Publications
This paper provides the first prevalence estimates of zero-sanitation across all 36 Indian states/UTs over 30 years, highlighting that states like Bihar, Uttar Pradesh, Odisha, and Madhya Pradesh have the highest burden. Zero-sanitation is concentrated in rural areas among the poorest and least educated households, emphasizing the need for states to address social determinants to achieve SDG 6.2 by 2030.
The Association between Anthropometric Failure and Toilet Types: A Cross-Sectional Study from India
Sustainable Development Goal 6.2 promotes private household toilets to end open defecation by 2030, but they may not be feasible for poor households, making well-managed shared sanitation a viable alternative. This study found no significant differences in child growth outcomes between households using shared toilets, private toilets, or practicing open defecation, suggesting that the health impact of shared sanitation warrants further research in other health contexts.
The study highlights that well-managed shared sanitation facilities, characterized by proper maintenance and accessibility, can play a crucial role in reducing open defecation, especially in contexts where private toilets are less feasible. These findings suggest the need for global sanitation policies to recognize and invest in high-quality shared toilets, distinguishing them from unmanaged facilities.
Swachh Bharat Abhiyan aimed to end open defecation in India by 2019, but regional disparities in toilet construction and use persist, particularly in rural Bihar. The study found that while residents are aware of the risks of open defecation, structural factors such as inadequate subsidies and distrust towards the government significantly hinder latrine adoption, challenging the assumption that reluctance to use latrines stems from a preference for open defecation.
Despite efforts to improve latrine coverage in India, 520 million people still practiced open defecation in 2017, potentially due to a focus on individual-level factors rather than broader social determinants. The study found that household dwelling space and the contextual factors of villages and states significantly influence latrine ownership, suggesting that future sanitation interventions should consider these social determinants to enhance progress toward SDG 6.
Public Health in Rural India: Exploring Sanitation Outcomes and the Role of Community Health Workers
India's economic reforms in 1991, driven by an IMF loan, spurred rapid growth, improving middle-class living standards but also exacerbating inequality, leaving hundreds of millions in poverty with poor sanitation and health outcomes. This dissertation has three papers which explore the social determinants of sanitation and health in India, highlighting barriers to latrine ownership in rural Bihar, the impact of household space and village context on latrine ownership, and the influence of Anganwadi Workers' characteristics on their performance in maternal and child health services
This chapter elucidates why sanitation needs to be considered a basic human right, not just a means to improve health. Considering sanitation as a basic human right might help the global development community meet the SDG for sanitation by 2030.
Intrinsic and instrumental perspectives to sanitation - ScienceDirect
Public health interventions are often valued for their broader social and economic benefits, but their intrinsic value as ends in themselves is frequently overlooked. This commentary argues for recognizing the intrinsic worth of sanitation interventions and advocates for a shift from demand-side to supply-side approaches to promote equity in health and development.