Archive for RICE Institute: Get Involved!

Do religious leaders talk about defecation in India?

Written by on July 30th, 2014

The SQUAT Survey teams randomly selected and interviewed around 3,200 rural households in over 300 villages in Bihar, Haryana, Madhya Pradesh, Rajasthan, and Uttar Pradesh.

Figure 1

char 1

We asked people if their religious leaders have ever told them where they should defecate or where they should not. Among all respondents, both those who have a working latrine or those who do not, 47% of Muslim respondents and only 29% of Hindus said that their religious leaders have told them something about where they should or should not defecate. This trend does not change if we look at the subset of people who own government latrines or even for those who built their latrine spending their personal money.

Figure 2

chart 2

Another interesting finding (Figure 2) from the SQUAT data comes from when we asked people what specific messages on defecation they had heard from their religious leaders, if they had heard one at all. More Muslim respondents said that their religious leaders ask them to use a latrine than Hindu respondents. We also found the opposite: more Hindu respondents than Muslim respondents said that their religious leaders ask them to defecate in open. There was not much difference between Hindu and Muslim respondents in terms of religious leaders asking them to go far from their house for defecation.

Researches in the past have shown difference in latrine access between hindus and muslims. And if we account the negative externality of open defecation on India’s children it is worth exploring as to why the difference exists. These may be preliminary finding but they certainly point towards a direction where much more can be explored.

New Maps: Which country has the most open defecation in the world?

Written by on July 1st, 2014

Using the method described by Friedrich Huebler on his blog, and using estimates of the WHO / UNICEF Joint Monitoring Programme on Water Supply and Sanitation, and with advice from my friend Srini, I created an open defecation map of the world. 

Open Defecation in the World, 2012

Map 1: Open Defecation in the World, 2012

The good news, as many of you are probably aware, is that open defecation is on its way out in most of the world. About 14% of the world defecates in the open. This statistic masks vast differences between countries, however: almost no one defecates in the open in China, while in neighboring India, about 48% of the total population defecates in the open.

Indeed, open defecation is increasingly concentrated in India, and some very poor conflict-torn countries, such as South Sudan and Chad. Most very poor countries, such as Bangladesh, Afghanistan, and Congo, have reduced open defecation, and moved up the “sanitation ladder” – a term used by sanitation professionals to describe the various rungs of a ladder, from the most unhygienic open defecation to the most hygienic “improved sanitation“.  Most of the people in these poor countries still don’t have “improved sanitation,” but they have moved up the “sanitation ladder” and are well on their way to eliminate open defecation.

India stands out in this comparison. It is not as poor as sub-Saharan countries, but is worse than most of them. Only a handful of countries in the world have worse open defecation than India. Part of the reason is that whereas people in the rest of the world are happy to move to kachha unimproved or shared latrines, the “sanitation ladder” in India is mostly absent. You can read more about this in SQUAT working paper no. 1‘s section 3.1.2 and Table 1:

The data for India show a “missing middle”: no country listed has a smaller ―middle fraction of unimproved or shared sanitation. Many countries, in contrast, have both a lower fraction of the population defecating in the open and a lower fraction with improved sanitation. In India, only 16% of the population is on a middle rung, compared with 40% in Bangladesh, and 45% for sub-Saharan Africa overall. Although the table only presents country-level statistics, the contrast for rural India is even starker: only 6% of rural Indians are in a middle category. In many countries, proceeding up the sanitation ladder was not only the path out of open defecation, but also an important step towards improved health and human capital.

Many people in rural India can afford to build simple latrines that people in poor countries such as Bangladesh use. It is also important to note that while present in Urban India, open defecation is primarily a rural issue: 89% of all the people who defecate in the open In India live in rural areas.

Open defecation, Rural, proportion, 2012

Open Defecation in the World, Rural, 2012

Map 2: Open Defecation in the World, Rural, 2012

Map 2 shows the proportion of the rural population that defecates in the open. You would see that all of South Asia, which is much poorer than India, and indeed, most of sub-Saharan Africa, has less rural open defecation than India. The countries which do have higher rural open defecation are horrible places to be in – Eritrea, South Sudan, or Chad. No one would recognise it as an achievement that India is better than these places in rural open defecation.

But is India really better than these countries when it comes to open defecation? Rice’s research shows that “Open defecation is particularly harmful to children’s health where population density is high”. Indeed, even intuitive reasoning would lead to the conclusion that for a kid, what matters is not the proportion of people defecating in the open in a country, but the number of people defecating in the open around his or her surroundings. A way to measure that is to measure number of people defecating in the open per square kilometre. Map 3, does exactly that.

Number of people defecating in the open, per square km, 2012

Number of people defecating in the open, per square km, 2012

India has more than 200 people per square kilometer defecating in the open. No other country in the world has a higher number of people defecating in the open per square kilometer. In fact, India has the most open defecation per square kilometer by a long long margin: the countries which have the second and the third most number of people defecating are Haiti and Nepal, which have 79 and 77 people defecating in the open per square kilometer. Bangladesh, Pakistan, all of sub-Saharan Africa, every place on the planet, is much better than India.

Neither population nor poverty can be blamed for the situation that India is in. Bangladesh, which has a much higher population density than India and is way poorer, or China, which has a larger population, are much, much better than India when it comes to sanitation.

