This measurement study examines differences in reported latrine use rates using alternative framing of questions to better identify indicators that accurately measure latrine use and support large-scale sanitation programmes.
Background
Open defecation (OD), a practice that carries serious public health and environmental Implications, continues to be a challenge globally. Programmes that seek to end OD, now a priority under the Sustainable Development Goals, have been extensively pushed by the GoI, particularly through the Swachh Bharat Abhiyan-Gramin (SBM-G). In light of growing awareness that latrines ownership does not automatically indicate use as well as the many challenges in measuring latrine use, this impact evaluation study was conducted to shed light on behaviour induced effectiveness of efforts that support latrine use. To measure this behaviour more accurately, this study compares the reported rates of latrine use between an individual-level and a household-level. It aims to conceptualise and develop robust reporting measures on latrine use that could be reliably embedded into large-scale household surveys.
Approach
The study was conducted in rural areas of four Indian states – Bihar, Karnataka, Odisha and Gujarat. Interviews were conducted in 10-30 households in 22-26 villages in each of the four states, once before the interventions were implemented, and another round approximately one year later. There are two main objectives of this study. First, this study tests whether responses to household-level questions differ from responses to individual-level questions. Secondly, this study seeks to compare latrine use measurements across different settings in rural India using standardised methods and practices. Open defecation, the primary outcome of interest, was measured across the study areas using two independent questionnaires, wherein half of the respondents were administered the Individual questionnaire and rest of the respondents were provided the Household-level questionnaire.
Key Findings
Study results show that reported OD is significantly different across the two survey instruments –individual question on latrine use finds 20 percentage points more reported OD than the household-level question. This difference is significant across the full sample as well as within project areas. An important inference from this measurement project entails that household-level questions may not be able to capture individual-level, intra-household variations in use. Based on the data, certain predictors such as gender, education, age (individuals over 60 years), type of latrine owned and whether latrine was self-financed or constructed with support from government/NGO emerged to be significantly correlated with reported OD and latrine use. This is consistent with previous studies that has identified these variables as significant predictors of open defecation and latrine use.
Implications
With latrine coverage increasing under SBM-G and ending OD receiving more attention from the government, findings from this study underscore the importance of making improvements to sanitation outcome measurement vis-à vis existing official survey methods to better understand the status of OD and latrine use practices among individuals in rural India and to understand the sustainability of progress made under largescale sanitation programmes targeting latrine ownership and use. The findings highlight the necessity for additional studies aimed at increasing the reliability and cost-effectiveness of both survey and non-survey based latrine use measures. Insights from the study can contribute to developing a reasonable mix of indicators and measurement methods that can appropriately inform sanitation policy and practice.