Over half of all Indians defecate in the open, and in rural areas almost 70% of households do not have a toilet or latrine. In contrast, less than 1% of people in China, 4% of people in Bangladesh, and about 25% of people in sub-Saharan Africa defecate in the open. Why is open defecation so prevalent in India?

For the past several months, our research team investigated sanitation beliefs and attitudes of rural people in six north Indian states. The SQUAT (squatreport.in) study interviewed over 3,200 households and our team conducted 99 in-depth semi-structured interviews. Our findings about why so many people defecate in the open may surprise you.

Here are a few misconceptions about why people in rural India defecate in the open.

Poverty: Although the media often claims that rural people are “forced to defecate in the open" because of lack of access to latrines, most people could already afford to build latrines. There is little relationship between gross domestic product (GDP) per capita and open defecation rates in poor countries around the world. Latrines that have led to a decline in infant mortality and a reduction of stunting in Bangladesh cost only about ₹ 2,000– ₹ 3,000.

Lack of water: Does lack of water lead to open defecation? In the SQUAT survey, only 3% of households without a latrine mentioned lack of water as an obstacle to latrine use. Indeed, in rural India, where about 70% of households defecate in the open, 90% of people have access to what the WHO-Unicef Joint Monitoring Report calls “an improved water source". In contrast, in sub-Saharan Africa, only about half of people have access to improved water sources, but far fewer people (35%) defecate in the open.

Poor latrine maintenance: Do rural people avoid latrines because they’re broken or clogged? In fact, broken latrines reflect a deeper problem: people who have low demand for latrine use don’t invest in repairing them. The SQUAT survey found that 40% of households with a working latrine have at least one person who defecates in the open, suggesting low demand for latrine use.

Why is open defecation so widespread in rural north India? Our research reveals a set of cultural factors that both encourage open defecation and discourage the use of affordable latrines. Villagers perceive benefits of open defecation; it is associated with good health and a wholesome rural life. Many people, including women, say they enjoy open defecation.

Many of our respondents see affordable latrines as socially unacceptable. People think that having latrines near the house is ritually polluting. Further, cleaning faeces, and by extension emptying pits, is associated with “untouchables"— the lowest group in the caste system.

Indeed, the need to periodically empty latrine pits is an important social obstacle to latrine adoption in rural India. Privately constructed latrines tend to be very expensive because they have large pits that rarely need to be emptied. The latrine pits built by SQUAT survey respondents are about five times larger than the size recommended by the World Health Organization (WHO) for a family of six. Even though using WHO-style latrines would save lives and improve health, most people think that only very expensive latrines with large septic tanks are socially acceptable.

Muslims in rural India are often an exception to this rule. Since ideas about ritual purity and pollution are typically different for Muslims, they are more likely to build and use the kinds of simple, affordable latrines that save lives in the rest of the developing world. The National Family Health Survey 3 (NFHS-3) found that while 77% of rural Hindu households defecate in the open, 55% of rural Muslims households defecate in the open.

Additionally, the SQUAT survey found that Muslims who own a latrine are more likely to use it than Hindus who own a latrine. This difference is particularly striking in households that own government latrines, which typically have smaller pits that need to be emptied every few years. The figure shows that about 40% of Hindus, but only about 7% of Muslims, with a working government latrine regularly defecate in the open.

Our research reveals important cultural dimensions to India’s open defecation crisis. Behaviour change, focused on building demand for affordable latrines should be the cornerstone of sanitation interventions. Building latrines with enormous pits for everyone who lacks one is prohibitively expensive: the average cost for latrine that SQUAT respondents considered minimally acceptable was ₹ 21,000. Building a ₹ 21,000-latrine for the 123 million households without one would cost ₹ 2.56 trillion, or approximately one-sixth of the 2012-13 total expenditure of the government. This is not a serious policy alternative to building demand for affordable, but nevertheless life-saving, latrines.

Published with permission from Ideas for India , a public policy portal.

Diane Coffey is a visiting economist at the Centre for Development Economics at the Delhi School of Economics, a PhD candidate at Princeton’s Woodrow Wilson School, and Executive Director of Research Institute for Compassionate Economics.

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