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Chapter - I
Introduction
An Overview
Sanitation, hygiene, and cleanliness are the hallmarks of a civilized society.
Sanitation is critical for health and sustainable socio-economic development1. There is an
increasing tendency for communities in rural hinterlands to defecate in the open much to
the annoyance of officials who are working overtime to deal with different aspects of
sanitation with individuals, families and the nation at large. NGOs and the staff and line
agencies in the government see this as a crucial aspect for development, as this seems to
be the biggest challenge for the governance of development in the 21st century.
Needless to emphasize, the quality of human life, inter-alia rests upon better
accessibility to sanitation. The agenda set for providing clean water and better sanitation
facilities apply more so for developing countries. For the marginalized communities, lack
of clean water and adequate sanitation acts as an impediment for the Human
Development growth in the communities across the world. A multidisciplinary subject,
sanitation has the inherent potential to harness healthy living among the public at large.
The larger societal development can only be achieved through empowering rural people
on core issues of sanitation.
The quality of human life, directly or indirectly, depends upon accessibility to
better sanitation. In the post globalization scenario, water and sanitation have become
important agendas for developing countries, not truly reflected in rural areas2.
The human development indicators also depend upon the better sanitation
accessibility to the marginalized communities. Sanitation is not only a development issue,
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but also an empowerment tool for the development of society and it has now turned into a
multidisciplinary subject in the global development sector.
In the process of integrated development of society, sanitation is one of the
determinants for both individual and family development. The Individual Sanitary
Latrine (ISL), or Individual Household Latrine (IHHL), may seem like an unlikely
catalyst for human progress. Almost one and all living in the developed world has access
to a private, flush toilet served by a continuous supply of piped water with taps and toilets
in close proximity. Access to sanitation facilities is one of the key indicators for human
development. In developing and under developed countries, sanitation continues to be a
big challenge for the governments, as well as civil society. As a result, at the other end of
the sanitation gamut are the millions of people forced to defecate in bags, buckets, fields
or the roadside. If the developed country model were the benchmark, the number of
people lacking sanitation would be far higher than that recorded by World Health
Organization (WHO) and United Nations Children’s Fund (UNICEF) data. The global
deficit would soar from 2.6 billion people to about 4 billion. The sanitation aspect shows
impact of the daily life of a common person because human waste is channelled by pipes
into sewerage systems and treatment facilities, ensuring that drinking water is separated
from the pathogens carried in faecal matter. Meanwhile, taps located in sanitation
facilities enable people to maintain personal hygiene.
Cleanliness and hygiene are important from not only the public health point of
view, but also socio and economic development of the family. There is no doubt to say in
this era sanitation dictates the human life3.
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India is just above Afghanistan and Pakistan in sanitation indices among
developing countries in the world. Even Bangladesh is above India in this crucial social
index4.The child malnutrition rate of 50 per cent in India is much higher than that of
Eritrea, an African nation, where it is only 35 per cent. While these figures may
disappoint Indians, there is no need for despair, Although India was once a laughing
stock for other nations, various government programmes, including total sanitation
campaign undertaken by the Ministry of Rural Development (MoRD), aimed at
ameliorating rural poverty and improving sanitary conditions, have resulted in
considerable improvement in living conditions.
Organisations like the World Bank and other multi donor or finance organisations
are promoting sanitation activities. They are also concentrating on awareness generation
and construction of infrastructure for providing better sanitation facilities. There was a
successful campaign “No Toilet, No Bride” in the state of Haryana. In fact after getting
sensitization about the need of toilet and sanitation practices, people were unable to
overcome their habitual practices, though the campaign impacted many and has turned
into most successful sanitation promotion effort till date. The awareness resulted in many
young women refusing to marry unless the bridegroom furnishes their future home with a
bathroom, freeing them from the inconvenience and embarrassment of using community
toilets or squatting in fields5.
Water and sanitation are key elements in the field of development. Shortage of
water is now recognised as one of the world's biggest problems. As brought out at a
recent Global WASH (Water, Sanitation and Hygiene for All) Forum in Dakar, Senegal,
people are far more concerned about what emanates from their mouths than from other
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orifices in their bodies. The technology employed in ridding ourselves of our bodily
wastes has remained unchanged, more or less, for three centuries.
The Water Supply & Sanitation Collaborative Council (WSSCC), a multi-
stakeholder organisation under the umbrella of the World Health Organisation in Geneva,
has been almost single-handedly trying to put sanitation and hygiene on the international
agenda. It succeeded in including sanitation as one of the UN's Millennium Development
Goals (MDGs), at the 2002 World Summit on Sustainable Development in Johannesburg
(the precursor to which was the spectacular Earth Summit at Rio 20 years earlier).
Countries have now pledged to halve the number of people without access to sanitation in
the world, a staggering 2.5 billion, by 2015.
Interestingly, the coverage of rural population increased from 56 per cent
habitations in 1985 to 99.6 per cent habitation in 2004". That sort of conclusion is
typically reached by referring to the number of villages covered, rather than the
households within them6.
Because people tend to use areas close to water when they defecate in the open,
once we have sanitation in place, we can install water facilities with the confidence that
these will not be polluted in the future. There is a long list of water borne diseases that
can severely debilitate and even turn fatal.
Water has to be treated with respect and in the knowledge that it is a finite
resource. To ensure that the local needs of everyone are met for both drinking and
cooking purposes. It is a misnomer that water is good for washing clothes or for watering
plants if it is not good enough for drinking.
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Too much water is needlessly wasted because people do not understand how
precious this natural resource is. The water pumps we use are all capable of being
repaired at the village level. It is no good installing sophisticated hand pumps if they
cannot be maintained. In Sierra Leone, rope pumps that can actually be made in the local
area are being used. Sanitation and water combined are important factors in improving
health, so it is only then that people are able to function efficiently in both education and
work, and we can move on to livelihoods7.
Development Administration and Rural Sanitation
The UN and other international development agencies are now focusing on
sanitation as a priority issue to propel the development agenda. Earlier, the development
process was considered the responsibility of the state alone. In the post globalization
scenario, there is a shifting of responsibility to address development issues in the name of
convergence and inter sector integration. Also, sector reforms have been started by
initiating a few pilot programmes on rural water supply and sanitation. Because of this,
space has been provided to civil society to intervene in the development process through
various initiatives. In a developing country like India, social development is all about
human progress, it centres on equality between women and men, social inclusion, access
to education, community cohesion and poverty eradication.
At its core are human dignity and human rights. For the 2.6 billion people who
have to defecate behind bushes, in plastic bags or buckets, along railway tracks or in
roadside ditches, human dignity is under daily assault8. The humble toilet can speed
social development in a number of ways.
