incorporates balance, disaggregation by person, and a specific time frame is: “Yesterday, did Dean defecate in the open or did Dean use the latrine?”
The best approach to asking this question starts with introductory text that makes the respondent feel comfortable and normalises both possible answers. One example is: “I have been to several villages like this one, and I have seen that some people who have latrines use them, and some people who have latrines defecate in the open.”

Then, as above, the surveyor asks about each person individually: “What about Dean - yesterday, did Dean defecate in the open or yesterday did Dean use the latrine? And Diane - yesterday, did Diane defecate in the open, or did she use the latrine?”

Unhurried, respectful interactions, and smaller sample sizes Of course, simply writing a well-worded question on a survey form does not guarantee respondents will tell surveyors the truth about where they defecate... Sampling error is the error that comes from the random variation inherent in drawing a small sample. It is theoretically well understood and can be statistically quantified.

Non-sampling error is the error that comes from poor measurement; its magnitude is anybody’s guess. A smaller survey with a more manageable sample size would have more sampling error but would permit the kind of training and monitoring of surveyors that would yield higher quality measurement.

(An excerpt from a note in Coffey and Spears’ forthcoming book, ‘Where India Goes: Abandoned Toilets, Stunted Developments, and the Costs of Caste’, winner of the 2017 Joseph W. Elder Prize in the Indian social sciences. Reprinted with permission from ideasforindia.in)

By Diane Coffey & Dean Spears