Lauding the Clean India Mission for making a 'promising start' in providing eight million toilets in the first year, a global agency, has stressed on more funding and changing the people's behaviour to make the programme a success.
Poor construction and failure to convince people to change their behaviour can lead to toilets falling into disuse, WaterAid, an international charity working on improving access to safe water, hygiene and sanitation, cautioned in its report on the status of world toilets released last week.
Referring to Prime Minister Narendra Modi's ambitious 'Swachh Bharat' (Clean India) mission to deliver a toilet to every household and end open defecation by 2019, it said: "This is no small task in a country where 560 million people still defecate in the open.
"One year in, they've delivered toilets to 8 million households - a promising start. But, to succeed, more funding, greater government prioritisation at all levels and a focus on changing people's behaviour to ensure everyone uses these new toilets will be required," said the report titled "It's No Joke: The State of the World's Toilets 2015".
Stressing on the need to change the people's behaviour to ensure everyone uses newly built toilets, it carried a photo of a household toilet stated to be in Madhya Pradesh's Panna district, which is used as a satellite dish stand.
"If just one person continues to defecate in the open, the environment remains polluted for everyone. If Clean India is to succeed, sanitation must be seen as a fundamental human right along with food, education, livelihoods and health, for everyone in the country - including the poorest and most marginalised," it said.
The report said 173 people were defecating in the open for every square kilometre in the country.
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"That ratio would be the same as 500 people having to defecate in the open in the Square Mile of the City of London, or 15,000 people in Manhattan, New York City. Open defecation leaves communities filthy and children ill and undernourished," it said.
The report said it is women and girls who feel the impact
of a lack of sanitation most severely.
"Without a safe, private place to relieve themselves, girls and women are often left with no choice but to go out at daybreak or in the evening to find a place to go in a field, roadway, railway track or bush.
"These unhygienic, unsafe conditions can contribute to infection and leave them more vulnerable to harassment or assault," said the report released on the occasion of World Toilet Day on November 19.
It said the impact of inadequate toilets at school is greater on girls who have begun menstruation.
"Without proper sanitary supplies or a safe, private place at school to wash and care for themselves, many girls stay home for that week each month; they quickly fall behind, and it's often not long before they stop attending entirely," it said.
"We all laugh at toilet humour - but the state of the world's toilets is really no joke," it said, adding more than 650 million people in the world do not have access to clean water, and more than 2.3 billion do not have access to a safe, private toilet.
"Diarrhea is one of the three most common killers of young children globally, along with pneumonia and malaria. Most of these deaths - 58 per cent of them - could be prevented by clean water, sanitation and good hygiene including hand washing with soap. That is more than 314,000 young children who could be saved, every year," it said.
More than 140,000 children younger than five years die each year in India due to diarrhea, it added.