Secretary, Department of Drinking Water and Sanitation, Ministry of Jal Shakti, Government of India
WHEN THE NEWLY elected Prime Minister of India, Narendra Modi, commenced his maiden Independence Day speech on 15 August 2014, my wife, Indira, and I were curious about his vision for the nation and the development agenda going forward. We were then living in Hanoi, Vietnam, where I was working for the World Bank. Forty-five minutes into his speech, we were jolted into amazement: the Prime Minister, in his first major address to the nation, was talking about the lack of toilets and the indignity of women and girls having to defecate in the open. This was unheard of; something culturally and socially taboo in most countries, especially in India, where such a topic was not discussed in polite society, let alone during a Prime Ministerial address to the nation.
The Prime Minister went on to announce that India would launch a Swachh Bharat Mission (SBM) – the Clean India Mission – and as a tribute to the Father of the Nation, rid the country of open defecation by 2 October 2019, the 150th birth anniversary of the Mahatma. I was beside myself with excitement and recall saying to my wife: ‘I’ve somehow got to get back to India and be a part of this programme. This is a once-in-a-lifetime opportunity to rid our country of open defecation.’ It was a very long shot, since I had left the Indian Administrative Service in 2009 and joined World Bank. Fortunately for me, however, about a year later, I was sounded out about my interest in returning to India and, in February 2016, was appointed Secretary to the Government of India in the Ministry of Drinking Water and Sanitation, 1 the nodal ministry for the Swachh Bharat Mission.
As I write this, it has been less than five years after the Prime Minister’s audacious announcement from the Red Fort. Flying in the face of naysayers who said that it was impossible to achieve Open Defecation Free (ODF) status in only five years, SBM, under the leadership of Prime Minister Modi, has increased India’s rural sanitation coverage to 99 per cent. We are now fully on track to achieve the goal of ridding the country of open defecation before the deadline of 2 October 2019.
Achieving an ODF India in record time also means that India is attaining Sustainable Development Goal (SDG) 6.2 – Sanitation for all – a whopping eleven years before the UN’s SDG target of 31 December 2030. From having the dubious distinction of being the home of 60 crore people practising open defecation in 2014 – 60 per cent of the world’s total population of open defecators – to achieving ODF status through behaviour change at scale, in less than five years, is nothing short of a miracle. Inspired and led by the Prime Minister, however, the country and its billion-plus population have done it. Impossible is indeed nothing!
Few would dispute that SBM today has become Indian’s sanitation revolution and one of the biggest behaviour change mass movements in history. The scale of the achievement, especially in rural India, is mind boggling. As the graph below indicates, the low rural sanitation coverage in India at the start of SBM meant that there were only about 7 crore individual household latrines (IHHLs) in rural India at the time. As of June 2019, almost 9.7 crore new toilets have been added, ensuring that virtually all rural households in India have access to a toilet at home, and sanitation coverage has increased from 39 per cent to over 99 per cent in these five years.
Figure 1. Rural sanitation coverage of India (Source: Census of India 1981, 1991, 2001, 2014, 2019; SBM-Integrated Management Information System 2019)
The steep acceleration in the coverage will be noticed after October 2014, with the slope taking a rocket-like trajectory towards the end. The numbers are quite staggering: over 5,67,489 villages have become ODF as of June 2019. Most importantly, the usage of toilets, the best indicator of behaviour change, is very high, estimated at well over 95 per cent by the World Bank Support Project’s Independent Verification Agency through its most recent National Annual Rural Sanitation Survey (NARSS) in 6,136 villages and 92,040 households across all states of India (March 2019).
The first major indication of the seriousness of the Government of India and the state governments with respect to making India ODF was demonstrated when they jointly earmarked a massive $20 billion budget for the programme. A significant portion of these funds was earmarked to be spent on Information, Education and Communication (IEC), signalling that behaviour change was to be at the core of this Mission right from its inception.
A major contributor to the success of SBM has been the policy shift towards an outcome-oriented approach, as opposed to an output-oriented one – focusing on eradicating open defecation as opposed to just building toilets. What has perhaps not been fully appreciated is that the concept of ODF itself was an early policy outcome of SBM. Prior to 2014, there had been different rural sanitation programmes in the country, but the focus of these programmes was more on constructing toilets (physical output) rather than mobilizing villages through behaviour change to become ODF (community outcome). The latter focus ensured that the entire community owned the responsibility of making their village ODF and local accountability shifted from the building of individual toilets to the community’s responsibility for using peer pressure to achieve the ‘last mile’ conversion of the village to becoming ODF.
