Role of WASH and Agency in Health: A study of isolated rural communities in Nilgiris and Jalpaiguri
Shyama V. Ramani
#2017-020
The objective of the Swachh Bharath Mission (SBM) or Clean India Mission
of the Indian Government is to eliminate open defecation in India
through installation of toilets and triggering of behavioural change by
2019. The problem is most daunting in isolated communities with poor
WASH infrastructure and local agencies with scarce resources. In India,
tribal communities, living near forests and along mountain ranges are
among the most isolated, which means that the study of the impact of
WASH (water, sanitation and hygiene behaviour) and the effectiveness of
local agencies responsible for public hygiene in such communities is
pertinent for our research query. Thus, this working paper presents the
results of a study of 20 villages located in two districts, Nilgiris and
Jalpaiguri, in two distinct Indian states - Tamil Nadu and West Bengal
respectively. The central research question is: What is the role of WASH
infrastructure and capabilities and local agencies in containing the
incidence of excreta related diseases in isolated rural Indian
communities? A novel multi-level model is developed and estimated and
further validated through focus research groups. It confirms that
disease incidence is jointly determined by the quantity as well as the
quality of WASH. The role of agency seems to matter more at village
level rather than at the household level.
Keywords: WASH, Sanitation, Health, Policy, India
JEL Classification: I15, O10, O20