A decade of the Total Sanitation Campaign - Rapid assessment of processes and outcomes - A report by the Water and Sanitation Program (2011)

Districts have been able to implement the sanitation programme successfully because they have religiously followed the protocols laid down in the TSC guidelines.

The Water and Sanitation Program has analysed secondary data on the Total Sanitation Campaign (TSC) available on government websites and conducted primary analysis in 22 sample districts spread across 21 states.

 With the use of secondary and primary data the report has not only been able to give a macro view of the TSC but also has been able to go into the nitty-gritty of the campaign. There are case studies of districts and villages that have achieved open defecation free status.

The study identifies 6 process indicators at the district level and grades the districts according to the use of these processes. They are - strategy for TSC implementation, institutional structure and capacity, programme approach to creating demand and scaling up, technology promotion and supply chain, financing and incentives and finally monitoring.

The report has been broken down into 5 chapters which are

  1. Introduction
  2. Towards nirmal bharat: The total sanitation campaign
  3. A decade of TSC: Progress and status
  4. TSC process and outcomes at the district level: Findings of the rapid assessment
  5. Summary and recommendations

A second document contains all the annexures. The annexures include data on benchmarking states and districts on the various process indicators, expenditures for constructing toilets at schools and in the homes of Above Poverty Line (APL) and Below Poverty Line (BPL) families, per capita district budget, average expenditure in anganwadi's etc.

This chapter provides a history and the rational of the TSC. Sanitation was a low development priority, this neglect was also reflected in the 2001 census data that determined that only one in five rural households had access to a toilet. The central government launched the campaign in 1999 to  achieve total sanitation by 2012. The innovation in the programme was that local bodies who are involved with communities would be involved in the implementation of the campaign.

In 2003, to boost the campaign, the centre announced the Nirmal Gram Puruskar. This award is a cash incentive to the local body's like the Gram Panchayat to achieve total sanitation.

A literature review, analysis of secondary data and collection and analysis of primary data was conducted for this report.  Here, a detailed explanation of the steps involved in the process, the rationale behind the steps and the names of states and districts covered are provided. Further, the system of grading come up with for different processes and their implementation is explained.

Towards nirmal bharat: The total sanitation campaign
The need for proper sanitation stems from the fact that everyday in India an estimated 1,000 children below five years of age die because of diarrhoea. Illnesses caused by lack of sanitation reduces productivity and depletes resources of families. Women and the girls face a lot of problems because of a lack of sanitation and there is a correlation between toilets in schools and continued education enrolment by young girls and teenage women.

It was only in the sixth five year plan that rural sanitation finally found mention. Further the central government moved the responsibility for rural sanitation from Central Public Health and Environmental Engineering Organisation to the Rural Development Department. The initial programme for rural sanitation was top down; the Central Rural Sanitation Programme (CRSP) had a narrow view of sanitation which was focused on construction of toilets and depended on one technology. There was no effort at social re-engineering. Thus even though more than Rs. 660 crore was spent and 90 lakh latrines constructed rural sanitation grew at 1% throughout the 90's.
Thus there was a rethink which lead to a new campaign which was not only demand oriented but was also based on the understanding that construction of toilets does not result in sanitation. The campaign fed off from the desire of the entire community to adopt safe sanitation and therefore the devolution of powers to the local bodies. This approach was reinforced by the institution of the Nirmal Gram Puraskar.

Tables provide information on the incentives provided by this award to both the community and those implementing the sanitation campaign. A flow chart provides the decision making structure and the direction of flow of funds for this campaign.

It has been found that there has been an increase in the level of acceptance of sanitation in rural India. Sanitation coverage has increased from 22% in 2001 to 65% in 2010. Graphs provide more information on this. However, from the data analysis one sees a difference in sanitation coverage between states which is also analysed through graphs and tables.

A decade of TSC: Progress and status
Secondary data for different states and districts is analysed by looking at-

  • the scale of the sanitation challenge in terms of number of households and schools without toilets etc,
  • the type of inputs and monetary allocation for project hardware and software components,
  • quantitative results in terms of number of toilets built,
  • qualitative outcomes in terms of number of award winners.

It was found that the average allocation for the total sanitation campaign in the districts was Rs 30 crore. Arunachal Pradesh had the lowest allocation - Rs 4 crore while Andhra Pradesh had the highest at Rs 73 crore. It was found that more was spent in the hardware component of the programme. Data is also provided on such expenditure for households and schools in each state through tables and graphs. The average school toilet expenditure is Rs 17,320/-.

Coverage of school sanitation under TSC in each state is provided through a graph. Also there are comparisons between sanitation coverage in schools and households.

It was found that most states gave equal importance to BPL households and APL house holds in providing sanitation. However, nationally BPL households were given higher priority.

TSC process and outcomes at the district level: Findings of the rapid assessment
The TSC moves from the top down approach to community participation therefore there was need to ascertain the level of understanding of this within district officials. 89% of the officials in the sample districts had an understanding of the TSC framework and its principles. Further, many districts aspire to achieve the Nirmal Gram Puraskar. However, despite this understanding there was a lack of strategy to ensure that the spirit of the TSC was carried through from planning to its implementation. On analysis, it was found that this was because implementation was based on unrealistic targets.

It was also found that there was need to enhance inter-departmental coordination. Further there was need for the common understanding to percolate to the lower officials at the sub-district level. As there is a nodal agency involved in the implementation of the TSC it was found that the district officials were not very well informed of the TSC implementation and progress in their area. Case studies where such problems were solved are provided as benchmarks that can be followed by other districts.

Analysis of monitoring systems at the block, district and village level and the financing and incentive programme are also provided.

Summary and recommendations
It has been recommended that there has to be more focus on the processes that lead to total sanitation. Sustainability of change in behaviour  only happens if there is a participatory process where the community understands and appreciates the benefits of total sanitation. There is also need to monitor successes to ensure that there are no slippages.

The report provides a thorough analysis of TSC. Beginning with its history and current status it provides a break down of what has gone right and what has gone wrong in this campaign. This report would be of interest to people who are decision makers and to those interested in sanitation in general.

Download the report here:



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