Culture and the health transition: Understanding sanitation behaviour in rural north India

Culture and the health transition: Understanding sanitation behaviour in rural north India, April 2015. International Growth Centre (ICG) Working Paper.

Authors: Diane Coffey, Aashish Gupta, Payal Hathi, Dean Spears, Nikhil Srivastav, and Sangita Vyas.

Key Facts

  • Poor sanitation spreads bacterial, viral, and parasitic infections including diarrhoea, polio, cholera, and hookworm. Despite this, 70% of rural Indian households defecate in the open, without a toilet
    or latrine. Over 60% of the people worldwide who defecate in the open live in India. Bangladesh, which shares a border with India, has a rural open defecation rate of only 5%.
  • Based on a survey of around 3,200 households, and 100 in-depth interviews, this research finds that having a household latrine is widely seen to damage the purity of the home. Open defecation, on
    the other hand, is widely seen to promote purity and strength, and is also associated with health and longevity.
  • A further reason for particularly poor hygiene in Indian public spaces is due to the ongoing renegotiation of caste-based social rules. Most Hindus remain inflexibly opposed to emptying their own latrine pits. As part of a push for greater equality, people from the lowest “untouchable” castes resist emptying latrine pits because this work is widely seen as degrading and reinforcing of their low social status.

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