Swachh Bharat Mission as a ‘Game-Changer’ for Public Health

Syllabus: Social Justice: Health

Source: TOI

Context: A study published in the *Nature* journal by the International Food Policy Research Institute suggests that the Swachh Bharat Mission (SBM) has led to a significant reduction in infant deaths by improving sanitation.

About SBM:

Swachh Bharat Mission (SBM) was launched on October 2, 2014, to fulfil the vision of a cleaner India by October 2, 2019. The objective of the Mission was to eliminate open defecation, eradicate manual scavenging, and promote scientific solid waste management.

Key Findings of the Report:

• Infant and Child Mortality: The post-Swachh Bharat Mission (SBM) period showed accelerated reductions in infant and under-five mortality rates.

• Toilet Coverage: Districts with over 30% toilet coverage under SBM saw a 5.3 lower Infant Mortality Rate (IMR) and 6.8 lower Under-Five Mortality Rate (U5MR).

• Improved Health Outcomes: Higher SBM coverage corresponded with greater utilization of health programs such as antenatal care (ANC) and institutional deliveries.

• Reduced Diarrheal Deaths: WHO reported 300,000 fewer diarrheal deaths in 2019 compared to 2014 due to improved sanitation.

• Child Wasting: Non-ODF areas experienced 58% higher rates of child wasting (Bill & Melinda Gates Foundation).

• Women’s Safety: 93% of women reported feeling safer at home with improved sanitation facilities (UNICEF).

• Education: Poor WASH facilities hinder student attendance and enrollment, particularly for girls.

Reasons for the success of the Swachh Bharat Mission (SBM):

Reason | Description

Community Engagement | SBM combined toilet construction with community involvement, encouraging local ownership of sanitation efforts.

Information, Education, and Communication (IEC) | Substantial investments in IEC campaigns helped bring about behavioural changes by raising awareness of the importance of sanitation and hygiene.

Capacity Building and Training | Extensive training programs for government officials, frontline workers, volunteers, and communities enhanced the implementation and sustainability of SBM.

Waste Management Systems | Developed systems for waste segregation, collection, transportation, disposal, and treatment, including recycling centres for effective waste management.

Citizen Engagement and Monitoring | Introduced mobile and web applications for active citizen participation, feedback, and monitoring of sanitation progress.

National Annual Rural Sanitation Survey (NARSS) | Periodic assessment of progress through NARSS ensured accountability and data-driven decision-making in rural sanitation efforts.

Limitations of Swachh Bharat Mission:

• Low Toilet Usage: Despite achieving 100% sanitation coverage by 2019, only 85% of rural Indians utilize safe and hygienic toilets, indicating a usage gap.

• Quality and Infrastructure Issues: Problems such as malfunctioning facilities, unhygienic conditions, and structural defects like full pits or collapsing superstructures impede toilet usage.

• Water Scarcity Impact: Limited water access, particularly in rural areas like Gujarat’s Dahod district, contributes to increased non-usage of toilets.

• Behavioural and Social Norms: Cultural norms and behaviours influence toilet usage, with some households repurposing toilets for activities other than defecation.

• Caste-Based Variances: Toilet access and usage exhibit variations across castes, with surprising trends showing higher non-usage rates among upper castes.

• Challenges in Larger Households: Overcrowding and inadequate facilities pose challenges to toilet usage in larger households.

• Issues in solid waste management: While toilet construction has been successful, scientific collection, segregation and disposal of growing waste volumes remain an issue due to resource and capacity constraints of urban local bodies.

• Partial focus on plastic waste: The mission has focused mostly on toilet construction and solid waste. Effectively tackling and recycling plastic waste is still a gap area.

• Centralized approach and targets: The focus has been on meeting toilet construction targets in a centralized, top-down manner. Decentralized, community-driven efforts have been fewer.

Way forward:

• Greater focus on behaviour change communication and public awareness campaigns, especially for hygienic toilet use, waste segregation and not littering. Engaging school children and youth groups can be highly impactful. The “Darwaza Band” campaign and community-level awareness programs have promoted positive sanitation norms.

• The “Darwaza Band” campaign and community-level awareness programs have promoted positive sanitation norms.

• Innovations in Technology: Decentralized sewage treatment plants, as seen in Devanahalli, highlight technological advancements in sanitation.

• Strengthening capacities of urban local bodies for scientifically collecting, segregating, transporting and processing different types of waste. Mechanized sweeping, underground waste bins can be expanded.

• Linking with other programmes: Align sanitation initiatives with other related programs like the Jal Jeevan Mission for better outcomes.

• Developing localized waste management models through community participation, and public-private partnerships, so that solutions are tailored to local needs. Programs like the “Nirmal Gram Puraskar” foster community involvement and awareness in achieving open-defecation-free villages.

• Programs like the “Nirmal Gram Puraskar” foster community involvement and awareness in achieving open-defecation-free villages.

• Expanding solid waste processing infrastructure through biomethanation plants, material recovery facilities, composting units etc. across towns and cities.

• Improved monitoring for functionality and maintenance of public/community toilets through citizen oversight and social audits.

• Expanding coverage of toilets to include slums and public spaces like bus stops, and parks, through customizable, prefabricated toilet models.

• Incentivizing waste segregation, recycling and reuse through both regulatory policies as well as awareness programs on circular economy principles.

Other initiatives for sanitation:

• Central Rural Sanitation Programme (CRSP): Launched in 1986, it was India’s initial step towards improving rural sanitation with substantial subsidies.

• Total Sanitation Campaign: Started in 1999, this marked a shift to a lower subsidy, demand-driven approach.

• Phase II of SBM-G: Focuses on sustainability, promoting solid and liquid waste management, and covering households left out earlier.

• National Annual Rural Sanitation Survey (NARSS): Conducted to assess rural sanitation coverage, showing 95% of rural India having toilet access.

• Rural Sanitation Strategy 2019 to 2029: The Ministry of Jal Shakti’s Department of Drinking Water and Sanitation (DDWS) has initiated a 10-year Rural Sanitation Strategy spanning from 2019 to 2029.

Conclusion

The mission should transition from a toilet-construction-focused programme to a more holistic, decentralized, community-driven cleanliness model relying on public participation for sustainability. The aim should be to make Swachhata a national way of life.

Insta Links:

• 75% of Villages Are Now ODF Plus under Swachh Bharat Mission – Grameen