Why expenditure on 'Swachh Bharat' is worthy and needs to be increased

For every rupee spent on sanitation, the society gets Rs 6.4 in social benefit

Nearly half of global deaths from diarrhoea occur in India – and most of these 800,000 annual deaths are due to a lack of clean drinking water and sanitation, according to a comprehensive global study. Prime Minister Modi has made both a priority, but what policies will do the most to help? New research points the way.

The research is by expert Bjorn Larsen, commissioned by Tata Trusts and Copenhagen Consensus as part of a project that will close gaps in evidence across several states, scrutinising more than 80 potential policies.

Clean drinking water is essential since its scarcity is to blame for more than 500,000 deaths each year. For Andhra Pradesh and Rajasthan, Larsen examines boosting the treatment of household drinking water by providing point-of-use water filters and launching a behaviour change campaign.

Just 10 per cent of households in Rajasthan and 23 per cent of households in Andhra Pradesh practice appropriate point-of-use water filtering. Based on experience abroad, the policy could feasibly encourage 15 per cent more households to start filtering.

The filters (₹2000 each) and parts replacement (₹500 annually) are the main cost, while recipients would have to spend time on filtering worth ₹430 annually, along with ₹130 in promotion costs. The total annualised cost for the program is about ₹3.60 billion in Rajasthan and ₹3.40 billion in Andhra Pradesh. Dr Larsen estimates the total benefits are worth ₹14.70 billion in Rajasthan and ₹10.30 billion in Andhra Pradesh – which includes lives saved, the reduction in sickness, healthcare cost savings, and productivity benefits from fewer lost work days. This means every rupee would generate benefits worth about four rupees in Rajasthan and three in Andhra Pradesh.

But how does this compare with other policies? By zeroing in on Rajasthan, we can examine the choices faced by policy-makers.

More than 85 per cent of households in the state have access to an improved drinking water source. What would it take to close the remaining gaps? Larsen estimates reaching the last 340,000 urban Rajasthan households would cost ₹490 million annually, whereas reaching the last 33 lakh households in rural Rajasthan would cost nearly ten times as much, at ₹465 crore.

The ₹1,430 cost per household per year includes the piped water supply or a tubewell or borehole, as well as operations and maintenance. And importantly for decision-makers, the benefits differ widely in urban and rural areas. Despite making up less than one-tenth of all households, urban households account for about one-third of all the lives saved. In rural areas, clean water will save relatively fewer lives, whereas the biggest benefit comes from reduced time – especially for women – spent carrying water. In total, each rupee spent in urban areas will generate ₹5.5 of social benefits, or slightly less at ₹4.5 in rural areas.

But even bigger benefits come from investment in improved sanitation. Most eligible households accepting the government’s incentive for sanitation opt for a flush or pour-flush system with a single- or twin-pit. Larsen assesses achieving this for 95% of households. In Rajasthan, the annualized cost of hygienic and clean sanitation runs to about ₹5,800 per household, with the cost cheaper in rural areas and more expensive in urban areas.

Every year, 13,600 lives will be saved in Rajasthan, along with avoiding some 83 million days spent sick. More than 7.2 million households receive health benefits worth about ₹15,000 each – a respectable three rupees back on the rupee. But the greater benefits come from the 31 million individuals who will no longer practice open defecation (even assuming a small percentage will stubbornly avoid using the improved facilities). Studies show these people will save 20 minutes a day, which can be spent on family, leisure or business. Using standard economic measurements, this freed-up time is worth ₹22,000 annually for each household. Added to the other benefits, each rupee spent on sanitation produces ₹6.4 of social benefits.

The figures work out slightly different in Andhra Pradesh, because of the different conditions – but there, too, the case for sanitation investment is strong.

This research provides evidence that further expenditure on policies like Swachh Bharat is very worthy, with considerable benefits to society. 

Dr Bjorn Lomborg is President of the Copenhagen Consensus Center, Manorama Bakshi is Senior Adviser to the India Consensus project