How Can We Fix the Gender Inequality in India’s Sanitation Woes?

How Can We Fix the Gender Inequality in India’s Sanitation Woes?

(The following article is an excerpt from the book ‘Voices on South Asia: Interdisciplinary Perspectives on Women’s Status, Challenges and Futures’ published by World Scientific.

This excerpt is from the chapter titled ‘Bridging Gender Inequality in Sanitation in India: Swachh Bharat Mission and Beyond’, authored by Deepa Karthykeyan, Co-founder and Director at Athena Infonomics. Deepa works closely with governments and foundations to provide advisory support on urban sanitation and finance. She has been instrumental in developing and leading a number of multi-disciplinary programs to address the challenges of service delivery in changing urban contexts.)

This chapter aims to supplement the national mission guidelines, with a few ideas to address concerns of influence and access based on best practices from India and elsewhere.

Bridging the Gender Gap: Levers for Change

a. The Toilet Construction Decision: Shifting the Power Balance

There is evidence to show that women are more likely to want a toilet, but are often constrained by their limited influence on asset purchase decisions in the HH (Routray et al. 2017). The limited influence of women on the toilet construction decision is explained as an outcome of factors, such as established power hierarchies within the HH, women’s lack of confidence to make such decisions and their financial dependence on men.

The relative lack of access to finance is a structural issue. Initiatives such as leveraging women’s Self-Help Group (SHG) networks to save and access credit specifically for toilets in urban and rural areas is a powerful resource to help bridge this gap. The formative research study on people’s toilet construction and use conducted in UP, revealed that HHs, which placed emphasis on institutional savings, were more likely to be willing to pay for a toilet. Strengthening women’s access to credit for toilet construction could empower them to have a larger say in the construction decision. Initiatives such as the Bhamasah scheme in Rajasthan, where the benefits and entitlements are directly transferred to the women of the family, present a useful precedent on empowering women to have a bigger role in the process of receiving government benefits (Financial Express 2017).

There is also an urgent need to expand the conversation on toilet designs for HH toilets to explicitly accommodate the preferences of women and girls. Toilet design clinics set up in Kenya by Water & Sanitation for the Urban Poor (WSUP) provide useful insights into a process that may be replicated in the Indian context to expand on the features to be considered in toilets to make them more appropriate for women, girls, and children. In Kenya, women participants in the clinics were observed to have more suggestions than men and very specific inputs on the type of floor (to enable easy cleaning), location (to prevent smell from reaching into the house), and appropriate size and design for children, among others (Gertrude Salano 2017).

Currently, there are no intrinsic drivers in the mission guidelines to encourage greater female participation in the process of toilet design selection and construction. A deeper analysis of reforms to incentivise local governments, district and state machinery to engage in a participatory process through interactions with local bodies/implementation agencies may be useful. These interactions may be used to assess their willingness to adopt consultative approaches to define designs for SBM toilets, identify key constraints (formal and informal) in changing the status quo, and to identify markers of local bodies, which choose to sign up for the intervention.

b. Innovative Approaches to Deliver Gender-responsive Public and Community Sanitation

Gaps in gender-sensitive public and community toilets can only be met with support from leadership in city governments/sanitation authorities and innovation in planning processes and financing structures. Acknowledgement of gaps that make public or community toilets less accessible or unsafe for women and programmes that aim at sensitisation among government officials is critical, and must be supplemented with practical solutions to overcome these gaps.

The model operated by Gramalaya and WAVE, two local NGOs in Tiruchirappalli (a city in the southern state of Tamil Nadu), presents a useful example of an alternate structure of operating community toilets. The model is driven by representatives from women SHGs in the community. Gramalaya begins by establishing a number of SHGs in a community, each with 15 to 20 members.Two SHG members are chosen to be leaders and jointly operate the team bank account. On average,half the HHs in a community are SHG members, hence half the community is directly involved in management of the toilet. These SHG groups take responsibility for the community toilet on a rotation basis. During that month, each SHG member is caretaker for a day, responsible for collecting user fees and maintaining the accounts book. The model adopts a token system at the pay-and-use toilets. After payment, each user is provided a token. This ensures transparency as it shows how many people used the toilet each day and how much income has been collected. In most toilets, these are set at a very small fee of 50 paisa (less than 1 cent) for adults for defecation and at two to three rupees for bathing and washing clothes. Urination and use by children, elderly, and single women is free (WaterAid and Gramalaya 2008).