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The sanitation challenges and nature of problems in rural and urban areas are
different from each other. In a developing country like India, there is a huge gap in
development initiatives. Likewise, sanitation is also diversified problem from rural to
urban areas. In the post independence era, there are many rural development schemes
initiated by the Government of India under the category of centrally sponsored schemes.
The state governments too with their own resources initiated a few development and
welfare programmes. In those days, rural sanitation programmes were part of the other
rural development schemes. There was no specific focus on rural water supply and
sanitation. After the nineties decade, the government recognized rural sanitation as a key
issue for public health. Under pressure from a few international organizations and United
Nations (UN), Indian government realized that rural sanitation is the tool for
development of communities as well as rural development.
Nature and Scope of Rural Sanitation
Providing better sanitation facilities is one of the biggest challenges till date. After
the millennium era, tackling sanitation and hygiene issues is becoming a key issue in
terms of providing sanitation facilities and in creating awareness among the masses for
behavioral change.
Social ailments like poverty are more than a lack of income or a shortage of
material goods. Human poverty, lack of basic capabilities for participating in the standard
activities of the communities is aggravated by lack of sanitation. For urban slum dwellers
and rural population, living in areas surrounded by human waste and garbage is creating
embarrassment and depriving people of participation, choices and opportunities. Around
8,00,000 people in India still live by manual scavenging by carrying feces in baskets on
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their heads, a livelihood that bars their inclusion in mainstream society9. In these pathetic
conditions, people are suffering due to lack of basic sanitation amenities. Poor awareness
is the main cause for this problem. The sanitation problems in rural and urban areas are
different and challenges also vary.
Rural Sanitation in India
In the mid nineties, the government of India strongly felt that rural water supply
and sanitation are crucial aspects for rural development. After consultations with the
different stakeholders, the Ministry of Rural Development finally decided to create a
separate department at Government of India level. Because of this, the Department of
Drinking Water Supply (DDWS) was created with separate institutional arrangements
with a focused approach. From then, the government is allocating separate funds and
making budgetary provisions to tackle the rural sanitation challenges. At the same time,
based on the institutional changes, the state governments have also created separate
departments and wings under the Panchayat Raj or Rural Development departments at the
state level. States like Andhra Pradesh created separate department to focus on issues
related to rural sanitation and safe drinking water.
Based on the above-mentioned institutional changes, the government had taken up
a few initiatives to assess the country’s situation on sanitation. A baseline survey about
rural water supply and sanitation was done by the government to understand the issue. In
line with the National Agenda for Governance, it was resolved to provide safe drinking
water in accordance with the stipulated norms on a sustainable basis to all habitations by
March 200410, which is also the target set in the approach paper for the Tenth Plan.
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Rural Sanitation coverage in India
The rural sanitation coverage in India is gradually improving every year. The
census data shows the scenarios from the last three decades. In the year 1981, only 1 per
cent of people had rural sanitation facilities. After two decades, in the year 2001, the
percentage reached 22 per cent. By the end of the year 2005, the number reached 33 per
cent. According to an estimate, 650 million people in India still defecate in the open
every day. If we examine other facts, out of the 48.5 per cent in the year 2007 an
estimated 200, 000 tons of fecal matter is deposited in the open every day. If we observe
from the public health point of view, totally six lakhs diarrhoea deaths occur in India per
year. It means 1000 deaths every day (40 deaths in 60 minutes). One more fact is children
aged below five fall prey to diarrhoeal deaths and surviving children suffer from three to
five episodes of diarrhoea every year11. According to available information, the rural
sanitation facilities still pose a challenge for the government and civil society. The reason
is not only low availability of funds, but also other aspects.
The National Sample Survey (NSS) Findings on Rural Sanitation Coverage
The National Sample Survey Organization (NSSO) released data related to rural
sanitation in November 201012. It has mentioned, in its 65th report on housing amenities
in India in 2008-09 (up to June 2009), that 65.2 per cent rural households and 11 per cent
urban households13 have no latrine facility. This report found that there was a lot of gap
between usage and access. There are also many sustainability issues involved in the
implementation process.
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Civil Society Activism
The Planning Commission review report on the XI Five Year Plan on Water and
Sanitation and Supply (WSS) programme also emphasized that there is a need for active
civil society interventions14. It applauded the civil society initiation that “sanitation of
late has gained importance amongst social sector activists and has become a globally
recognized sector wherein various sector specialists have started contributing towards
ways to track sanitation coverage apart from the reports submitted by National Statistical
Organizations mandated to do all efforts.” It also mentioned that so far NSSO has been
able to track the usage of sanitation facilities through sample survey to be treated as
access to sanitation, rather than only having a sanitation facility which could be tracked
online.
After the year 1990, Government of India started the special focus on rural
sanitation in developing policies. Keeping this in view, the Government is trying to
assess the ground situation and the rural sanitation scenario and as a result, many studies
and evaluations have been taken up exclusively or as a part of rural sanitation
programmes in India. Most importantly, the 54th round of National Sample Survey was
conducted in July 1999 on drinking water, sanitation and hygiene in India exclusively.
This survey provided a lot of insights and other valuable information on rural sanitation
and drinking water supply. There is a natural correlation between water and sanitation.
By making these two elements as a base for hygiene, the sample survey was successfully
completed. The survey emphasized on the data relating to source, quality of drinking
water, and conditions of sanitation and hygiene of households. This data was collected in
the first half of 1998.
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Many interesting insights came to light about the sanitation scenario of rural
India. Till such time of the survey, 50 per cent of rural households were getting water
from tube wells/hand pumps. Only about 31 per cent of rural households reported having
their source of water within their premises, the rest had to go out to fetch their drinking
water from another sources15. About 60 percent did not have to go beyond half a
kilometre for this. Seasonal disruption of supply was common, especially in the summer
months. Households still depended on supplementary sources, especially where tube well
or hand pumps were the main sources. Practices of water filtering or boiling water before
drinking were almost non-existent. States have reported that more than 95 per cent
coverage has been achieved16.
However, reliable data on the ground reality of rural water supply is not available.
A re-assessment survey of rural habitations has become necessary and the data should be
updated periodically through a ‘Return Filing’ system, whereby each Panchayat Raj
Institution (PRI) will report on the status of these services in its area.
Random sampling will be needed to validate this survey. In view of the
importance of basic data, however, Central assistance for Panchayat Raj Institutions
(PRIs) and Urban Local Bodies (ULBs) could be subject to submission of returns in this
regard. Finally, the survey found that there was no sensitization and awareness creation
among the rural community on rural water supply and sanitation aspects. Based on the
data provided by the National Sample Survey Organization, the government of India
framed new strategies to tackle the on ground problems.
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UN Recognition and Declaration of Right to Water and Sanitation
The United Nations (UN) passed the following a landmark resolution on water
and sanitation17.
We commit ourselves to… “improving the quality and
effectiveness of healthcare services delivery by providing
integrated healthcare services through coordinated
approaches at the country level, the increased use of
common platforms and the integration of relevant services
of other sectors, including water and sanitation.”
