The NFHS-5 Sanitation Story: Case for Moving from Access to Adoption

Abstract

This commentary analyses the recently launched National Family Health Survey (NFHS-5) (2019–2020) factsheet to investigate the claim of an open defecation free (ODF) India. The official data from Swachh Bharath Mission (SBM) was used to declare India ODF on 2 October 2019. The SBM statistics reported that India has achieved 100% sanitation coverage, that is, the fraction of households with access to individual household latrines (IHHLs). However, the NFHS-5 data shows that even though India witnessed an improvement in sanitation in the past four to five years, we are far from achieving universal elimination of open defecation. In an attempt to evaluate the differing claims made regarding India’s ODF status by two Government of India’s data sources, I explain the distinction in their objectives. While the SBM captures access to IHHLs, NFHS-5 records the place which the members of the household usually use for defecation. The two datasets jointly suggest that access to toilets does not concurrently translate to its usage. Hence, determining the ODF status of Indian communities on mere access to toilets is an inadequate representation of the sanitation environment. There is substantial merit in moving the sanitation outcomes from access to the adoption of toilets.