Achieving Sanitation MDG in Uttar Pradesh

Presented atNational Seminar on Decentralized

Governance in Water & Sanitation in Rural India

June 28th, 2012NIAR, Mussoorie, Uttarakhand

Uttar Pradesh – A Profile

• Area 243,290 sq km with population 210 m

• Contributes nearly 8% of India’s GDP

• Only 5 countries in the world have more population than Uttar Pradesh

• One out of every five open defecator in India lives in Uttar Pradesh

State Level Disaggregation of Number of Open Defecators

125

71

54

50

49

44

39

39

32

31

27

11

11

4

1

0 20 40 60 80 100 120 140

Uttar Pradesh

Bihar

Maharashtra

Madhya Pradesh

Andhra Pradesh

Rajasthan

West Bengal

Tamil Nadu

Orissa

Karnataka

Gujarat

Haryana

Punjab

Himachal Pradesh

Kerala

Millions

Sanitation Trends

16 14.510.2

19.7 18.320.6

12.9 12.9 14.716.9

19.6

020

4060

8010

0%

Cov

erag

e

1989 1991 1993 1995 1997 1999 2001 2003 2005 2007Year

Total Estimated

1993 : NSS49r 1996 : NSS52r 1999 : NFHS2 2000 : MICS 2001 : Census 2006 : NFHS3

Access to Improved Sanitation Coverage: TotalUP

19.6

16.9

14.7

12.9

12.9

2006

2000

1995

1991

1990

EstimatedValues

• Click to edit Master text styles– Second level– Third level

• Fourth level– Fifth level

Only 6.9% increase in improved sanitation from 1990 to 2006 (16 years)

Sanitation Trends in Rural UP

3.9 4.7

11.18.8 10.2 9.9

3.73 3.735.87

8.5511.8

020

4060

8010

0%

Cov

erag

e

1989 1991 1993 1995 1997 1999 2001 2003 2005 2007Year

Rural Estimated

1993 : NSS49r 1996 : NSS52r 1999 : NFHS2 2000 : MICS 2001 : Census 2006 : NFHS3

Access to Improved Sanitation Coverage: RuralUP

11.8

8.55

5.87

3.73

3.73

2006

2000

1995

1991

1990

EstimatedValues

• Click to edit Master text styles– Second level– Third level

• Fourth level– Fifth level

Increased nearly 3 times in last 15 years but grossly inadequate

MDG target for Uttar Pradesh

• Projected population of UP in 2015 220 million

• MDG Target (56.5%) 124.5 million

• MDG achievable at current rate (24%) 53 million

• Unimproved toilet users 33 millon

• Open defecators in 2015 135 million

• MDG target shortfall 71.5 million

Four Districts Contribute 11% of Open Defecators

District Projected Population of Open Defecators (2007)

• Allahabad 4,084,668

• Azamgarh 3,741,821

• Jaunpur 3,651,550

• Sitapur 3,429,279

• Click to edit Master text styles– Second level– Third level

• Fourth level– Fifth level

Click to edit the outline text format Second Outline

Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

• Seventh Outline LevelClick to edit Master text styles

– Second level

– Third level

• Fourth level

– Fifth level

18 districts contribute 37% of open defecation

Name of District Projected Population of Open Defecators

(2007)

Gorakhpur 3,217,968

Hardoi 3,194,743

Sultanpur 3,097,598

Kheri 3,002,027

Ghazipur 2,908,639

Rae Bareli 2,846,420

Kushinagar 2,817,120

Gonda 2,809,449

Agra 2,781,767

Pratapgarh 2,764,099

Name of District Projected Population of Open Defecators

(2007)

Ballia 2,625,415

Etah 2,574,837

Deoria 2,561,347

Budaun 2,561,243

Barabanki 2,522,946

Unnao 2,472,429

Aligarh 2,417,982

Bahraich 2,352,095

Independent Variables Model 1 Model 2 Model 3 Model 4 Model 5 Remarks

Percent literate Female Population (Age 7+)

0.85 (0.21)***

0.48 (0.17)***

0.42 (0.16)***

0.25(0.18)*

Percent literate male Population (Age 7+)

0.64 (0.29)**

Households have BPL Card (%)

-0.85 (0.11)***

- 0.74 (0.11)***

-0.63 (0.14)***

Dist cumulative TSC expenditure per capita

-0.13 (0.04)***

-0.12 (0.04)***

Households use piped drinking water (%)

0.50 (0.18)***

Constant -17.68 -22.32 25.30 27.94 29.86

R square 0.19 0.08 0.56 0.61 0.65

Adjusted R square 0.18 0.07 0.54 0.59

N 70 70 70 70 70

Independent variables impacting Toilet Use Dependent variable: "households have access to toilet facility (%)“

*** significant at 1% level; ** significant at 5% level ; * significant at 10% level

020

4060

80

30 40 50 60 70Percent literate Female Population (Age 7+)

households have access to toilet facility (%) Fitted values

Access to Sanitation vs Female Literacy

one percent increase in female literacy in a district is found associated with 0.25% to 0.48% increase in toilet use.

020

4060

80

0 10 20 30 40 50households use piped drinking water (%)

households have access to toilet facility (%) Fitted values

Access to Toilet Facility vs Water Supply

One percent increase in household piped drinking water in a district is associated with 0.50% increase in toilet use behavior.

020

4060

80

0 20 40 60households have BPL Card (%)

households have access to toilet facility (%) Fitted values

Access to Toilet Facility vs Poverty

an increase of BPL card holders by 1% in a district results in a decrease of toilet use behavior by 0.63%.

Medical Expenses by Income Quintile

Income Quintile

Lowst Quntile

2nd Lowest

Middle 2nd Highest

Highest

Average Monthly Income

Rs 873 Rs 2,186 Rs 3789 Rs 6074 Rs 38,143

medical expenses on diarrhoea, cough, fever

Rs 90.98

(10.4%)

Rs 192.36

(8.8%)

Rs 290.63

(7.7%)

Rs 507.92

(8.4%)

Rs 1071.51

(2.8%)

Net Social Benefits of Total Sanitation

• Reduction of deaths of children below 5 years by 90,000 to 100,000 per annum

• Averted loss of wages on account of sickness

• Averted cost of medicines for treating sickness

Net Social Benefits of Total Sanitation in Uttar Pradesh is Rs 10,244 crores (NPV, at 10% discount rate), which is equal to 4% of State SDP

Conclusions

• Focus on districts with higher concentration of Open Defecators (4 plus 18)

• Give priority to those districts which have higher female literacy because of higher chance of success

• Give priority to districts with better water supply systems because of higher chance of success

• Scope for developing innovative health insurance products linked to sanitation for households in lower income quintiles

THANK YOU