Over 120 countries voted for the resolution, which was proposed by Bolivia.
Countries recognised that more than 884 million people lack access to safe drinking
water and 2.6 billion have no basic sanitation. Diarrhoea, caused by lack of sanitation, is
now the biggest killer of children under the age of five years in Africa. A rights-based
approach is critical to ensure that the billions of people living without sanitation and the
millions without safe water get access to these. It is heartening news that the resolution,
recognising water and sanitation as a basic human right, has been passed by a majority
vote. It is particularly encouraging to see the crucial reference to sanitation, due to its
historic neglect despite its importance for human development. It is, however, regretful
that the vote wasn't passed by consensus, which exposes a distinct lack of political will
on this issue. Abstentions illustrate the continuing lack of priority given to sanitation –
which is astonishing given that slow progress on sanitation is holding back progress on
achievement of many of the other Millennium Development Goals (MDGS).
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Right to Sanitation and Courts in India
In independent India, there have been many occasions to highlight the sanitation concept.
In the legal context also, there have been some cases in this regard. The apex court has
declared sanitation as a part of fundamental right to life under Article 21 of the
Constitution of India18.
“Article 21 protects the right to life as a fundamental right.
Enjoyment of life and its attainment including their right to
life with human dignity encompasses within its ambit, the
protection and preservation of the environment, ecological
balance free from pollution of air and water, sanitation
without which life cannot be enjoyed. Any contra acts or
actions would cause environmental pollution.
Environmental, ecological, air, water, pollution, etc. should
be regarded as amounting to violation of Article 21.
Therefore, hygienic environment is an integral facet of
right to healthy life and it would be impossible to live with
human dignity without a humane and healthy
environment.”
- Virender Gaur v. State of Haryana, (1995) 2 SCC 577
(Supreme Court of India)
“preservation of the sanitation and environment falls
within the purview of Article 21 of the Constitution as it
adversely affects the life of the citizen and it amounts to
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slow poisoning and reducing the life of citizen because of
the hazards created, if not checked.”
- L.K. Koolwal v. State of Rajasthan, AIR 1988 Rajasthan 2
(High Court of Rajasthan)
Constitutional Obligations
The 73rd and 74th Constitutional Amendment Acts (CAA) are benchmark events
in the path of self rule in villages and urban areas. The Constitution gives State
governments the authority to address issues related to sanitation (Seventh Schedule, List
II, Entry 6)19. Further, Article 243G of the Constitution, read with Eleventh Schedule,
Entry 23, provides for the devolution of powers and responsibilities regarding health and
sanitation to panchayats. A number of panchayat/ panchayat raj laws identify sanitation
as one of the responsibilities of panchayats/ gram sabhas. However, the duty is usually
framed in narrow terms and the broader issues, such as collection, transportation,
treatment and disposal (and reuse), receive little or no attention.
The National Sample Survey is the main source to draw strategies for addressing rural
sanitation problems in the country. A project based approach has been initiated by the
government with help of national and international civil society and development
organisations20. As a result, priorities have been set up to achieve the objective of
providing safe drinking water to all rural habitations in India. Based on the objectives
given below, a few priorities have been given to habitations. These strategies paved new
ways in the sanitation sector in India. The priorities are as under:
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I. Highest priority to be given to ensuring that the ‘not covered’ habitations are
provided with sustainable and stipulated supply of drinking water and sanitation
facilities.
II. It will be equally important to ensure that all the ‘partially covered’ habitations
having a supply level of less than 10 litres per capita per day (lpcd) and those
habitations facing a severe water quality problem are fully covered with safe
drinking water facilities on a sustainable basis. Thereafter, other ‘partially
covered’ and ‘quality affected’ habitations are to be covered.
III. Once drinking water supply facilities are provided to all rural habitations as per
the existing data by 2004, the remaining period of the Tenth Plan would be
utilized for consolidation purposes. This will involve covering newly emerged
habitations and those, which have slipped back to ‘partially covered’ or ‘not
covered’ status due to a variety of reasons. Simultaneous action is also needed to
identify and tackle habitations where water quality problems have emerged
recently.
IV. It should be ensured that Scheduled Caste (SC) and Scheduled Tribe (ST)
population and other poor and weaker sections are covered fully on a priority
basis. A systematic survey of all such identified habitations shall be undertaken.
The above priorities show that the government of India considers rural sanitation
as a highly prioritized issue in the rural development field. In these findings, a few norms
have been framed to assess the vulnerability related to rural sanitation. The main norms
are more realistic, as opined by the experts and development organizations. The
stipulated norms of supply would be 40 lpcd of safe drinking water within a walking
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distance of 1.6 kilometre or elevation difference of 100 metres in hilly areas; to be
relaxed as per field conditions applicable to arid, semi-arid, and hilly areas21. At least one
hand pump/spot-source for every 250 persons is to be provided. Additional water is to be
provided under the Desert Development Programme (DDP) areas for cattle, based on the
cattle population. The water requirements for cattle need not necessarily be met through
piped water supply and could be made through rainwater harvesting structures/spot
sources. In the states where 40 lpcd has been achieved in all habitations, the next step is
to raise the level of availability to 55 lpcd22. Moreover, the water sanitation and public
health are interrelated and inter dependant aspects from the development point of view.
Rural Water Supply, Sanitation, and Public Health
Water is one of the precious natural resources for not only human beings, but also
for all living beings including animals and plants. Water, which is essential for life,
growth, and health, can also be a source of spread of disease and cause of ill health, if
contaminated or improperly handled and stored. Safe drinking water and improved
sanitation play a major role in the overall well-being of the people, with a significant
bearing on the infant mortality rate, death rate, longevity, and productivity. The poor,
both in rural and urban areas, bear a disproportionate burden due to non-availability of
water, as well as of poor quality. They often supplement public sources of water with
supplies obtained at high prices from other sources. Women bear the physical burden of
fetching water. Women and children are particularly vulnerable to the effects of water
contamination. Without the access to safe drinking water and sanitation facilities, it is
impossible to protect public health.
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Globally, 70-80 per cent of illnesses are related to water contamination and poor
sanitation23. The national objectives of reducing morbidity and mortality largely depend
on the reduction of diarrhoea and jaundice. In fact, no water supply and sanitation
programme can be successful if water-related illnesses are not reduced. It is a matter of
concern that despite the progress made with water supply, the level of water-related
diseases continues to be high. Causes of contamination of water are: indiscriminate use of
chemical fertilizers and chemicals, poor hygienic environment of the water sources,
improper disposal of sewage and solid waste, pollution from untreated industrial effluents
and over-exploitation and leading to quality degradation. Thus, the supply of additional
quantity of water by itself does not ensure good health. Proper handling of water and
prevention of contamination are also equally important.
