Questioning the "health effect" of government's toilet construction drive to end practice of open defecation in the country, a new study has suggested that the approach should not only meet "international coverage targets" but must aim at improving public health in general.
"Our findings raise questions about the health effect of sanitation initiatives that focus on increasing latrine construction but do not end open defecation or mitigate other possible sources of exposure," claims the study published in the Lancet medical journal today.
The study was conducted between May 20, 2010, and December 22, 2013, in 100 rural villages in Puri, a coastal district of Odisha to assess the effectiveness of a rural household sanitation intervention to prevent diarrhoea, soil-transmitted helminth infection, and child malnutrition.
However, it has found that there was "no improvement" in public health merely because of toilet construction.
"Although latrine coverage increased substantially in the study villages to levels targeted by the underlying campaign, many households did not build latrines and others were not functional at follow-up. Even householders with access to latrines did not always use them," it says.
The study suggests that combined with other possible exposures, such as no hand washing with soap or safe disposal of child faeces, suboptimum coverage and use may have "vitiated" the potential health effect generally reported from improved sanitation.
"Although the sanitation campaign in India has been modified to address some of these challenges, the programme still focuses mainly on the building of latrines - the main metric for showing progress towards sanitation targets," the study says.
"Although these efforts should continue, sanitation strategies can optimise health gains by ensuring full latrine coverage and use, ending open defecation, and minimising other sources of exposure," it says.
"...Approaches should not only meet international coverage targets, but should also be implemented in a way that achieves uptake, reduces exposure, and delivers genuine health gains," it adds.
