A recent report published in Nature-reveals that India's Swachh Bharat Mission, launched in 2014, has played a pivotal role in reducing infant and under-five mortality rates. Improved access to toilets, clean water, and better sanitation across rural and urban areas has resulted in a considerable decrease in deaths among children under five.
The Swachh Bharat Mission, initiated by Prime Minister Narendra Modi, has been instrumental in transforming India's sanitation landscape. A quasi-experimental study analysed data from 35 states and 640 districts over nine years and found that districts with significant toilet construction saw infant mortality rates decrease by 5.3 points and under-five mortality rates drop by 6.8 points.
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Prime Minister Modi expressed his satisfaction on X (formerly Twitter), acknowledging the report’s findings and emphasising the crucial role that proper sanitation plays in reducing infant and child mortality. He noted that clean, safe toilets have become a "game-changer" for public health.
With India accounting for one-fifth of global under-five deaths, the Nature study sought to examine the Swachh Bharat Mission’s effect on these alarming statistics. The study found that every 10-percentage point increase in toilet access at the district level corresponded with a 0.9-point reduction in infant mortality and a 1.1-point drop in under-five mortality.
The report also highlighted the broader health benefits of the mission, which helped curtail open defecation. Open defecation has been a persistent issue in rural and some urban areas of India, leading to contamination and a rise in diseases such as diarrhoea and typhoid. The widespread availability of toilets helped mitigate these risks.
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The Swachh Bharat Mission is the largest sanitation programme in the world, building over 100 million household toilets and declaring six lakh villages open-defecation-free. From 2015 to 2020, India saw a two-fold increase in toilet availability and a decline in open defecation rates from 60 percent to 19 percent.
While the study highlighted concerns over the actual usage of newly built toilets and sustained behavioural changes, it also underlined the programme's significant contribution to improving child healthcare in India. Alongside sanitation improvements, there were advancements in maternal education, healthcare access, and the availability of clean cooking fuel.
The mission continues to demonstrate how large-scale national initiatives can lead to widespread improvements in public health, saving thousands of young lives each year.