Important Elements in Rural Sanitation
In accordance with the studies and various findings, there are a few most
important elements involved in rural sanitation. If these elements are handled properly,
many public health problems can be solved. So far, majority of the diseases are spreading
due to lack of proper sanitation and availability of protected drinking water sources. Even
though the protected drinking water source is available, if there is no proper sanitation or
water handling and better sanitation practices, the problem will be the same. Keeping this
in view, the following, most important elements have been identified to address rural
sanitation issues in a focused manner. Later these were identified as better sanitation
hygiene practices24. They are: i) Safe handling of drinking water, ii) Disposal of waste
water, iii) Safe disposal of human excreta, since human excreta is associated with more
than 50 per cent of diseases, iv) Safe solid waste disposal, v) Home sanitation and food
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hygiene, vi) Personal hygiene, particularly, washing one’s hand with soap, and vii)
Sanitation in the community.
The above-mentioned best hygiene practices are unavoidable aspects in the
process of rural sanitation. So far, due to lack of awareness, rural communities are
generally not familiar with the hygiene practices.
Hygiene Practices and Water Diseases
Recent studies have shown the importance of washing one’s hands with soap as it
reduces diarrhoeal disease by 43 percent25. Respiratory problems, such as sniffles and
coughs cases were brought down by 45 per cent when hands were washed five times a
day.
Safe sanitation practices should be a compulsory part of school curricula and of
all programmes where women are trained in community, economic and health issues
affecting the household. After many studies, surveys and consultations, the government
of India decided to tackle rural sanitation issues through a strong communication
strategy. From then, the government started a pilot programme as part of the sector
reforms in water and sanitation.
Reforms in Rural Sanitation
The government of India recognized rural sanitation as a priority issue and also
restructured the existing programmes by seeking involvement of the community and civil
society to sustain the sectoral reforms in the long run. In order to address the problem of
sustainability, the Government approved sector reforms programme in March 1999 to
ensure the active participation of the community in rural water supply. The new policy is
already being implemented.
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The new institutional setup at state level to speed up reforms in identified districts
all over the country was started as a pilot programme in 199926. State Governments have
identified 63 districts for introducing reforms. The reform projects incorporate
institutionalization of community participation through capital cost sharing and
shouldering of full O&M responsibilities. The experience gained during the
implementation of these pilot projects would be utilized for expanding the reform
package to other districts in the second phase. This will ensure a satisfactory and
sustainable rural water supply programme in the whole country.
For the success of the proposed reform process, however, complementary
reforms, such as increasing user charges for water used in irrigation and industry are
necessary.
Key Issues in Sector Reforms
The two decades period (1980-2000) was very significant for the rural sanitation
sector because sanitation issues have become key interventions in the development
agenda at the national and international levels. With the help and support of international
organizations, the sanitation and hygiene aspects have become priorities for the country.
The sector reforms in rural water and sanitation have started with sector reforms
programme in 1999 with a different approach, as specified below:
The new strategy thus relies heavily on the use of Central/State funding as
a critical incentive to drive the reform process. As such, it is important that
conditionality for disbursement of central funds to state administrations
and from state administrations to PRIs is explicitly defined. The
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conditions which must be met and the activities for which funding can be
applied must be clearly specified.
Resources for information education communication/human resource
development (IEC/HRD) now given for different sectors, particularly,
public health, nutrition, drinking water, sanitation, etc, should be pooled
together at the district/state level to the extent possible.
NGOs are found to be particularly good at outreach and have the
advantage of being able to sharply focus on and activate the participation
of communities.
All existing social organizations, women’s self-help groups, cooperative
societies, the civil society, educational institutions, private institutions, etc,
should be involved for effective implementation of a large scale sanitation
programme.
In the sector reforms pilot project a few new insights have come to light.
Involvement of the community and technical innovations and community affordability,
etc, aspects are crucial to achieve the goal. The government has also extended more
support to initiate rural sanitation as a social movement all over the country. After
implementing sector reforms, a few directions have been received from field realities.
Based on those experiences and feedback, the government of India designed an exclusive
programme with a multi pronged strategy to tackle the rural sanitation problems in India.
Launching of Total Sanitation Campaign (TSC)
The Total Sanitation Campaign (TSC) is a full-fledged rural sanitation
programme is the first of its kind. The results of sector reforms pilot projects and lessons
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and inputs from other countries as also various international development agencies have
also taken had been into consideration when designing this programme.
A few important elements have been added in this programme for better and
concrete results. They are: the existing Total Sanitation Programme should include safe
disposal of night soil, rainwater, domestic liquid and solid waste. It should not be
restricted to construction of latrines only. Awareness of sanitation standards and health
impact of unsanitary conditions continues to be low. Rural sanitation should be promoted
as a total package consisting of safe handling of drinking water, scientific disposal of
wastewater, safe disposal of human excreta including child excreta, solid waste
management, domestic sanitation and food hygiene, personal hygiene and village
sanitation.
Restructure of Total Sanitation Campaign Programme
The sector reforms project on rural sanitation has given many insights to go
further and tackle the public health issue through providing better sanitation facilities for
rural households. As the 54th round of National Sample Survey (1999) indicates, only
17.5 percent of rural populations were using latrines27. There is a need to implement a
revitalized programme for rural sanitation, which must have the following elements:
Preference needs to be given to the twin pit model of water-sealed latrines.
However, the cost of such a unit may be an inhibiting factor. The
successful model of Midnapur in West Bengal, where a single pit is
provided initially, may also be considered for adoption in other districts
with appropriate changes to suit local conditions.
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School sanitation (providing toilets) should be given highest priority to
inculcate safe hygienic habits among school children.
Village Panchayats should adopt building byelaws where dry latrines are
not permissible. Any latrine to be constructed should be of the water-
sealed type with a leach-pit. This will obviate the problem of manual
scavenging.
Considering that the programme of installation of low-cost toilets has not
met with the expected degree of success, a fresh start is required. The
State Council for Sanitation, proposed that the under urban sanitation
sector, should also have the mandate for rural sanitation.
Subsidy for the low-cost household toilets should only be given to rural
below poverty- line (BPL) families, and it should be on par with subsidy
for the urban households. For the success of the scheme, a subsidy of 50
per cent of the cost of the unit, inclusive of sub and superstructures for the
basic twin-pit pour flush system, appears to be necessary in this
programme.
A quick exercise to arrive at the realistic present costs in different regions,
terrains, soil conditions, etc., should be carried out so that the subsidy
amount can be estimated.
In order to mobilize the required funds for rural sanitation, financial
institutions/banks including HUDCO and the National Bank of
Agriculture and Rural Development (NABARD) should extend loans at
lower interest rates to states for provision of sanitation facilities. Low cost
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loan schemes, like micro-credit through NGOs, should be adequately
supported. Various fiscal concessions, such as reduced excise duty, sales
tax and lower electricity charges, should be made available to the
manufacturers of low cost sanitary materials. Private participation should
be encouraged in setting up building centres and sanitary marts in rural
areas to provide cost effective sanitation technology to the rural
households.
