“When I got pregnant, it was hard to walk to the field to defecate as the path was not safe. My mother-in-law used to accompany me because I needed help sitting down and getting up.”–Maheshwari (25), Raichur, India. India has the highest number of people, 732 million, with no access to toilets and women and girls are among the worst affected.
 
The report by WaterAid, titled Out Of Order:The State of the World’s Toilets 2017, further stated that 355 million women and girls lack access to a toilet. If they were to stand in a line, the queue could circle the Earth more than four times.

 
Source: WaterAid
Note: Data as of 2015
 
India’s low ranking on the sanitation index is despite the changes brought by the government’s Swachh Bharat (Clean India) Mission. Launched in October 2014, it increased the country’s sanitation coverage from 39% to 65% by November 2017, according to government data. In this period, 52 million household toilets were built in rural India.
 
The cleanliness campaign has reduced the proportion of people defecating in the open by 40%, meaning more than 100 million people now use toilets, according to the WaterAid report.
 
India also ranks sixth among the top ten nations working to reduce open defecation and improving access to basic sanitation. The percentage of population without access to at least basic sanitation fell from 78.3% in 2000 to 56% in 2015, according to the report.
 
Diarrhoeal diseases kill 60,700 Indian children each year
 
Each year, 60,700 children under five years die from diarrhoeal diseases, the WaterAid report said.
 
Diarrhoea remains the second leading cause of death in Indian children under five years, killing an estimated 321 children every day in 2015, as IndiaSpend reported on July 29, 2017, based on a World Health Organization factsheet.
 
Hookworms, which can spread through open defecation, cause diarrhoea, anaemia and weight loss in women, according to the report. These problems are linked to low birth weight and slow child growth–38% of children in India under five are stunted, according to the National Family Health Survey, 2015-16, (NFHS-4) data.
 
Indian states with poor access to sanitation report high incidence of diarrhoeal diseases. Uttar Pradesh, Bihar, Madhya Pradesh, Assam and Chhattisgarh had the highest rate of mortality among children under five years of age, higher stunting (low height-for-age) rates and higher prevalence of diarrhoea due to poor sanitation, as IndiaSpend reported on April 26, 2017, based on NFHS-4.
 

States With Higher Access To Improved Sanitation
Had Lower Prevalence Of Anaemia, Diarrhoea

Source: National Family Health Survey 2015-16
*reported in two weeks preceding the survey **Among women aged 15-49 years
 
The tables above show the top five and bottom five states based on the percentage of households with improved sanitation, according to NFHS-4. States with higher percentage of improved sanitation have lower levels of anaemia among women (both pregnant and non-pregnant). These states also reported fewer cases of diarrhoea than the national average.
 
For example, Kerala, which had the highest percentage of households with improved sanitation (98.1%)–the national average was 48.4%–also had the lowest prevalence of diarrhoea (3.4%) and the lowest percentage of women with anaemia (22.6%).
 
Bihar, with only 25% households using improved sanitation, had the highest prevalence of diarrhoea (10.2%) and the highest percentage of anaemic pregnant women (58.3%).
 
For women, high risk of illiteracy, harassment
 
Apart from poor health, lack of toilets means that more than 1.1 billion women and girls globally get limited education and face harassment. In rural India, high dropout rates and non-enrolment among girls can be attributed to absence of toilet facilities, as IndiaSpend reported on July 19, 2017.
 
In rural India, 23% of girls have listed menstruation as the chief reason for dropping out of school. As many as 28% of them said they do not go to school during their period because they lack clean and affordable protection, as IndiaSpend reported on June 19, 2017.
 
Sanitation policies should cover the needs of those who are vulnerable, said Raman VR, head of policy at WaterAid India.
 
“Adolescent girls and women want facilities in which they can manage their periods safely and hygienically,” he said, “Pregnant women need easily accessible and usable toilets, and the elderly or people with disability require toilets with design features that help overcome the physical constraints they typically face.”
 
(Salve is an analyst at IndiaSpend.)

Courtesy: India Spend
 

The post 732 Million Indians Have No Access To Toilet, At Risk Of Diseases: New Report appeared first on SabrangIndia.

 
Uttar Pradesh (UP), Bihar, Madhya Pradesh (MP), Assam and Chhattisgarh had India’s highest under-five mortality, higher stunting (low height-for-age) rates and higher prevalence of diarrhoea due to lack of “improved sanitation”–usually a house with its own latrine connected to a sewer or septic tank–according to the National Family Health Survey 2015-16 (NFHS-4).
 
Unsafe water, poor hygiene practices and inadequate sanitation are not only the causes of the continued high incidence of diarrhoeal diseases but a significant contributing factor in under-five mortality caused by pneumonia, neonatal disorders and undernutrition, according to this 2016 report by the United Nations Children’s Fund.
 
Poor sanitation makes unhealthy children prone to water-borne diseases such as diarrhoea, jaundice and cholera, as IndiaSpend reported on January 6, 2016.
 
Improved sanitation, as we said, refers to a household with its own toilet, connected to a piped sewer system or flush to septic tank, flush to pit latrine, ventilated improved pit/biogas latrine, pit latrine with slab, twin pit/composting toilet, which is not shared with any other household.
 

Source: National Family Health Surveys 2005-06 and 2015-16
Under-five mortality rate: deaths of children under the age of five per 1,000 live births
 
India’s under-five mortality rate–deaths of children under the age of five per 1,000 live births–declined from 74 in 2005-06 to 50 in 2015-16. Over the same time period, households with have improved sanitation have gone up from 29.1% to 48.4%.
 
Bihar has the the lowest percentage (25%) of households with improved sanitation, and the state recorded an under-five mortality rate of 58 deaths per 1,000 live births in 2015-16.
 
One of the leading causes of under-five mortality is diarrhoeal diseases, mostly caused due to lack of sanitation, according to this 2015 study by Public Health Foundation of India, a Delhi-based think tank.
 
Bihar is followed by Chhattisgarh, with only 32.7% of households reporting use of improved sanitation facilities.
 
Uttar Pradesh has the highest under-five mortality (78 deaths per 1,000 live births) and only 35% households reported use of improved sanitation facilities.
 
Only 44% rural households in UP reported toilet coverage till October 2016 under the Swachh Bharat Abhiyan (Gramin), a central government programme to make India open defecation-free by October 2, 2019.
 
As many as 77% rural households practice open defecation (as against the national average of 55%), IndiaSpend reported on October 1, 2016.
 

 
Diarrhoeal diseases are the third largest cause of deaths among children under the age of five in India, according to this 2015 study by Indira Gandhi Medical College and Research Institute, Puducherry.
 
UP, with the highest under-five mortality rate of 78, also reported the highest prevalence (15%) of children suffering from diarrhoea prior to the survey.
 

Diarrhoeal diseases are also responsible for stunting in children (low height-for-age), according to this 2015 study by The institute of Fiscal Studies, a UK-based think tank.
 
“Growth failure (stunting), often associated with poor nutrition, is correlated, likely in a causal way, with lower educational and labour market attainments,” the study said.
 
(Salve is an analyst with IndiaSpend.)

Courtesy: India Spend
 

The post Sanitation Failures Kill, Stunt Children Most In UP, 4 Other States appeared first on SabrangIndia.