India with a population of 1.25 billion is the second most populous country in the world with a large chunk of the population, as high as 69%, resides in rural India, mostly villages and countryside. The development of human resources, especially of those living in the countryside is indispensable for growth of India. Human resource development lies at the heart of economic, social and environmental development. It involves the provision of facilities in the field of health, sanitation, nutrition, education, etc. by the specific needs of the vulnerable population.

Human health is an essential component of sustainable development. Among the indicators selected at the UN Conference, on Basic Social Services for All in 1997, ‘the percentage of the population with access to safe water and sanitation’ was one too. Sanitation, simply, refers to the maintenance of hygienic conditions, through services of garbage collection and wastewater disposal. It also includes the safe disposal of human and animal faeces and urine.

Lack of sanitation has many serious health repercussions along with economic losses amounting up to US$260 billion annually. In 1997, 33% of all deaths, worldwide, were due to infectious and parasitic diseases. About 1.7 million deaths a year worldwide are attributed to unsafe water, sanitation, and hygiene, mainly through infectious diarrhoea. It was found that nine out of ten such deaths is in children, and virtually all of the deaths are in developing countries (WHO, 2002). WHO stated that, by 2025 there were still be 5 million deaths among children under 5 years of age and 97% of them will occur in developing countries, most of them will be due to infectious diseases combined with malnutrition.

Lack of adequate sanitation is a pressing problem in India. Open defecation is a traditional behaviour which is attributable to a combination of factors, most prominent being a lack of awareness of the people about the associated health hazards. Around 595 million people, which are nearly half the population of India, defecate in the open. India accounts for 90 percent of the people in South Asia and 59 percent of the 1.1 billion people in the world who practice open defecation. These practices lead to contamination and spread of diseases, about 43 percent of children in India suffers from some degree of malnutrition – attributed to water, sanitation, and hygiene. There is also, an important gender dimension since women and girls suffer most, risking sexual assault while open defecating away from the village in the dark. Furthermore, the total annual economic impact of inadequate sanitation in India amounts to a loss of ₹2.4 trillion ($53.8 billion) in 2006. There is a per capita annual loss of ₹2,180 ($48). Prevailing High Infant Mortality Rate is also largely credited to poor sanitation.

The concept of sanitation was earlier limited to disposal of human excreta by cesspools, open ditches, pit latrines, bucket system etc. At present it connotes a comprehensive concept, which includes liquid and solid waste disposal; food hygiene; and personal, domestic as well as environmental hygiene. Proper sanitation besides being necessary from a  general health point of view, has a vital role to play in our individual and social life too. Sanitation is one of the basic determinants of quality of life and human development index. Sanitation can reduce the incidence of infectious diseases by 20% to 80% by inhibiting disease generation and interrupting disease transmission. The concept of sanitation was, therefore, expanded to include personal hygiene, home sanitation, safe water, garbage disposal, excreta disposal and waste water disposal.


In response to the fore mentioned problems and requirements, rural sanitation programme in India was introduced in the year 1954 as a part of the First Five Year Plan of the Government of India. The 1981 Census revealed rural sanitation coverage was only1%. The International Decade for Drinking water and

Sanitation during 1981-90, began giving emphasis on rural sanitation.


Central Rural Sanitation Programme (CRSP) was launched in 1986 primarily with the objective of improving the quality of life of the rural people and to provide privacy and dignity to women.

Since its inception and up to the end of the IXth Plan, 9.45 million latrines were constructed for rural households under the CRSP as well as corresponding State MNP (Minimum Needs Programme). The total investment made under the CRSP was US$ 138 million, and under the State sector MNP, US$ 232 million.

Despite the massive outlays for sanitation the Programme led to only a marginal increase in rural sanitation coverage, with an average annual increase in the rural sanitation coverage of only 1 percent for the reason that CRSP was based on erroneous assumption that provision of sanitary facilities would lead to increased coverage and usage. Poor utilization of whatever toilets were constructed under the Programme was due to many reasons i.e. lack of awareness, poor construction standards, emphasis on high-cost designs, the absence of participation of beneficiaries, etc. Additionally, most of the States could not provide adequate priority to the sanitation programme. The CRSP had also neglected school sanitation, which is considered as one of the vital components of sanitation. CRSP also failed to have linkages with various local institutions like Integrated Child Development Services, Mahila Samakhya, PRIs, NGOs, research institutions, Self-help Groups, etc.


After 13 years of slow rural sanitation progress, the Total Sanitation Campaign was launched in 1999. The Total Sanitation Campaign (TSC) was a community-led, people-centred, demand-driven and incentive-based programme ideal to address India’s rural sanitation crisis. The TSC Guideline appeared to present an ideal, cutting-edge policy to eliminate insanitation in rural India, advocating a shift from a high subsidy to a low subsidy regime, a greater household involvement and demand responsiveness.

