The Planetary Health Alliance
Background: Sanitation campaign in India found renewed interest after Prime Minister Narendra Modi mentioned about it in his 2014 Independence Day speech which followed launch of “Swachh Bharat Abhiyan”(SBA). Construction of Individual Household Latrines(IHHL) is one of the key components under the mission to achieve ‘Open Defecation Free’(ODF) status. While IHHLs have been constructed in majority of villages in Gujarat, government is now campaigning for its increased utilization. The study assessed factors contributing non-utilization of IHHLs.
Methods: Four villages were randomly selected in Charutar region of Gujarat and 313 eligible respondents were surveyed after obtaining written informed consent. Trained surveyors collected socio-demographics and observational data using a structured questionnaire. In case of non-utilization, an open-ended question probed reasons for the same. The responses were summarized to report key findings.
Findings: Out of 313 respondents,85(27.16%) reported that not all the family members in their household are using IHHL. Review of responses revealed that elderly members were reluctant to use latrines constructed just outside the household. Higher number of family members was also reported as a barrier because one latrine couldn’t be sufficient for all the members. Structural limitations due to non-fitting of commodes (N=11), overhead tanks (N=121/39%), taps (N=163/52%), limited water storage capacity, inadequate drainage facility including shallow cesspool were identified as barriers to IHHL utilization.
Interpretation: Following fast-tracked construction of IHHL, now the challenge is to promote sustained utilization.Broadly, the barriers can be categorized as household- and structure-related. Participatory research involving IHHL beneficiaries and relevant stakeholders can help further investigate key barriers to non-utilization and list out locally adaptable, potential solutions. The findings can then be utilized to strengthen program planning & implementation, and design context-specific health promotion intervention to achieve ODF-status. Opportunities for resource sharing between IHHL beneficiaries and local self-government to fix-up structural barriers can also be investigated.