Devarya Srivastava is an Intern at Outline India.He is a second-year economics student at Shiv Nadar University. Here is a snippet of his views on measuring WASH (Water, Sanitation ,and Health) behaviour after his experience in the field for Outline India’s internal research project.
One of the key objectives of the Swachh Bharat Abhiyan is to make India an Open Defecation Free (ODF) Zone by 2nd October 2019, 5 years after Prime Minister Modi first announced the scheme. By no means is this a straightforward task-– apart from requiring the construction of sanitation infrastructure in villages and rural areas (which account for 90% of the open defecation statistics) across India, it also involves the mammoth challenge of inculcating behavioral changes to improve sanitation practices of millions across India. The key to this challenge is ensuring that accurate, timely and reliable data about water, sanitation, and health (WASH) is available. There are several challenges to be overcome, both social and logistical, with the quality of data that is typically collected, and which can severely disrupt the task of making India an open defecation free country. It is interesting to note that no well-respected large scale data sources in India such as Census of India, DLHS, IHDS and NFHS distinguish between latrine use and latrine ownership. Treating the both as the same not only creates a false impression of defecation rates falling but also does not take into account intra-household dynamics such as lack of water, toilets not being functional, no toilet seats to name a few.
When conducting surveys to measure wash behavior, it is of critical importance that the questions be framed in a manner so as to elicit a response from the respondent which is substantial and accurate i.e. the answer is able to assist the surveyor and that the answer does not have an element of ambiguity to it. This requires framing questions in a balanced manner which does not lead the respondent and captures all of the relevant details. For example, to gauge defecation practices, a question could be framed as:
Where do you generally defecate every day?
Do you defecate in the open or use a latrine or Do you use a latrine?
While the latter question would generate faster responses, the former would be an example of a more balanced question, as there is no bias toward one answer over another. The respondent can be reasonably subjective in answering the surveyor’s question, rather than just replying with a yes or a no. A balanced survey does not introduce choices in the questions and lets the respondent decide his answer.
It is not just the construction of the survey which poses a challenge. At times social and cultural norms can impinge on the quality of data collected. Consider for example a surveyor who refuses to inspect a toilet, associating toilets with being polluted. The surveyor would not be able to determine the actual use of toilets in that area without first knowing that there exists a proper, functioning toilet in the first place. Moreover, owing to social stigmas and the sensitive nature of the subject, it not unusual to find that many studies have found that respondents tend to mislead the surveyor by giving false information. There is an important gender component to this because female respondents may be less comfortable discussing their intimate sanitation practices with a male surveyor.
At times, misinformation may happen because respondents are not able to grasp the questions asked. For example a question such as do you wash your hands might merit a yes or no response but might be based on the respondent washing his/her hands a week ago or not during a critical time such as after defecation whereas question such as have you washed your hands in the past 24 hours leaves no space for any miscommunication. It is important that the surveyor is clear and articulate in his question formation, and explains explicitly the details required.
Various reports on WASH behaviour have concluded that it is more accurate to measure data by conducting surveys on individuals, rather than on households. While this might take more time, it will ultimately lead to a more detailed study of WASH behaviour. Within a household, it is likely that different members will have different habits, subject to age and gender, which could determine if some members of a family defecate in the open, while others do not.
Returning to the ambition of making India open defecation free by 2019, it is clear that much will depend on the recruitment of competent surveyors, who are trained to ask questions in a manner that does not lead the respondent in any particular direction with regards to the answer. It is encouraging to know that in the 69th round of the NSS, has taken the important step of distinguishing between latrine use and latrine ownership. Further bold steps like this taken by the NSS and the current government’s commitment might just make this distant utopia into a reality.