The recommendations made with regard to urban low cost sanitation also
apply to the rural segment. Creation and maintenance of a record of
locally relevant information regarding various technological options,
hydro-geological information, availability of building materials, choices in
design, etc, at the block level should be organized through the panchayats,
sanitary marts and building centres.
For the success of the scheme, and to overcome the huge problem of
insanitary practices in the country, a massive programme of education,
propagation, training, designing and development, production, and
installation, needs to be undertaken. NGOs should be mobilized to support
the programme, especially for supervision, monitoring, training, and
development work. A suitable provision for the participation of the Non
Governmental Organizations (NGOs) in the sanitation programme should
be made in the project costs.
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According to the TSC programme, revitalization had given new paradigms for
rural sanitation initiatives in India. At present, in all the rural areas of districts in the
country, including Union Territories, the TSC programme is being implemented.
So far, we learnt about initiatives, which have been taken up by governments.
However, from the last few decades at the global level, many initiatives have taken up
with international organizations. Especially the United Nations and United Nations
Development Programme (UNDP) have focused on rural sanitation. The new millennium
year 2000 entry is a turning point for rural sanitation.
Sanitation and Global Action
In September 2000, the United Nations General Assembly adopted the eight
Millennium Development Goals (MDGs) that challenged the global community to reduce
poverty and increase the health and well-being of all peoples. In September 2002, the
World Summit on Sustainable Development in Johannesburg reaffirmed these goals and
added access to basic sanitation as a centerpiece of the poverty eradication commitments.
The target to halve the proportion of people without access to basic sanitation by 2015
has been laid down in the Johannesburg Plan of Action Implementation (JPOI)28. Later,
the twelfth session of the United Nations Commission on Sustainable Development
(CSD-12), held in New York in April 2004, reviewed the state of implementation of the
goals and targets in the thematic areas of water, sanitation, and human settlements. The
CSD-12 identified constraints to, and continuing challenges for, the implementation of
these goals, including the JPOI target on access to basic sanitation. Based on that review,
CSD-13, in April 2005, recommended policy actions to be implemented by member
States in addressing these challenges. The international community reviewed the progress
24
towards the implementation of these recommendations during CSD-16 in May 200829.
Despite significant efforts by governments, progress on sanitation targets has been slow
and uneven.
International Year of Sanitation - 2008
The United Nations General Assembly decided to declare the years 2008 as the
International Sanitation Year. As UN identified the importance of sanitation, public
health, poverty reduction, economic and social development, and the environment are
vital elements for the process of sustainable development. The General Assembly,
through its Resolution No. 61/192 of 20/12/200630, urged all UN member countries to
concentrate on sanitation awareness and community participation. It was decided to
promote action at all levels, taking into account the recommendations of CSD-1331. After
going through all available information on rural sanitation at international, national, and
other levels, the researcher found that there is a big gap of communication in the rural
sanitation programmes. Because of lack of awareness on rural sanitation among rural
stakeholders, many developmental problems are arising. Poor sanitation facilities are
impeding the development process. To tackle these problems, first we need to focus on
rural sanitation issues. The major problem in rural sanitation is lack of awareness and
inadequate sensitization. With effective communication strategies, these problems can be
tackled. The total sanitation campaign has been is mainly designed with awareness
component in mind.
All initiatives about rural sanitation in India are being implementing through the
state governments concerned. The central government is playing a facilitator’s role only.
India is not only a developing nation, but also well known for socio, economic, political
25
and cultural diversities. Tackling the sanitation issue is not only a development agenda
but also linked with behavioural aspects. Even today, open defecation has been going on
in many villages. There is a need to usher in behavioural change in regard to rural
sanitation and hygiene. The behaviour change communication has to take place
thoroughly by taking into account the prevailing socio, economic, political and cultural
diversifications in the villages. After going through the available information about the
rural sanitation, the present research study has been mooted. The research study’s main
objective is how the Information, Education and Communication (IEC) campaigns are
impacting the rural households to change their behaviours towards sanitation practices.
Objectives of the Study
Objective: 1
To study the role and impact of Information, Education and
Communication (IEC) campaigns in rural sanitation initiatives
Objective: 2
To know the impact of different campaigns on the absorption of suitable
low cost, effective and appropriate sanitation technologies by the rural
people
Objective: 3
To know how various communication tools have been employed for
implementation of rural sanitation programmes
26
Objective: 4
To assess linkages with the three-tier Panchayat Raj institutions through
rural sanitation programmes
Objective: 5
To understand the rural sanitation approaches and implementation
modalities of rural sanitation programmes through the communication
processes
Objective: 6
To analyze the extent of media coverage given to core issues of sanitation
in media
Objective: 7
To analyze how NGOs, media representatives and government
functionaries look at sanitation
Scope of the Study
The research study is proposed to provide an empirical data of presentation
related to the rural sanitation initiatives under rural sanitation programmes in Medak
district of Andhra Pradesh. The study focuses on the rural sanitation with emphasis on the
role and impact of IEC and the media. The study will seek to identify some of the
significant issues in rural sanitation. The data and other information were collected for
the period of 2003-2013.
Limitations of the Study
In spite of all the care taken, this study has its limitations. These include: material
availability, limited time, geographical limitations. Again, it is not possible to make an
27
overall assessment of the implementation of rural sanitation programmes for a PhD theses
work for the entire Andhra Pradesh state.
Methodology
The research study is empirical. The study has been undertaken based on primary
and secondary data. The primary data has been mainly obtained from official records,
registers, government orders, pamphlets, brochures, training material and unpublished
material. The researcher has conducted interactions, face-to-face discussions with rural
stakeholders and held consultations with the officials dealing with this subject at various
levels.
Case study of two of the selected villages was done to understand the
implementation of the programme. The researcher also conducted formal and informal
interviews and followed the technique of participation and non-participation by several
officers and beneficiaries. Formal and informal interviews were conducted for the study,
which proved to be highly beneficial in collection of factual data, reliable information
from the officials and beneficiaries.
Information was gathered from the district administrative authorities of Medak
and the Panchayat Raj - Rural Water Supply & Sanitation (PR - RWS & S) Department
of Government of Andhra Pradesh (GoAP). Interviews, interactions, and discussions
gave an insight into the implementation of rural sanitation coupled with an intensive
fieldwork for completion of the research.
28
Chapterization
The research work is spread over six chapters along with introduction.
Chapter one gives the concept, nature, scope and objectives of rural sanitation
have been mentioned. The introduction also gives, review of literature, scope,
limitations, methodological approach and hypotheses.
Chapter two traces the background of rural sanitation programmes in India.