From a cautious beginning in late 2014, the first significant milestone was achieved in late 2015, with the tiny state of Sikkim becoming ODF. Thereafter, the next four states to become ODF were Himachal Pradesh, Kerala, Haryana and Uttarakhand, by late 2016. Today, in June 2019, almost all the states and Union Territories in the country are ODF.
Degree of Difficulty: Marketing a Product Not Many Wanted
Implementing SBM, the world’s largest behaviour change programme, in a five-year time frame has not been easy. Building infrastructure like roads, houses or power lines, while no doubt challenging, is relatively uncomplicated: it takes resources and requires engineering and management skills. But changing behaviour in tandem with implementing infrastructure (construction of toilets) is an uphill task, with a very high degree of difficulty. We sometimes used to compare the SBM challenge with attempting to paint the wings of a plane in flight. Why was it so difficult?
SBM was complex and incredibly challenging because there was no obvious demand for toilets. Marketing gurus tell us that you may have a good product, but you still need to promote it because there may be other similar products in the market which compete with yours. In the case of SBM, the major competition to adoption of toilets was the deeply ingrained and centuries-old habit of open defecation. Demand for a toilet had to be stimulated to wean people away from the habit of open defecation and therefore a behaviour change campaign had to be designed and implemented at scale . At the same time, a massive infrastructure programme to construct toilets – close to a 100 million in rural India – had to be rolled out. This in itself was an incredibly challenging task and, given the scale of the country’s geographical and cultural diversity, a decentralized and flexible approach was adopted for the supply of toilets at the local level. In most parts of the country, the preferred toilet technology option was the ‘invented in India’ twin pit–leach pit model, a low-cost, highly effective and environmentally friendly toilet.
Stimulating Demand: Behaviour Change at Scale
Disruption Begins at Home
While getting hundreds of millions of people in rural India to adopt and use toilets was going to be no easy task, we realized that behaviour change, like charity, has to begin at home. We, at the Ministry of Drinking Water and Sanitation, had to first change our own behaviour from scepticism about the success of such a mammoth programme to belief that it could be done. My colleagues in the Ministry, while fully enthusiastic about the goal, were somewhat hesitant to wholeheartedly commit and do whatever it took to achieve it. We had to create a mini-disruption in the staid, low-profile Ministry of Drinking Water and Sanitation, shake things up and make our own colleagues in Delhi believe that the goal of an ODF India was doable. This included doing things differently, working in ‘mission-mode’ instead of following the traditional, non-time-bound approach to work in government offices, flattening out the organizational hierarchy, bringing in young and fresh talent from outside to take on new functions, such as agile planning, PR, communications, social media and rapid feedback on progress to districts, and even creating a clean environment in the Ministry by renovating the toilets in the building.
In the Ministry, the ‘new normal’ office timings became early mornings till late evenings. ODF Saturday video conferences with district collectors across India, Lunch and Learn workshops with field functionaries, and frequent travel to states, districts and villages became the practice. Disruptions were frequently carried out including the entire senior management of the Ministry. Bollywood stars and even the Comptroller and Auditor General of India shocked observers and the press when they volunteered to empty toilet pits themselves, demonstrating how the twin-pit design worked to convert toilet waste into safe and usable compost (the farmers of UP like to call this ‘sona khaad’ – gold compost).
The PM-CM-DM-VM Framework
Since sanitation is constitutionally a state subject in India’s federal structure, the Union Government could only broadly play the role of a provider of financial and technical assistance and that of coordinator, convenor and monitor. Implementation of SBM, however, had to be done by the states, districts, panchayats and villages. SBM put into practice the concept of cooperative, competitive federalism by invoking the well-known Prime Minister–Chief Minister–District Magistrate construct, and added its own innovation to this formula: the grassroots-level Village Motivator! PM-CM-DM-VM thus became the effective implementation mechanism. It took the combined effort of the Central, state and district teams, however, to operationalize this approach.
My team at the Ministry and I travelled extensively to different states to actively engage with and motivate all levels of state government officials to put SBM in mission-mode in their own domains. I myself have travelled over 150 times to the field, visiting each state at least once. I would typically call on the Chief Minister, impress upon him or her the importance of the programme, always meet the Chief Secretaries and request them to put SBM on their top-three list of state priorities and then, perhaps most crucially, meet and motivate the young DMs. I always learned the most from these young officers who were constantly innovating and coming up with local solutions to make their districts ODF. Full kudos to these young, bright and energetic civil servants fully committed to development at the grassroots level.
