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Improved water and sanitation to speed up the achievement of all eight MDGs
" Consumption of contaminated drinking water is a major cause of many diseases in India. "

Approximately 400,000 to.500, 000 children below five years of age die due to diarrhoea annually in India.  Young children bear a huge part of the burden of disease resulting from the lack of hygiene and sanitation. Consumption of contaminated drinking water, improper disposal of human excreta, lack of personal and food hygiene, and improper disposal of solid and liquid waste have been the major causes of many diseases in India. High infant mortality rate and high levels of malnutrition are also attributed to poor sanitation.

Household data from the 2001 Census indicated that only 22 percent of rural households use sanitary facilities. Disparities exist across states - ranging from 81 percent in Kerala and 60 percent in Assam to 9 percent in Madhya Pradesh and 8 percent in Orissa. The landless and the marginalized continue to be left without toilets. Approximately 24 percent urban households either have no access or choose to pollute the environment and make it more conducive for the spread of communicable diseases including polio that has been long targeted for eradication.
Only 22 percent of rural households use sanitary facilities
Major factors that have impeded effective implementation of a rural sanitation programme include very low priority accorded to sanitation as a social and community issue, lack of infrastructure and systems to reach all rural households, and most importantly, scarcity of water.

The Total Sanitation Campaign (TSC) launched in 1999, has helped overcome some of these obstacles. Of the 138.2 million rural households in India, (2001) nearly 3.5 million have constructed household toilets with support from the TSC. Over 1,700 women’s complexes, 41,000 school toilets have been built, apart  from other support facilities such as rural sanitary marts (RSMs), at a total cost of just over Rs. 2.92 billion (approximately US $ 62 million).

Among the fourteen objectives of the 10th Plan, the role of sanitation and hygiene are intrinsically linked to the objectives of reducing IMR; Maternal Mortality Ratio (MMR); ensuring completion of five years of schooling for all children by 2007; providing potable drinking water in all villages; cleaning of major polluted river stretches and to provide “shelter for all” by the end of the 10th Plan.

India’s first nationwide programme for sanitation, the Central Rural
Sanitation Programme (CRSP) was launched in 1986 by the
Ministry of Rural Development.

TSC Objectives
With the emergence of the above findings and the realisation that high subsidies were not promoting uptake of sanitation facilities, the
TSC was launched in April 1999, with advocating shift from a high subsidy to a low subsidy regime, advocating a greater household involvement and demand responsiveness, and providing for the promotion of a range of toilet options to promote increased affordability.

The main objectives of the TSC are to:
• Bring about an improvement in the
general quality of life in rural areas
• Accelerate sanitation coverage in rural areas. Eliminate open defecation to minimize risk of contamination of drinking water sources and food.

• Generate demand through awareness and health education
• Cover all schools and Anganwadis in rural areas with sanitation facilities and promote hygiene education among students and teachers
• Encourage cost effective and appropriate technologies in sanitation
• Endeavour to reduce water and sanitation related diseases.

Safe water and sanitation for India’s 638,738 primary schools is now a priority within both the Rural Development and Education Departments of GoI.

The TSC (currently covering 520 of India’s 607 districts) aims to cover all primary and upper primary schools with safe water, child-friendly toilets, and hygiene education that empower children to lead healthy lives. 

Additionally, TSC attempts to cover village based early childhood development centres for under five children known as anganwadi
centres also with safe water and baby-friendly toilets.
The TSC aims to make sanitation and hygiene a people’s agenda
The Government of India has decided to sanction TSC projects in all districts of the country by 2006-2007 so as to achieve full sanitation coverage by 2012. It has planned to provide all rural schools and Anganwadis with safe drinking water and sanitation during the 10th plan, by end 2007.

Incentives and awards – Nirmal Gram Puraskar

Recognizing  the  role  of  elected local representatives (Gram Panchayats) to promote sanitation through collective community action,  the Government of India instituted an  award, called  Nirmal  Gram  Puraskar  (NGP) in  October  2003.  The NGP awards are given to districts, blocks, and Gram Panchayats that have achieved 100% sanitation coverage of individual households, 100% school sanitation coverage, are free from open defecation and conduct clean environment maintenance. This award was given for the first time on 24th February 2005 by His Excellency, the President of India, Dr. A.P.J. Abdul Kalam. In 2005, forty Gram Panchayats from six states achieved open defecation free status. Over 1000 applications have been received for the 2006 award.

The TSC aims to make sanitation and hygiene a people’s agenda through a management structure that makes the gram panchayat the
prime mover, motivator and monitor of the programme.

Success stories
There are several success stories from across India. Some of these, such as East Medinipur in West Bengal, Khammam in Andhra Pradesh, Ramanathapuram in Tamil Nadu, and South Tripura in Tripura uniformly reflect strong commitment to achieve results. 

Mayamma, a woman from Dammapeta in the state of Andhra Pradesh says “Earlier it was difficult for us to go for nature’s call but now we feel comfortable.”


UNICEF proposed measures until 2007

In order to create and sustain interest and vibrancy for improved sanitation and sanitation as a social movement within the civil society, CEP in collaboration with Advocacy and Partnership Section will increase its investment in media and visibility work and develop a number of advocacy materials and actions which will be used to influence decision makers and opinion leaders and formers. Key actions and interventions include:

Support to Government to develop policies/lead in Regional Cooperation

Development of advocacy strategy and media plan

Develop advocacy materials to document successful experiences

Work with Parliamentarians and Opinion Leaders

Work with Schools and Youth organizations in 16 integrated districts

Knowledge management

Work with other partners (especially in the 16 districts, with an agreement at the national level)

Improved water and sanitation will speed up the achievement of all eight MDGs: helping eradicate extreme poverty and hunger; achieving universal primary education; promoting gender equality and empowering women; reducing child mortality; improving maternal health; combating HIV/AIDS, malaria; contributing to environmental sustainability and developing global partnerships for development

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