On planning, a simple manual (in local languages) guiding the steps towards planning for new investments in public and community toilets should be made available to sanitation engineers and city managers and must include considerations like distance, the condition of the path, hours of availability and privacy, in addition to the more commonly tracked metric on installed capacity (number of toilet seats for men and women). The release of public money in the form of viability grants may be linked to the fulfilment of the prescribed conditions.

c. Positively Influencing Social Norms to Improve Women’s Sanitation Behaviours

The swachhagrahi (cleanliness ambassadors/champions) movement initiated by the Ministry of Drinking Water Supply and Sanitation is a powerful lever of inter-personal communication and has the potential to influence and sustain sanitation practices and behaviours that are gender trans formative. A study on testing marketing strategies to influence social norms, revealed that mental models and social norms are malleable, and, when challenged, can lead to behavioural change (Gauri et al. 2018). The study showed that tangible behavioural change could be achieved relatively quickly and at a low cost using behaviourally informed information interventions. The study tested two low-cost delivery channels, both utilising local resources and personnel.

Both interventions were relatively successful at influencing practices and beliefs around latrine use. It is worth noting that both delivery channels were relatively low cost. Posters (used in the mass communication treatment villages) have very low marginal cost and can be scaled up easily to reach a wide audience. Once recruited, swachhagrahis can deliver in-person messages to additional HHs at a low marginal cost. In our intervention, the swachhagrahis were unpaid. Community events may have relatively higher marginal cost but offer greater visibility and diffusion potential to reach a wider audience and spark conversations. Our results suggest that community-level delivery methods may be more effective at changing norms relative to individual delivery methods, but the latter is more influential at changing personal beliefs.

Swachhagrahis are the foot soldiers of the mission and the motivators for bringing about behavioural change with respect to key sanitation practices in rural areas [SBM (Gramin) 2018, Ministry of Drinking Water and Sanitation 2017]. Their role involves tracking the status of mission outcomes on the ground by geotagging the toilets constructed, assisting in construction/retro-fitting of defunct or poorly built HH and institutional toilets in the villages, communicating about financing options for the upgrading of sanitation, hygiene and bath facilities in homes so that HHs can construct better quality facilities, and spreading awareness on safe disposal of sanitary waste and menstrual hygiene management (Swachh Bharat Mission (Gramin), Ministry of Drinking Water and Sanitation 2018).

Swachhagrahis must undergo compulsory training (as per mission guidelines), where they are equipped with the necessary skills and knowledge. The training programme is built on community-led total sanitation (CLTS) principles. However, the gender content in the programme is limited to creating general awareness on menstrual hygiene management. Equipping swachhagrahis with powerful communication tools that would help HHs re-consider some of their existing practices, which hinder women’s’ access and use of toilets, as well as a wider awareness that would enable them to build more gender-friendly toilets could be a potent mechanism to influence practices on the ground.

d. A National System to Measure and Track Gender Outcomes on Sanitation Investments

A lot of what we know about the gendered impact of sanitation (positive or negative) from mission investments is mostly anecdotal or informed by small studies implemented in pockets. The verification protocols used to track mission outcomes do not disaggregate and measure outcomes for different groups. This is a critical gap that needs to be filled.

Gender analysis frameworks have a long history in development practice to strengthen gender outcomes. We can learn from these frameworks to support design, implementation, and measurement to ensure we are moving closer towards bridging the gender equality gap in sanitation (Lala et al. 2017). Tools and frameworks such as the gender equality framework (USAID 2008), performance assessment framework (AUSAID 2008), and gender analysis tool (Status of Women Canada 2013) may serve as useful references to help the mission develop its own framework and apply it to improve programming through measurement and learning.

In a paper on formulating a hybrid approach to improve gender main streaming in WASH through analysis and measurement, the authors pro pose six categories to capture key issues namely: participation, access to services, control over resources, benefits/outcomes, governance/decision making, and operation and management, and go on to outline the feature of the hybrid framework for measuring gender outcomes in WASH in India (Lala et al. 2017). This offers a useful starting point and may be built on and integrated into both the policy design and programming initiatives and a measurement tool to track the mission’s performance on gender equality.

Role Ahead

Despite the absence of an explicit articulation of a set of gender specific goals in its first avatar, the SBM has been successful in creating interesting examples on ways in which women can participate in and influence the mission’s outcomes. However, in the absence of specific provisions in policy to address the key gender gaps and practical mechanisms/levers for implementation, the mission’s impact on bridging the gender equality gap remains limited.

At the end of 2019, there will be a larger baseline of HH toilets built, which is a positive step for the mission. In the following phase, the national government, in partnership with states and cities, should prioritise four key actions to move closer towards bridging the gender gap in sanitation.

Deepa Karthykeyan
Deepa is a co-founder & director at Athena. In addition to business development, Deepa works closely with governments and foundations to provide advisory support on urban sanitation and finance.