The concept of total sanitation – the entire community becoming open defecation-free (ODF) – was reinforced with the introduction of the Nirmal Gram Puraskar (NGP) in 2004. NGP is a clean village award scheme in which high-level authorities distributed cash to Gram Panchayats (GPs) for achieving total sanitation.

However, the sound policy did not translate to good practice because interventions were poorly implemented. As a result, outcomes were insufficient. Reported progress was exaggerated: actual rural sanitation coverage in India was 31% in 2011, as per India’s last census, not 68% as reported by India’s Department of Drinking Water and Sanitation. TSC was, in fact, a government-led, infrastructure-centred, subsidy-based and supply-led programme. The TSC’s poor performance was officially confirmed in late 2011 when India’s Minister of Drinking Water and Sanitation stated, the “TSC has been a failure. It is neither total nor sanitation nor a campaign.”


Encouraged by the success and high publicity that villages got through the NGPs, TSC was renamed and re-established as Nirmal Bharat Abhiyan in 2012. Most of the TSC objectives and strategies remained intact; still the year to attain the vision was extended from 2017 to 2022. Conversely, the vision was shifted from “access to toilets to all” to “attaining Nirmal status.” The objectives specifically mentioned  the provision of toilet facilities in schools that were not under Sarva Siksha Abhiyan, but a year of achieving the target was not mentioned (Under TSC, the year of provisioning toilet facilities in school was 2013).

The strategy was to transform rural India into ‘Nirmal Bharat’ by adopting the 'community led' and 'people-centred' strategies and community saturation approach. A "demand driven approach" was to be continued with emphasis on awareness creation and demand generation for sanitary facilities in houses, schools and for a cleaner environment.  Rural School Sanitation was a major component and an entry point for wider acceptance of sanitation by the rural people. Wider technology options were being provided to meet the customer preferences and location- specific needs. Intensive IEC Campaigns were planned for the involvement of Panchayati Raj Institutions, Cooperatives, ASHA, Anganwadi workers, Women Groups, Self Help Groups, NGOs etc.

A report by the CAG covering TSC and NBA from 2009 to 2014, pointed out the various flaws in NBA. The MDWS had shown an achievement of construction of 693.92 lakh IHHLs up to February 2011 in 16 states. The actual figure being 367.53 lakh households (Census 2011) having toilets within the premises. With respect to management of funds, it was pointed out that the ministry only released 48% of the funds demanded by the states and 16 states did not release their share of funds at all. Also, in nine states of Andhra Pradesh, Assam, Gujarat, Jammu & Kashmir, Kerala, Manipur, Madhya Pradesh, Maharashtra and West Bengal around ₹212.14 crores remained unutilized for periods ranging between 4 months to 29 months at state/district/block/gram panchayat level.


Launched on the birth anniversary of Mahatma Gandhi, the Swachh Bharat Abhiyan is a restructured Nirmal Bharat Abhiyan which aims to achieve Swachh Bharat by 2019, as a fitting tribute to the 150th Birth Anniversary of Mahatma Gandhi.

It has two submissions: the Swachh Bharat Mission (Gramin) and the Swachh Bharat Mission (Urban).

In rural areas, it advocates improving the levels of cleanliness in rural areas through Solid and Liquid Waste Management activities and making Gram Panchayats Open Defecation Free (ODF), clean and sanitised. The Mission shall strive for this by removing the bottlenecks that were hindering the progress, including partial funding for Individual Household Latrines from MNREGS, and focusing on critical issues affecting outcomes.

India needs 847 lakh toilets to be constructed in the next 4 years for attaining Swachhta. Since the initiation of the SBA, 182.12 lakh toilets have been constructed, and 59786 villages have been self-declared as ODF.

India has witnessed both Government led top-down aid models that involve funding sanitation products, subsidizing toilet costs, as well as building latrines and providing incentive for doing so; as well as community led sanitation policies give wish to increase awareness of the importance of sanitation. Swachh Bharat Abhiyan is an integration of both these models.

Swetaparna Sarangi of NIT Rourkela interned with the centre for a month. She reviewed the state policies on water and sanitation from a historical perspective. She pointed out that despite massive outlays for sanitation, the programme for sanitation in India has converted to only a marginal increase in the field of rural sanitation with an average annual increase of only 1%. This is because CRSP (Central Rural Sanitation Program) was based on erroneous assumption that provision of sanitation facilities would lead to increase of coverage and usage.