We also held frequent national and regional workshops with DMs and chief executive officers (CEOs) of districts from across the country to get them to share experiences and learn from each other. Recognizing the work of DMs/CEOs by honouring them with national awards, including those presented by the Prime Minister himself, encouraged a healthy, competitive spirit among young field officers, all the way from the district level to the block development officer and the panchayat sachiv, in the race to become ODF.
Behaviour Change on the Ground
Along with the DM, the village motivator (VM), or swachhagrahi, trained in community approaches to sanitation, and played a critical role in behaviour change on the ground through inter-personal communication with the village community. Today, SBM has over 6,25,000 swachhagrahis, on an average of one per village. The swachhagrahi uses an array of context-specific tools and techniques, including social mapping and extensive discussion at both the community and individual household levels to convince people about the usefulness of building a toilet and then using it. In some cases, the health factor works, i.e. making parents, especially mothers, realize that defecating in the open meant that flies would carry the excreta back to the food chain at home and consequently spread disease. In others, warning the community about the contamination of groundwater through open defecation is a strong motivator. Disgust at the shameful habit of open defecation would also be evoked. In the end, after an intense face-to-face discussion with the community, the village would get ‘triggered’ into accepting the fact that open defecation was not good for their community and committing to become ODF in the shortest possible time.
Behaviour Change through Mass Media
Many myths and stigmas persisted in rural India, acting as steep barriers to behaviour change. These included misconceptions such as (i) having a toilet on the household premises is impure; (ii) only women need to use toilets and it is okay for men to go outside; and (iii) someone else needs to clean my toilet. Such widespread stigmas had the effect of constraining the demand for toilets and needed to be effectively tackled. Mass media played a big role in dispelling such myths and misconceptions. SBM ran several such campaigns, strongly supported by our brand ambassadors, including Amitabh Bachchan, Akshay Kumar and Anushka Sharma. The Darwaza Band (shut the door on open defecation) I and II campaigns became big hits and were used across the country on all media platforms in different languages. This campaign focused on the use of toilets, especially by men and also on sustaining the changed behaviour over time. Akshay Kumar’s Bollywood hit Toilet: Ek Prem Katha debunked the myth that it is impure to have a toilet at home and also encouraged women to stand up for themselves by steadfastly demanding a toilet for themselves. The radio campaign, Shaucha Singh, gave us a mascot who debunked these myths in all languages of India. Overall, the media – social, print, radio and television – played a big role in popularizing SBM and encouraging people to build and use toilets.
But it was not only the PM-CM-DM-VM formula and mass media programmes which resulted in behaviour change at scale. People from all walks of life adopted the SBM as their own and triggered a mass movement, aptly named a ‘jan andolan’ by Prime Minister Modi. Scale had to be addressed with scale and Team SBM leveraged a huge number of behaviour change agents across the country to lead the campaign. These included 12 crore school students, over 10 lakh masons, many of whom are women, 625,000 swachhagrahis, 250,000 sarpanchs, 700 district magistrates, over 500 young professionals (Zila Swachh Bharat Preraks) in the districts and over 50 national brand ambassadors. Needless to say, our Communicator-in-Chief, the Prime Minister himself, never missed an opportunity to talk about the importance of SBM and, from a national platform, motivated and exhorted his fellow countrymen to join and lead the programme to make the country ODF and swachh.
Such was the true involvement of all sections of society in this behaviour change effort that a 2019 study by the Gates Foundation has found that a communication spend of approximately Rs 25,000 crore was mobilized by SBM from various stakeholders, which is ten times the Government’s budgetary investment in behaviour change efforts, i.e. Rs 2,500 crore. The study further estimates that, on an average, every rural Indian has been reached by SBM-Grameen messages at least 3,000 times in the last five years.
In fact, multiple surveys including India Today ’s ‘Mood of the Nation Survey’, in the run-up to the 2019 general elections, found that SBM has made one of the strongest impressions on the respondents among government schemes. With a high number of women endorsing the programme, the government’s initiative to provide safe sanitation right to their households has received widespread appreciation.
