Scaling up Rural Sanitation in India

The WHO-UNICEF Joint Monitoring Program (JMP) for Water and Sanitation, which tracks progress towards the water and sanitation targets of the Millennium Development Goals, estimates that 36% of the world’s population, or 2.5 billion people, lack access to an improved sanitation facility, defined by the JMP as ‘‘one that hygienically separates human excreta from human contact.” This situation means that a large proportion of the world’s people live at risk of contamination of their environment by human fecal matter. Even more striking is the number of people who resort to the euphemistically named practice of ‘‘open defecation’’, defined by the JMP as ‘‘no facilities or bush or field includes defecation in the bush or field or ditch; excreta deposited on the ground and covered with a layer of earth (cat method); excreta wrapped and thrown into garbage; and defecation into surface water (drainage channel, beach, river, stream or sea).” Over 1 billion people still practice open defecation, and this sanitation practice has been associated not only with conditions such as diarrhea and helminth infections but also with stunting in children. In this context, the Government of India launched its ambitious Total Sanitation Campaign. But a paper published in this week’s issue of PLOS Medicine by Patil and colleagues shows that improving sanitation in rural India is far from straightforward/

Scaling up Rural Sanitation in India. C. Brocklehurst. 2014. PLoS Med 11:8, e1001710.