Chapter three explains the various rural sanitation programme implementation
and the institutional setup in Andhra Pradesh.
Chapter four gives an insight on media and rural sanitation.
Chapter five deals with a case study on rural sanitation programme in Medak
district.
Chapter six is related to observations and perceptions of the general public and
officials about rural sanitation and conclusions.
Review of Literature
Many international organizations have published lot of material, which is
available in print and electronic modes. Moreover the Government of India and state
governments have also issued many publications and reports on rural sanitation. The
researcher has gone through the relavant literature available before undertaking the
research study. The Millennium Development Goals (MDGs) have been framed by the
United Nations with Environment and Sanitation as one of the goals. The Asian
Development Bank published a book on sanitation and discussed the sanitation
conditions in South Asia.The authors have mentioned, 43.4 per cent population is living
on less than $1.25 per day in South Asia. MDGs stipulate that many more people should
29
have access to improved water sources and sanitation by 201532, and also that the
mortality of children under five should be reduced by two thirds. The mere provision of
water supply and sanitation facilities is not enough to bring down mortality and morbidity
rates significantly; hygienic behaviour has a greater impact on health and also helps to
ensure hygienic maintenance.
An enlightened study was undertaken by International Resource Centre (IRC), the
Netherlands titled “Actions Speak: The Study of Hygiene Behaviour in Water and
Sanitation Projects” in 1993 by Boot, M., & Cairncross, S. (1993). Actions Speak: The
Study of Hygiene Behaviour in Water and Sanitation Projects. The Hague: IRC
International Water and Sanitation Centre.
MDGs defined many strategies for sustainable development for the world. In a
special chapter of a book titled “Key Indicators for Asia and the Pacific 2010, the Rise of
Asia’s Middle Class” issues relating to sanitation have been examined. The MDG No. 7
has defined clear cut targets about the sanitation and has four sub targets. Target 7A,
integrate the principles of sustainable development into country policies and programmes
and reverse the loss of environmental resources. This target is applicable to the
developed, as well as to the developing, economies of the region. 7B, reduce biodiversity
loss and achieve significant reduction in the rate of loss by 2010, 7C, the new target
introduced in the revised MDG framework envisages 50 per cent reach by 2015 and
improving water and sanitation facilities in urban and rural areas. The targets are to reach
to at least 50 per cent of the households that have no access to drinking water source and
to improve sanitation facilities. By 2020, 7D proposes to achieve significant
improvement in the lives of at least 100 million slum dwellers.
30
Slums are defined as dwellings in urban areas with at least one of the following
characteristics: (i) lack of access to improved water supply, (ii) lack of access to
improved sanitation, (iii) overcrowding (three or more persons per room), and
(iv) dwellings made of nondurable material. This target is for the world as a whole and
does not refer to any particular economy.
European Commission’s (EC’s) report emphasizes on the important role of
sanitation and safe water in maintaining health. The ‘sanitary revolution’ in the 19th and
early 20th century to played a vital role in reducing illness and death from infectious
diseases in industrialised countries.
In the International Drinking Water Supply and Sanitation Decade (IDWSSD),
1977-87, a report was published by the UN, which talked about achieving cent percent
sanitation by 1980s. The aim was clear to achieve 100 per cent coverage in water supply
and sanitation. Interestingly, in a study undertaken by Department for International
Development (DFID)in 1998, it was noticed that the general provision of services did
increase but the sanitation facilities could not keep pace with the rising population,
meaning that the number of people continued to rise, unserved by good sanitation
facilities. A Systematic Review and Meta-analysis” by Lorna Fewtrell and John M.
Colford, Jr. in 2004 focussed attention on how the neglect of sanitation and hygiene
issues result in increase cases of diarrhoea all over the globe. Global Annual Assessment
of Sanitation and Drinking Water (GLAAS) is the key resource about sanitation and
hygiene published by UN water. It provides a lot of information and fact sheets. The
purpose of the GLAAS report is to provide key information, based on data collected from
a large number of sources, regarding sanitation and drinking-water in the developing
31
world: specifically, the use of sanitation and drinking-water services, government policies
and institutions, investments of financial and human resources, foreign assistance and the
influence of these factors on performance. It strives to enable comparisons to be made
across countries and regions and is expected to achieve global reporting within the
coming years. This first report covers 42 countries and 27 external support agencies.
The World Health Organization (WHO) and the United Nations Children's Fund
(UNICEF) provide a lot of information and progress in this sector. A 2010 update has
been published by them and it is available. The Joint Monitoring Programme (JMP)
report describes the status and trends with respect to the use of safe drinking-water and
basic sanitation, and progress made towards the MDG drinking-water and sanitation
targets. Each report assesses the situation and trends anew. This is a bible in sanitation
and supersedes previous reports.
The Millennium Development Goals Report, 2009 was released by the United
Nations Department of Economic and Social Affairs (UNDESA). This report presents an
annual assessment of progress towards the MDGs. It points to areas where progress
towards the eight goals has slowed or reversed. The progress on drinking water and
sanitation was mentioned with special focus on sanitation.
The WHO in its 2005 edition report, the “Joint Monitoring Programme (JMP)”
focuses on the changes that simple improvements in water and sanitation services can
make to people’s lifestyles, health and economic prospects – and the relatively small
investments needed to make those improvements. The report provides a list of the main
agencies that provide advocacy and technical support in the water, sanitation and hygiene
sectors. The report concludes with statistical tables showing the increased targets of the
32
MDG drinking water and sanitation and drinking water and sanitation coverage estimates
at regional and global levels. It also talks about how to meet the MDG drinking water and
sanitation targets.
The United Nations Development Programme (UNDP), UN Millennium Project
Task Force released a report on Water and Sanitation in 2005 This is intended primarily
for the policy and technical communities concerned with the achievement of the Goals,
particularly target 10, in governments, international organizations, bilateral donor
agencies, specialized nongovernmental organizations, water agencies, and academia. It
identifies what it will take to meet the targets on water and sanitation, including
pinpointing the actions needed in other sectors; and identifying the actions needed in the
water resources sector to meet the MDGs as a whole.
The United Nations Educational, Scientific and Cultural Organization (UNESCO)
released an interesting document on “Women and Water: An ethical issue”.
This publication is concerned with the ethical issues arising from the special role
of women in water use and from related social and environmental problems. It discusses
both the nature of some of the key problems and the efforts in recent decades by both
inter-government and non-governmental organisations to overcome these problems.
A strategy paper was issued by the United Nations Development Programme
(UNDP), Stockholm Environment Institute (SEI) in 2006 on water and sanitation issues.
This paper analyses the relationship between water management and poverty reduction. It
considers water’s potential contribution to all of the MDGs, and not just those that refer
explicitly to water.