SQUAT survey findings up at!

Written by on June 27th, 2014

Our new research paper and policy brief summarizing findings from the SQUAT survey are now up!  Check out the SQUAT Report website at

It is clear that many people who live in households with latrines still defecate in the open.  What we need now is a focus on motivating latrine use rather than continued efforts to build more latrines.  Some of our key findings include:

  • 40% of households with working latrines have at least one member who defecates in the open.
  • More than half the people who have government latrines don’t use them.
  • Among those who defecate in the open, 47% say they do so because it is pleasurable, comfortable, or convenient.  Toilet use is often considered optional, not an urgent need.
  • 51% of those who defecate in the open report that widespread open defecation would be at least as good for child health as latrine use.
  • People want expensive latrines: most families in rural India can already afford to buy the simple latrines that save lives in Bangladesh.

To achieve its goal of eliminating open defecation by 2019, the Government must redirect sanitation policy towards promoting latrine use.  India needs nothing short of a Latrine Use Revolution, publicly directed by the country’s top leaders and known to every rural Indian.

If you want to learn more, we hope you’ll explore further on the SQUAT Report site.  Help us spread the message and get everyone engaged in starting a Latrine Use Revolution!



Webinar link for Dean’s presentation at PHFI

Written by on June 26th, 2014

Dr. Dean Spears is presenting the findings of the Squat Survey at PHFI. We posted the event details in the post before this, but here is the webinar link. You can watch Dean live presenting this paper at PHFI.

presenting SQUAT survey findings at PHFI on Thursday

Written by on June 24th, 2014

squat logo

At 3pm on Thursday, June 26th — the day after tomorrow — I will be making the first presentation of the findings from our new paper.  The paper summarizes the survey results.  One key finding is that open defecation is very common even among people who live in households with latrines, so programs that hope to eliminate open defecation must move beyond latrine construction to promoting behaviour change.  I hope you will join us this Thursday to learn more!  Here is the announcement of the talk:

Revealed preference for open defecation:

Evidence from a new survey in rural north India

Thursday, June 26th — 3pm

PHFI, Plot no. 47, Sector 44, Gurgaon (webinar connections also available from PHFI)

hosted by Dr. Neha Raykar, PHFI


To stop open defecation go the Pulse Polio way: HT Op-ed

Written by on June 23rd, 2014

Diane and Dean’s op-ed in the Hindustan Times came out today: here is the link.

A house in rural Bihar being marked by polio karyakartas after the girl kid in the house was immunised.


D&D argue that

Open defecation is killing children, stunting growth, and holding India back from a more developed future. We don’t need the government to build a toilet in every house; what India needs is a ‘toilet use’ revolution. The NDA has declared its goal of eliminating open defecation in India by 2019. But no sooner was the goal announced than a debate began: Will the government be able to achieve it? We are optimistic that it can — if it breaks with old policies, and launches a ‘latrine use’ revolution. If the budget announces a plan to build more latrines without a plan to promote their use, then the government will likely earn praise for appearing to keep its sanitation promise — but it will be falling into the trap that doomed past policies. Nothing short of a campaign to end open defecation — on the scale of Pulse Polio — will reach this urgent goal.

You can see the full submission to the Hindustan Times here.

Data journalism site IndiaSpend agrees with Sangita’s op-ed

Written by on June 21st, 2014

IndiaSpend, which does a lot of interesting stories, did a report toilets in India. It’s view? Fixing India’s sanitation problem requires more than just toilets.

Check out the full story here.

Lawrence Haddad on the SQUAT Survey

Written by on June 20th, 2014

Lawrence Haddad wrote a blogpost reporting the results of the SQUAT Survey! Check it out here! As Lawrence said, we will report more results from the survey soon, and are writing articles that talk more about the data! We did create a website to disseminate the results. There’s not much there and we are still working on it, but you can check it out here.

A new blog on Centre for Global Development: “Honey, West Bengal Shrunk the Kids”

Written by on June 18th, 2014

Clever title aside, Victoria Fan and Rifaiyat Mahbub of the Centre for Global Development discuss the overlaps between an older paper by Shroff et al and a more recent one by Arabinda Ghosh and r.i.c.e researchers, both explaining the differences in health outcomes between West Bengal and Bangladesh.

Fan and Mahbub end with:

And yet both our study and this newer study seem to be deficient and complement each other. Our study did not account for the nutritional status of women or the problem of open defecation in trying to understand differences in health indicators across West Bengal and Bangladesh. Meanwhile, the recent study stopped short of disentangling oral rehydration therapy and immunization.

More research that increases the scope of these two studies and examines the combination of the factors explored in two works discussed needs to be undertaken. Drawing on these natural experiments is also a fruitful area for research – the Two Bengals, Two Punjabs, two Germanys, two Koreas, two Chinas, etc. Any takers, public health students?

We are all for more research on this topic, and we are definitely all for taking advantage of more natural experiments!

Squat and Switching Questionnaires are up!

Written by on June 16th, 2014

Along with a description of the switching study as well. We promise more, including a new website for the Squat Survey (which is being created as I type), but for now, you can read the questionnaires of the switching and the squat study on the survey data page. Here!


Featuring Recent Posts WordPress Widget development by YD