A Randomized, Controlled Study of a Rural Sanitation Behavior Change Program in Madhya Pradesh, India
Poor sanitation and open defecation are thought to be a major cause of diarrhea and intestinal parasite infections among young children. In 1999, India launched the Total Sanitation Campaign with the goal of achieving universal toilet coverage in r...
| Main Authors: | , , , , , |
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2014
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2013/11/18512377/randomized-controlled-study-rural-sanitation-behavior-change-program-madhya-pradesh-india http://hdl.handle.net/10986/16913 |
| Summary: | Poor sanitation and open defecation are
thought to be a major cause of diarrhea and intestinal
parasite infections among young children. In 1999, India
launched the Total Sanitation Campaign with the goal of
achieving universal toilet coverage in rural India by 2012.
This paper reports on a cluster-randomized, controlled trial
that was conducted in 80 rural villages in Madhya Pradesh to
measure the effect of the program on toilet access,
sanitation behavior, and child health outcomes. The study
analyzed a random sample of 3,039 households and 5,206
children under five years of age. Field staff collected
baseline measures of sanitation conditions, behavior, and
child health, and re-visited households 21 months later. The
analysis finds that implementation of the program activities
was slower than the original timeline (only 35 percent of
villages were triggered more than six months before the
follow-up survey). Nevertheless, the Total Sanitation
Campaign successfully increased toilet coverage by 19
percent in intervention villages compared with control
villages (41 percent v. 22 percent), while reported open
defecation decreased by 10 percent among adults (74 percent
v. 84 percent). The intervention also led to some
improvements in water quality and protozoan infection, but
consistent improvements were not observed across multiple
child health outcomes (diarrhea, helminth infections, child
growth). However, the exposure period was likely to have
been too short to result in any benefit of the sanitation
interventions on child health. Given the large improvements
in toilet construction documented, an additional follow-up
survey with a longer period of exposure would yield valuable
information on the effects of improved sanitation conditions
on health outcomes. |
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