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Despite initial hiccups, Swachh Bharat mission scores on health report card

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Study reveals health indicators for children, women have shown improvement in areas that have become open defecation-free under Swachh Bharat in the past year.

Even as questions are being raised over the Narendra Modi government’s track record of delivering on the Swachh Bharat mission, there is one report card where the PM’s pet project seems to be scoring well — the state of health report.

A study, undertaken by the Bill & Melinda Gates Foundation (BMGF) on behalf of the drinking water and sanitation ministry to assess the health impact of the Swachh mission in rural areas, reveals that health indicators for children and women have shown considerable improvement in areas that have become open defecation-free (ODF) in the past one year.

The report, accessed by ThePrint, shows that the cases of diarrhoea among children are 46 per cent more in non-ODF areas; there are 78 per cent higher cases of worms in stools of children in non-ODF areas; 58 per cent higher cases of stunting among children and 48 per cent more cases of women with lower body mass index (BMI) than those in non-ODF areas.

The study observes that “becoming ODF had a positive impact on child’s health and nutrition, evident from the fact that the health and nutritional indicators of the children and mothers belonging to the ODF areas were comparatively better than their non-ODF counterparts”.

It notes that if there were 13.9 per cent children with diarrhoea in the past two weeks preceding the survey on non-ODF areas, the figure was 9.3 per cent in ODF areas.

Similarly, against 7.4 per cent children found with cholera in the past two weeks before the survey in non-ODF areas, the same was 1.7 per cent in case of ODF areas.

The report says there were 39.6 per cent stunted children in areas infested with open defecation, while it was 33.7 per cent in ODF areas. There were 29 per cent women with a BMI below normal in a non-ODF area while the figure was 19.6 per cent in case of areas declared free of open defecation.

Some of the survey results of the Bill & Melinda Gates Foundation
Data: Bill and Melinda Gates Foundation report

According to government data, over 2.5 lakh villages in 217 districts have been declared free of open defecation so far and there has been a 30 per cent increase in households with toilets since 2 October 2014 when the mission was launched by the PM.

As part of this rapid pilot study, information was collected around three key child morbidity illnesses — diarrhoea, fever and intestinal worms and nutrition,child and mother anthropometry.

A total of 4,000 households were interviewed for the study — 2,000 each for ODF and non-ODF villages. Twenty villages each were selected from one ODF and one non-ODF district in five states — Uttar Pradesh, Madhya Pradesh, Rajasthan, West Bengal and Karnataka.

“This study is one of the clearest evidence we have now on how open defecation affects health. The report shows increased stunting, malnutrition, respiratory problems in children living in areas where open defecation is prevalent,” a top official from the ministry of drinking water and sanitation told ThePrint.

Diarrhoea which claims so many lives of children, also has a clear co-relation with the prevalence of open defecation, the official added. “That is why we are so focused on involving women and children in our mission — we have over one lakh women ‘swachh aagrahis’ and they are our biggest ambassadors, educating village after village on how becoming open defection-free can free the children of diseases.”


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