A joint research by LSHTM, KIIT and Emory University found improvements in toilet use and coverage, better child faeces management and reduced diseases among children in selected programme villages of Gram Vikas.

Lack of clean water and poor sanitation and hygiene habits such as open defecation and unsafe child faeces disposal in rural households exposes children to enteric pathogens associated with a range of poor health outcomes. Although government efforts have increased toilet coverage, open defecation continues to be widespread in vast areas of rural India, with only a few households having access to safe running water, toilets and bathrooms in their homes. 

Between June 2015 and October 2016, Emory University, USA, KIIT University, Bhubaneshwar, and London School of Hygiene and Tropical Medicine, London, in collaboration with Gram Vikas assessed the long term effectiveness of Gram Vikas’ water and sanitation interventions on child health outcomes. The matched cohort study, with 45 programme and 45 control villages, was conducted in Ganjam district of Odisha where the intervention was completed five years ago. 

Every household, in each of the 45 villages, selected for the study has piped water supply to the kitchens, bathrooms and toilets. The water and sanitation infrastructure in these villages are community-owned and managed as under the MANTRA approach of Gram Vikas. In contrast to most interventions with only community water supplies and/or partial community sanitation coverage, the Gram Vikas programme provides piped water at each home and ensures that every household has improved toilet and bathing rooms. 

Study Findings

Gram Vikas intervention villages had higher and improved toilet coverage (85% vs 18%), more adults using toilets (74% vs 13%) and more people practising safe disposal of child faeces (35% vs 6%) than the control villages. Children in these villages also had lower rates of soil-transmitted helminthiasis and improved height-for-age scores (HAZ scores). The protective effect of the combined water-sanitation intervention model on HAZ scores is noteworthy in a country like India, which has one-third of the world’s stunted children. 

While the programme helped achieve substantial gains in WaSH coverage, access and use, intermittent availability of preferred water and high levels of water storage continued to be a possible source of exposure to enteric pathogens for children. 

A first of its kind study evaluating the effectiveness of a combined on-premise water and sanitation intervention in rural India, and the first to assess the longer-term impacts of such an intervention, it noted that “a combined intervention, where provision of household piped water connections is contingent on community sanitation coverage, can substantially decrease open defecation.” 

Read the full paper published by Oxford University Press on behalf of the International Epidemiological Association: https://bit.ly/2SSzrOT