Modi's toilet construction push may have saved 60,000-70,000 lives a year since 2014: Nature study

Prime Minister Narendra Modi’s push to construct toilets in houses as part of the Swachh Bharat Mission (SBM) may have saved up to 60-70,000 lives a year, according to a study published in Nature journal.

In 2014, Modi announced the nationwide push to build toilets to eradicate open defecation as part of the SBM. The study has found that the initiative substantially reduced infant mortality rate (IMR) and under-five mortality rate (U5MR) in India.

The IMR refers to the death of the child before their first birthday, according to World Health Organization (WHO).

In a post on X (formerly Twitter), Soyra Gune, one of the five authors of the study, said that what set India’s SBM apart that while most low- and middle-income countries focus on curative and preventive measures, the SBM induced behavioural change.

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Gune said, “Most literature on reducing mortality in low- and middle-income countries (LMICs) focuses on preventative and curative interventions during the prenatal and postnatal period. However, there is scant evidence available on the association between large scale investments in sanitation and mortality in LMICs. The SBM’s approach of combining behaviour change counselling with toilet construction differentiates it from earlier large-scale sanitation investments and programs in India.”

Child deaths came down as toilet construction went up

The Nature study showed that between 2003 and 2020, the infant mortality rate was more than halved in India as the average toilet coverage increased.

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In 2003, the average toilet coverage in houses was 46.7 per cent and infant mortality rate exceeded 60 per 1,000 live births.

In 2020, the average toilet coverage in houses was 81.2 per cent and infant mortality rate had fallen below 30 per 1,000 births.

Since 2014, when the Swachh Bharat Mission was started, India witnessed 10 per cent decline in infant mortality rate (IMR) and under-five mortality rate (U5MR).

Benefits go beyond child deaths

The benefits of the toilet construction under the SBM have gone far beyond preventing children’s deaths, according to the study.

The study found that the increased toilet coverage also marked improvements in maternal education, pregnancy healthcare, hospital births, health insurance, and clean cooking fuel.

Notably, the push for toilet construction also occurred at a time when the Modi government pushed for the adoption of cooking gas over firewood and pushed for piped water connections.

Recent research also highlights the broader benefits of increased toilet access, including women’s safety, financial savings from reduced medical expenses, and overall improvements in quality of life, said the authors in the study.