33
The Water Supply and Sanitation Collaborative Council (WSSCC) in 2005
published a booklet on Community-driven development for water and sanitation in urban
areas and its contribution towards meeting the MDG targets. This booklet focuses on the
role of local, community-driven schemes in directly addressing the needs of the unserved
or ill served in urban areas.
In 2004, the WSSCC published a book on the voices of those with long
experience of, and commitment to, the cause of ‘water, sanitation and hygiene for all’.
The publication brings together the contributions of engineers, sociologists, doctors,
community and NGO leaders, government ministers, local government officials,
academics, and private sector executives from Asia, Africa and Latin America.
United Nations Development Programme (UNDP) in 2004 released a document
on Water Governance for Poverty Reduction, Key issues and the UNDP response to
MDGs. This document examined the governance aspects of the water and sanitation
crisis as also the various social, economic, environmental and capacity challenges as
these relate to the MDGs, proposing solutions at every level. It draws on the experience
and work of the UNDP.
The World Health Organization (WHO) and United Nations Children's Fund
(UNICEF) in 2008 in a publication provided an assessment of the population currently
using an improved drinking-water source and basic sanitation disaggregated by urban and
rural areas.
In 2009 the United Nations Economic and Social Commission for Asia and the
Pacific (UNESCAP) issued a discussion paper on Institutional Changes required to
achieve the MDG target on Sanitation. This report presented the institutional progress
34
made in selected UNESCAP member countries towards achieving sanitation goals.
Institutional progress consists of changes in administrative, legal and financial rules and
practices that have been made with sanitation goals in mind.
In 2005 the Global Health Council issued a book on sanitation and child health.
The publication explained how infectious diseases affect the world unequally.
Interestingly, the book says that sixty two percent of all deaths in Africa and 31 per cent
of all deaths in Southeast Asia are caused by infections. A half of all child deaths each
year are due to diarrhoea and acute respiratory infections, both of which are transmitted
from person to person during everyday interaction through droplet and airborne spread,
through skin contact and through contamination of the environment.
An interesting study by Luby et al. (Lancet, 2005) suggests that hand washing
with soap can reduce respiratory infections in children under five by 50 percent. Hand
washing interrupts the transmission of disease agents and so can significantly reduce
diarrhoea and respiratory infections, as well as skin infections and trachoma.
The Asian Development Bank (ADB), in its annual report of 2008 mentioned
about its engagement with the civil society on sanitation aspects. It was brought out that
the ADB engages with global, regional, national, and local CSOs undertaking advocacy
or service delivery and working in a range of sectors, including water and sanitation,
agriculture, irrigation, and transport.
The United Nations University and United Nations University Institute for Water,
Environment and Health (UNU-INWEH), Canada in 2010 released a publication, titled
“Voices from the Field”. It was mentioned that sanitation is the single most neglected
MDG sector – accorded low priority by donor and recipient governments alike. It is clear
35
that without an extraordinary effort at all levels, the MDG target for sanitation will be
missed by one billion people.
The International Year of Sanitation 2008 made sanitation as a big policy issue at
the global level. Many publications and reading material, factsheets, booklets, pamphlets
and posters that are being used in campaigns, were issued on the occasion.
A report on greater access to cell phones than toilets in India by UNU-INWEH (2010)
offers a 9-point prescription made many people think about achieving Millennium
Development Goal for Sanitation by 2015.
The World Bank released working papers from time to time on various
development issues. Likewise, in 2005 a paper on Water Supply & Sanitation was
published. It gives valuable sectoral information.
Third South Asian Conference on Sanitation’s (SACOSAN’s) Delhi Declaration
on “Sanitation for Dignity and Health”states that, “Every one of two South Asians is still
forced to undergo the indignity of defecating in the open, or using other forms of
unimproved sanitation”. The conference was held on November 16-21 2008 at Vigyan
Bhawan, New Delhi. The fourth SACOSAN conference conducted in Sri Lanka and the
fifth is scheduled to be organized in Nepal. All these SACOSAN conference proceedings
and discussions are helpful to South Asian countries to collectively tackle sanitation
issue. The SACOSAN is working as an intergovernmental organisation with members
from government organisations, civil society organisations, the media, academia and
research organisations. This has become a vibrant forum for discussing and formulating
better polices for sustainable sanitation and has emerged as a regional level forum.
36
Asian Development Bank (ADB) in 2007 released a discussion note, titled
“Dignity, Disease, and Dollars”. It advocates that sanitation should be an urgent priority
for governments in Asia. Our call to action—“Dignity, Disease, and Dollars”—has been
chosen deliberately to focus attention on three areas where stakeholders need to see
results: Better facilities for individuals so they can regain their dignity, disease prevention
and healthy environmental outcomes for the wider community, and financial viability of
sanitation services for provider governments and utilities in tandem with affordability for
households.
The Water Aid India released a document on sanitation conditions in India in
2005. In an enlightened report, titled “Drinking Water and Sanitation Status in India,
Coverage, Financing and Emerging Concerns”, have been highlighted.
The Sweden based development organisation, Stockholm Environment Institute
(SEI) is initiating the EcoSanRes Programme for Improved Livelihoods around the
World. In 2004, the organisation published a document on sanitation in a global
perspective.
“Feeling the Pulse, A Study of the Total Sanitation Campaign in Five States”, done by
Water Aid India in 2008. A few published case studies on rural sanitation are very much
useful for researchers.
“Human Development Report, 2006”, published by the UNDP mentioned about
sanitation like beyond scarcity: Power, poverty and the global water crisis. This report
discloses that, some 2.6 billion people, half of the developing world’s population, do not
have access to basic sanitation. It also said, while basic needs vary, the minimum
threshold is about 20 litres a day. Most of the 1.1 billion people categorised as lacking
37
access to clean water use about 5 litres a day one tenth of the average daily amount used
in rich countries to flush toilets. On an average, people in Europe use more than 200
litres, in the United States more than 400 litres. When a European person flushes a toilet
or an American person showers, he or she is using more water than is available to
hundreds of millions of individuals living in urban slums or arid areas of the developing
world. Dripping taps in rich countries lose more water than is available each day to more
than 1 billion people.
The International Development Agency published a study in 2005, titled
“Sanitation and Water Supply, Improving Services for the Poor, Sanitation and water
supply”. It emphasises that sanitation and hygiene are affordable, highly effective life
savers. Reliable and safe water supply and sanitation services can contribute significantly
to income generation, health, and education. Services provide dignity and reduce the
environmental squalor that directly impacts people around the globe.
One more important publication of Asian Development Bank in 2009, titled
“India’s Sanitation for All: How to Make It Happen”, emphasises on a few insights
related to sanitation in India exclusively. They are in all an estimated 55 per cent of
Indians, or close to 600 million people, who do not have access to any kind of toilet.