Keeping the Buzz Alive
The SBM jan andolan involves all age groups and sections of society, and we ensured that this people’s movement manifested itself at regular intervals of time through tailored mass campaigns and large events with the Prime Minister. Be it the gathering of 6,000 women sarpanchs in Gandhinagar who were honoured by the Prime Minister for their contribution to Swachh Bharat on 8 March 2017 (International Women’s Day), the mass triggering of behaviour change in Bihar by 20,000 swachhagrahis from across the country in April 2018 to celebrate the 100th anniversary of Gandhiji’s Champaran Satyagraha movement, or the gathering of over 50 sanitation ministers from around the world, along with the UN Secretary General, in India to learn from the success of the Swachh Bharat Mission during the Mahatma Gandhi International Sanitation Convention (MGISC) 2019, the Mission has managed to stay relevant and exciting.
The autumn of 2017 witnessed over 5 crore primary schoolchildren across the country participating in swachhata painting and essay-writing competitions, resulting in mass awareness about sanitation. There was also active involvement of para-military personnel across the nation who participated in the making of short swachhata-related videos. This was followed by the Swachh Bharat Summer Internship in the summer of 2018, where over 4 lakh students and rural youth enrolled to perform swachhata-related activities across the country, including helping to dig toilet pits, clean villages and the dissemination of sanitation-related messages. Other events included the mobilization of over 20 crore volunteers for clean-up activities during the 15 September–2 October 2018 Swachhata Hi Seva campaign and the Swachh Sundar Shauchalaya (clean and beautiful toilet) toilet painting and decoration campaign in January 2019. The single biggest swachhata event during the entire five-year SBM period had to be the January–March 2019 Kumbh Mela, which was attended by more than 20 crore people. With over 1.2 lakh well-maintained toilets, it was almost universally acknowledged that this was truly a Swachh Kumbh, the likes of which had never been seen before. All of these campaigns ensured that the buzz of SBM remained alive and kicking. There was never a dull moment!
Sustaining the Changed Behaviour
Having achieved almost full sanitation coverage in the country, our focus over the past several months has been, and continues to be, on working with states, districts and villages to sustain the changed behaviour of toilet usage and make it last. Continuous efforts are needed at all levels to sustain behaviour change and efforts in this direction include ensuring that there are (i) adequate institutional arrangements at the Central, state, district and village levels for sustaining the change; (ii) appropriate financial incentives; (iii) continuing the IEC campaign; and (iv) strengthening the capacity of states, especially at the district, gram panchayat and village levels. Further, to keep the interest of the village community in sanitation alive, a detailed programme called ODF Plus, focusing both on ODF sustainability as well as on solid and liquid waste management (SLWM), is under implementation.
The Impact of SBM
The positive outcomes and impact of SBM are already being felt. First and foremost, the dignity and security of women and girls – the uncomfortable issue raised by Prime Minister Modi during his inaugural Red Fort speech – has been addressed by providing them privacy through the availability of individual household toilets. Broader health, economic and environmental outcomes of SBM have also been established over this relatively short period. A World Health Organization study in 2018 found that SBM will have saved over 3 lakh lives by October 2019, with over 1 lakh lives expected to be saved on an annual basis after that. A UNICEF study in 2017 found that 82 per cent people felt that their status and prestige have increased due to SBM, and 87 per cent women felt safer after getting a toilet at home.
The same study found that the economic benefits of sanitation were very tangible at the household level. Their study estimated that in an ODF village, each family saves up to Rs 50,000 annually on account of reduced medical costs, time which can be used more productively, and lives saved. The study also concluded that the economic benefits of sanitation per household outweigh the cumulative investment (government spend plus other modes of financing including household contribution) by 4.3 times over a ten-year period.
Highlighting other significant health benefits of sanitation, the Bill & Melinda Gates Foundation (BMGF) conducted a study in 2017 that showed significant improvements in diarrhoea prevalence, stunting and wasting among children, and in the BMI of women in ODF areas, as against comparable non-ODF areas. Further, an environmental impact study conducted by UNICEF in early 2019 has revealed that, in terms of faecal contamination, non-ODF villages were, on average, 11.25 times more likely to have their groundwater sources contaminated (12.7 times more from contaminants traceable to humans alone).
SBM’s positive ripple effect has spread to the creation of jobs as well. Direct employment opportunities have been created for masons, labourers and in industries supplying sanitaryware. Likewise, indirect employment opportunities have sprung up in several associated sectors. One estimate is that the achievement of an ODF India and the construction of about 10 crore toilets in the last 5 years generated over 90 crore person-days of employment. 2 The Toilet Board Coalition estimates that the sanitation market in India by 2021 will be a US $62 billion industry.
