The untold story of India’s sanitation failure, Addendum

Three months ago, a paper dealing with the causes of the failure of the Total Sanitation Campaign (TSC) in India and written by Brian Bell and myself, was published in the journal Water Policy.
A very succinct summary: the TSC –the national rural sanitation campaign of India between 1999 and 2012– was a ‘good’ policy on paper, but yielded very poor results. Its valuable core principles –community-led, people-centred, demand-driven and incentive-based– did not happen in practice. The result: millions of latrines ‘planted’ throughout the country without any involvement or appropriation by the ‘beneficiaries’, severely affecting sustainability. We identified five main causes behind the theory-practice gap in the TSC: low political priority; flawed monitoring; distorting accountability and career incentives; technocratic and paternalistic inertia; and corruption.
The paper draws from research in 2011 and by the time we were finishing the paper (end of 2012), the sanitation campaign had been modified and re-branded into the Nirmal Bharat Abhiyan (NBA).Therefore we added one last paragraph where we pointed out the main changes in the NBA and theorised about its possible consequences. Our main concern was that it might stumble again into the problems, as these changes failed to address adequately the five main hurdles mentioned earlier that had hampered the implementation of the TSC.
I have recently had the opportunity to go back to India and spend a couple of weeks in the field, and have to some extent confirmed our concern.
A positive development observed is the increased social attention and the political priority of sanitation, although they are still below what the scale of the Indian sanitation crisis requires.
Regarding the changes in the guideline, the most relevant ones were the increase in the subsidy amount and its convergence with the MGNREGA rural employment scheme. Though it may have reduced the problem of toilets built only up to the substructure, this has had several negative consequences too.
For instance, government officers in many areas were complaining about the MGNREGA convergence and pointed out that it was a nightmare in terms of bureaucratic burden and coordination efforts, leading to delays in payments, time- and money-consuming procedures and disinterest from the households.
But I felt that the most problematic consequence was that it has increased even further the construction focused implementation, driven by supply and subsidies and neglecting demand creation. As a consequence, the message has been reinforced that sanitation is not a problem of each and every household, but a government issue (household toilets even carry the logo of the campaign). Moreover, the construction focus has aggravated the problems of distorting accountability and career incentives, technocratic and paternalistic inertia and corruption.
The increased subsidy has also generated tensions between those who are eligible for it and those who are not. The reason is that among those ineligible are millions of below poverty line households that reportedly got a latrine during the TSC –and are thus not entitled to get the subsidy in the NBA– but never really had a functional one. Now they see that their neighbours –including some above poverty line households– are receiving very high subsidies for their latrines. I witnessed in several villages the tensions this generated, jeopardising the collective perspective and the prospects of making entire villages ODF.
Finally, to what concerns the monitoring system, and as I discussed in a recent post, there are some positive innovations taking place, but perverse incentives leading to overreporting still remain.
To sum up, I believe that the NBA has not produced substantive changes and is thus moving in a similar –and worrying– direction to one the TSC followed. There is however enough knowledge and capacity at the grassroots and among government officers to reverse this situation, but a strong leadership and courage to radically transform the campaign will be required.