Among those who make up this shocking total, Indians who live in urban slums and rural
environments are affected the most. In rural areas, the scale of the problem is particularly
daunting, as 74 per cent of the rural population still defecates in the open. In such
environments, cash income is very low and the idea of building a facility for defecation in
or near the house may not seem natural. And where facilities exist, they are often
inadequate. The sanitation landscape in India is still littered with 13 million unsanitary
38
bucket latrines, which require scavengers to conduct house-to-house excreta collection.
Over 700,000 Indians still make their living this way.
Research and action research on sanitation
Many research and action research initiates have been taking up on sanitation at
various levels. Many action research activities have taken up by international
organizations. The Government of India in collaboration with international organizations
like UN, UNDP, UNICEF, Water Aid, Plan International, CARE and multi donor and
bilateral institutions like the World Bank, Asian Development Bank, DFID, etc has
undetaken various studies on sanitation.
There is an interesting action research partnership with Participatory
Methodologies Forum of Kenya (PAMFORK) in promoting participation through the use
of Participatory Action Research (PAR) methodologies, facilitating multi-stakeholder
processes that deepen the understanding of the relationship between Water, Sanitation
and Hygiene (WASH). The study emphasized on students’ performance, learning in
schools, building, and strengthening capacities of stakeholders from the district level to
implement WASH related interventions that are evidence based. The determination and
the relationship between status of water, sanitation and hygiene (WASH) in Schools and
Performance of boys and girls has also been discussed.
The concept of rural sanitation was incorporated by the Government of India in
the post- independence years in its development and welfare programmes. Along with the
rural development activities, rural sanitation initiatives were also started in India. Under
the umbrella of “Community Development” programme rural sanitation is being
implemented in various locations in the country. A quick glance at the literature shows
39
that it was only after 1990 that the rural sanitation becomes a priority issue in the arena of
development. During this millennium, many international organizations, particularly the
UN, have put high concentration on rural sanitation.
At national and international levels, several studies have been undertaken on
various facets of rural sanitation. The researcher also found that there were only few
academic studies conducted from universities in India. From the last 50 years, several
international development organizations have conducted a number of studies and surveys
with an emphasis on rural sanitation.
The researcher focused on a brief review of past studies, looked into the role and
impact of the IEC campaigns and media in the process of rural sanitation programmes.
The research scholar also utilized the various development journals, fact sheets,
newsletters, reading material, and background material, seminar/conference proceedings
related to rural sanitation from the national and international perspective. The
Government of India and Ministry of Rural Development have developed various types
of materials like books, booklets, guidelines, brochures and reports on rural sanitation.
Reputed journals like Yojana and Kurukshetra official publications of GoI were also
referred for this study.
Information and Communication Technology (ICT) is playing a crucial role in the
world. ICTs facilitated this study. Many national and international organizations, along
with various governments, are running departmental websites, which are good sources of
information duly accessed by the researcher for this study. Updates and data bases that
exist were successfully incorporated from a variety of websites. Also, official information
40
through periodic press notes and brochures helped this scholar to utilize the information
pertaining to various developmental activities.
41
References 1. UNICEF: Supporting government schemes on rural sanitation. (2012, October 1).
UNews, 8, 14. 2. Rural Water Supply and Sanitation. (2008). New Delhi: Ministry of Rural
Development. 3. Sanitation 2008. (2008, January 1). UN Water Factsheet No. 3, 4, 6. 4. Sanitation Scenario. (n.d.). ODS UN. Retrieved December 26, 2009, from
http://daccess-ods.un.org/access.nsf/Get?Open&DS=A/RES/61/192&Lang=E 5. Dietvorst, C. D. (n.d.). dietvorst | Sanitation Updates. Sanitation Updates | News,
Opinions and Resources for Sanitation for All. Retrieved May 12, 2010, from http://sanitationupdates.wordpress.com/author/dietvorst/
6. Tenth Five Year Plan (2002-2007) on Water and Sanitation. (2007). New Delhi: Planning Commission of India.
7. Eleventh Five Year Plan - A Document. (2007). New Delhi: Planning Commission of India.
8. Ecological Sanitation. (2008, April 9). ESA UN. Retrieved February 5, 2010, from http://esa.un.org/iys/docs/1%20fact-sheet_health.pdf
9. Ibid 10. A Review on Water and Sanitation. (2002). New Delhi: Planning Commission of
India. 11. Rural Water Supply and Sanitation Review. (2007). New Delhi: Planning
Commission of India. 12. Household Sanitation in India. (2012). New Delhi: National Sample Survey
Organization, The Government of India. 13. Ibid 14. Water Supply and Sanitation. (2012). New Delhi: Planning Commission of India. 15. 54th National Sample Survey. (1999). New Delhi: NSSO - Ministry of Planning,
the Government of India. 16. Ibid 17. United Nations Official Document. (2010, August 3). Welcome to the United
Nations: It's Your World. Retrieved September 12, 2010, from http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/64/292
18. A Primer on Water and Law Policy in India. (2012). New Delhi: Environmental Law Research Society (ELRS).
19. A Primer on Water and Law Policy in India. (2012). New Delhi: Environmental Law Research Society (ELRS).
20. Guidelines of Central Rural Sanitation Programme (CRSP). (2001). New Delhi: Ministry of Rural Development, Government of India.
21. Guidelines of Central Rural Sanitation Programme (CRSP) (pp. 1-10). (2001). Introduction. New Delhi: Ministry of Rural Development, Government of India.
22. Ibid 23. India: Accelerating Sanitation Coverage in Rural India. (2003). Bangkok: World
Health Organization - South East Asia Office 24. Tenth Five Year Plan (2002-2007) on Water and Sanitation. (2008). New Delhi:
Planning Commission of India.
42
25. Tenth Five Year Plan (2002-2007) on Water and Sanitation. (2008). New Delhi: Planning Commission of India.
26. Sanitation Contributes to Dignity and Social Development, International Year of Sanitation
27. (2008). Sanitation is Vital for Human Health. Un Water Factsheet, 4(3), 7. 28. Bharat Nirman Plan Document. (2007). New Delhi: Planning Commission of
India. 29. Ecological Sanitation. (n.d.). ODS UN. Retrieved December 25, 2009, from
http://daccess-ods.un.org/access.nsf/Get?Open&DS=A/RES/61/192&Lang=E 30. United Nations and Sanitation. (2008). New York: United Nations. 31. Ecological Sanitation. (2008, April 9). ESA UN. Retrieved February 5, 2010, from
http://esa.un.org/iys/docs/1%20fact-sheet_health.pdf 32. ODS UN. (n.d.). Sanitation in Developing Countries. Retrieved December 25,
2012, from http://daccess-ods.un.org/access.nsf/Get?Open&DS=A/RES/61/192&Lang=E
33. Rural Water Supply and Sanitation. (2009). New York: UN. 34. Rural Drinking Water Supply and Sanitation in the Eleventh Plan Period
Excerpts. (2009). New Delhi: Planning Commission of India.