A very welcome result of SBM has been the empowerment of women and girls. Women, at all levels, have played a key role in the success of the programme, and SBM provided a unique opportunity for them to take a leadership role in their communities. Women comprised roughly 30-40 per cent of the volunteers – swachhagrahis – who led the process of ‘triggering’ behaviour change at the village level. The process of triggering depended heavily on surveillance committees – nigrani samitis – which had many women members, to persuade villagers not to defecate in the open. Women’s self-help groups, Mahila Samakhya groups, and other such bodies were also drawn into the campaign. In many states, elected women representatives in panchayati raj institutions also played an active role in implementing SBM. The Mission also created an opportunity for entrepreneurship. A World Bank study in 2018 on the leadership role of women in the SBM presented accounts from the ground on how women took on the job of masons, a traditionally male-dominated profession, and earned money from toilet construction.
Everybody’s Business
As a consequence of SBM, the idea of swachhata is now ingrained in the minds of most Indians and has also spread across sectors. The Railways have now achieved ‘ODF’ status as well: all railway carriages now have bio-toilets instead of the erstwhile iteration which had the opening for excreta to drop on to the track. All government schools in India now have separate toilets for boys and girls and all primary and community health centres have toilets as well. A Swachh Iconic Places initiative has also been implemented where some of the most important and iconic monuments of cultural, religious and tourist importance in the country have been made swachh to international standards. In addition, every Ministry celebrates a Swachhata Pakhwada in turn throughout the year, where sanitation-related activities are mainstreamed into their core programme. Further, each Department and Ministry now has a Swachhata Action Plan (SAP) which has a unique budget code (96), and is funded through the Department’s own resources. The total funds committed for the SAP during the two-year period of 2017–18 to 2018–19 were over Rs 35,000 crore or about US $6 billion. Sanitation has now truly become everyone’s business .
SBM’s iconic logo of Gandhiji’s glasses has become the nation’s pride and a true symbol of the ‘yes we can’ spirit of our people and all that we can achieve together. In fact, one can find the SBM logo on currency notes, calling attention to the country’s commitment to the cause. There is still much work to be done in the coming years, starting with the need to sustain our ODF status and also in implementing solid and liquid waste management, especially in urban and peri-urban India. But the good news is that sanitation has now firmly set its roots in the country’s developmental agenda.
Key Lessons Learned – the 4 Ps
After almost five years of implementation experience under SBM, the key lessons we have learned could be categorized under four buckets, which were shared with the international community, including the UN Secretary General, at the MGISC in October 2018. These are the 4 Ps: (i) Political Leadership (ii) Public Financing (iii) Partnerships and (iv) People’s Participation. This book is structured around the framework of the 4 Ps. The last P – People’s Participation – was perhaps the most integral to the success of SBM. The programme ultimately succeeded because the people of the country adopted the programme as their own and made it a jan andolan, a people’s movement, in much the same way as the Freedom Movement prior to 1947, when a mass people’s campaign, led by Mahatma Gandhi, ended the British Raj. Led personally by Prime Minister Modi, SBM became another great people’s movement, this time against open defecation, with similar spectacular results, ending with freeing India from open defecation.
Why This Book?
This book was conceptualized as a collaborative effort stemming from the very essence of sanitation being everyone’s business . An incredible achievement like making India ODF could only happen with the coming together of a range of stakeholders through a range of partnerships. Its vision is to share the journey and implementation model of the programme which overcame the significant challenges of scale, speed, stigma, and ensuring sustainability . The book also attempts to capture the intricacies, complexities and scale of SBM and give the reader a sense of how it all happened from multiple perspectives. Each author brings an individual level of expertise in the sector, as well as a glimpse of having worked with the Mission in some capacity. Many of them are leaders in their respective fields and key contributors to India’s development and growth story. From the lens of these authors, this compendium of essays attempts to provide a macro as well as micro perspective to cover the journey of SBM across topics. The essays in this book, categorized under the framework of the 4 Ps, provide a timely and crucial input to the national and global sustainable development agenda, and I am grateful to be able to share them with you.
My twenty-five years’ experience in the water and sanitation sector has appropriately culminated in the pursuit of what many people thought was an impossible dream. The Swachh Bharat Mission turned out to be possible due to the vision and transformational leadership of Prime Minister Modi, which in turn triggered the jan andolan, perhaps the biggest behaviour change movement ever. I would like to sincerely thank each of the authors who contributed to this book. I hope that the readers enjoy the incredible story of the Swachh Bharat Mission through their essays.