KOCHI: Around 60 per cent of Indians do not have access to safe and private toilets, a new study has claimed.A report titled 'It's No Joke - State of the World's Toilets' by WaterAid states that "If all 774 million people in India waiting for household toilets were made to stand in a line, the queue would stretch from Earth to the moon and beyond."According to the study released on the occasion of World Toilet Day today, the world's second most populous nation has 60.4 per cent of its people without access to safe and private toilets."Since 1990, access has improved by 22.8 percentage points, putting India at seventh out of eight countries for improvement in South Asia. In South Asia , Nepal has seen the most improvement, followed by Pakistan and Bhutan," the report stated.Noting that the resulting health crisis is a serious matter, the report said that more than 140,000 children younger than five years die each year in India due to diarrhea."Nearly 40 per cent of India's children are stunted; this will affect both their life chances and the future prosperity of India. India also has high rates of maternal and newborn mortality linked to sepsis," the report said.The equipment necessary to prevent infection during and after child birth is simple and inexpensive, but requires clean water and soap along with clean surroundings, which are difficult to achieve in an environment contaminated by open defecation and without good hygiene practices such as handwashing with soap by clinic staff and midwives, it said.Prime Minister Narendra Modi has given the sanitation issue a top political priority, and last year launched Swachh Bharat (Clean India) Mission.Commenting on Swachh Bharat, which aims to ensure a toilet for every household by 2019 and to educate people about the long-term health and economic benefits of using a a proper sanitation system, the report said that "by simply building the toilets won't be enough.""What will be absolutely crucial is getting local, state and national government to make this a priority, and creating the cultural shift that will ensure that once the toilets are built, they are used by everyone," it added.