Determining factors affecting defecation and health & economic impact of sanitation practices: case study of urban slums in Delhi
Student name: Ms Srishti Dixit
Guide: Dr Sukanya Das
Year of completion: 2017
Host Organisation: TERI University
Supervisor (Host Organisation): Prof. M N Murty
Abstract: WHO (2008) states that 10% of the total global burden of diseases can be averted by making sanitation, water and hygiene related improvements including 1.4 million avertable diarrheal deaths every year. Highest burden of such diseases falls upon less developed nations. While it is important to quantify the burden of disease, it is also crucial to understand what factors lead to such prevalent use of open defecation and improper hygiene. Such factors may vary geographically, culturally, politically. In our study we focus on urban population of national capital of India. In India diarrhea is reportedly the third largest cause of child mortality and causes a whopping 13% of child deaths each year (NCBI 2015).
Through our study, we wish to understand; what are the factors that impact the choice of modes of defecation among urban slum population. Another component of the study tries to address the health and economic impact of sanitation practices. For the purpose, we choose two slums of Delhi which come under the same municipality but have different defecation patterns. The chosen slums of Mansarovar park and Seelampur have high and no open defecation respectively. Using random sampling method, we collect data from 139 households (68 and 71 respectively) on sanitation, water, hygiene, illness and expenditure components. We compare the slums based on incidence of Diarrhea as a proxy of health outcomes.
We use multinomial logistic regression analysis and try to impact of various factors that affect the choice of mode of defecation. Finally, we adopt cost of illness method to come up with economic quantification of burden of disease of diarrhea, separately for each slum. We try to explain the difference in the costs between the two slums by employing a logistic regression modeling. Consequently, we shall be able to make some policy suggestions. We shall be able to comment on whether providing access to toilets is the only step that needs to be taken or are there some other factors to design policies for eliminating open defecation and diarrheal disease burden and what is the reach of present government policies on sanitation.
Keywords: Sanitation, Open defecation, Private toilets, Community toilets, Diarrhea, Cost of illness
