Sanitation Issues at Base of Pyramid in India Summary of the Key Findings for a better understanding of the perceptions and barriers to improved sanitation behaviors.
The understanding of health dimension related to sanitation (negative health impact) is not of vital importance to this population #
Reason:
1) Lack of capacities and resources at the Gram Panchayat (GP) level as well as inappropriate language and lack of targeting in the ongoing Information, Education, and Communication
2) The expenditure on health care and hygiene is quite high and usually, it takes a backseat while utilizing a family's monthly expenses
Governance, Technical aspects and Environment
Social Barriers
Beliefs
Toilet construction and usage
Gender Inequality
Reason: 1) women’s demand for toilet was never given priority
Common people believe that defecating far from home is safe and good practice
Knowledge of low cost toilet design or inadequate space for a toilet
Affordability #
Lack of Information
Behavioural Barriers & Observations
1) People have a sound understanding of personal hygiene and cleanliness of home environment, yet their understanding acts as a barrier for adoption of safe sanitation and hygiene practices pertaining to their environment and public spaces
2) All the respondents of interviews claimed that they like cleanliness and practice the same
at personal and household level.
Brushing teeth and cleaning tongue everyday morning, bathing with soap, wearing washed clothes, cutting hair regularly as well as shaving (men), washing hand after returning from defecation,
as are mentioned as the most commonly practiced personal cleanliness habits.
Reason: Correlation the sanitation has with impurity among mixed caste villages, where handling human feces or trying to dispose it is seen as an infringement to the purity
of the human body and home of the upper caste.
4) A shared consciousness of keeping the immediate environment clean is missing, people usually have a very strong desire to keep immediate surrounding clean (private space, for e.g. houses, bedrooms) clean whereas Public spaces are not treated with the same prestige. #
5) Mothers expressed
that just a casual look at the child’s feces (colour, form, quantity, frequency of defecating) helps them know the condition of their stomach
Use of Hygiene related products
Result: Women are highly averse to the idea of using diapers, and handling child feces is perceived as natural and inevitable part of child care. #
People attribute health problems to their hard work, excessive exposure to torching sun, ill fate and evil forces.
Caste Structure #
Lack of understanding on the oral fecal route of contamination
People do not attribute lack of sanitation
to be the primary cause for major illness. Lack of proper nutrition, hard physical labour or general weakness of the human system over the years from early marriage and child birth, weakness from repeated bouts of malaria and viral fevers, etc., are seen as some of the most important factors for poor health condition than sanitation and hygiene borne factors
toilets stink particularly when the shit
and urine gets mixed up; floors are always wet; claustrophobic feelings; privacy is inadequate as people outside can hear the sounds; cannot move away from the shit (which is shared as an advantage
with open defecation practice); urine and watery motion will be absorbed by soil in open defecation while in the toilet the spillover may spoil clothes; not good to use the same toilets used by menstruating women, and sitting on/in the toilet causes a lot of sweating.
Experiences with Toilet usage #
Aspirations for
a better quality and healthy life do not include sanitation and toilet in their list of priorities. Housing, education of children, land purchase and land improvement, social costs of community life like marriages and deaths receive more priorities, hence, people spend their meager cash on these and are not willing to spend large amount to build toilets. #
Rejection in dealing with government due to bureaucracy related to allotment of subsidy and funds #
Delay in sanctioning and releasing
of Government subsidy from 3–12months which is resulting in low motivation and con dence among the others in need of toilets.
Reason 2) Dignity, privacy, and security are perceived more as the needs of women and girls. These are also unfortunately reiterated by the IEC messages, thus often reinforcing stereotypes of gender #
Effect: prevents men from not using the toilets
and puts forth their unwillingness to accept toilet as a common place of defecation for all the family members
A toilet near or in the house was not desired as it smells and is considered impure. Families expressed constraint of space as a problem for toilet construction
local masons do not have the knowledge of the same which is resulting in high cost and inappropriate designs.
Reason 3) Many women, girls and elderly do
feel desperate need for toilet, but they think that it is unreasonable to make the demand considering the nancial crisis of the family and the struggle of their parents or head of the family.
Decision making power at home is mostly concentrated in the hands of male members, while the toilet is a more compelling need for women, girls, and the elderly people. It
was found that despite being poor many families are borrowing huge investments for crop production, drilling of bore wells, purchasing of luxuries like two wheelers, televisions, and mobile phones
People to People Perception
Mostly the BCC messages on TV or radios are perceived as messages for urban areas that end up portraying
a stereotype of rural people where they are depicted as dirty and lacking hygiene consciousness
Lack of understanding
and motivation, competing priorities, lack of personnel capacities, challenges of mobilizing the entire village community when it is divided on political party lines, delays in release of funds, slow response from the government o cials are some of the key constraints
Sarpanches also feel that their elected position does not really give them much power to check the behavior of the people and toprovide compliance for common good. Leadership capacity, political backing, and credibility of the individuals play more signi cant role than the
formal position as elected ‘sarpanch’.
Supply side Barriers: supply of the material for toilet construction in a remote/tribal hamlest at reasonable price acts as a supply side barrier.
Ensure Proper septage management and safe disposal.
Access to Water #
If the households built toilets, then their water requirement will increase atleast three times the current rate which will in turn
lead to increase in the cost of water supply. Will there be three times additional water supply available
There is currently no mechanism other than contractors and the Panchayats becoming contractors of toilet construction, to facilitate this outcome. Panchayats are the lowest level of self governance, elected political bodies. If they are entrusted, often without any additional human resources, responsibility of development projects implementation then this executive function can distort their governance function.