Toilet construction under the Swachh Bharat Mission and infant mortality in India
Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program ini...
| Autores principales: | , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Springer
2024
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/151971 |
| _version_ | 1855521108860600320 |
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| author | Chakrabarti, Suman Gune, Soyra Bruckner, Tim A. Strominger, Julie Singh, Parvati |
| author_browse | Bruckner, Tim A. Chakrabarti, Suman Gune, Soyra Singh, Parvati Strominger, Julie |
| author_facet | Chakrabarti, Suman Gune, Soyra Bruckner, Tim A. Strominger, Julie Singh, Parvati |
| author_sort | Chakrabarti, Suman |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program initiated in 2014—and infant (IMR) and under five mortality rates (U5MR) in India. We analyzed data from thirty-five Indian states and 640 districts spanning 10 years (2011–2020), with IMR and U5MR per thousand live births as the outcomes. Our main exposure was the district-level annual percentage of households that received a constructed toilet under SBM. We mapped changes in IMR and U5MR and toilet access at the district level over time. We fit two-way fixed effects regression models controlling for sociodemographic, wealth, and healthcare-related confounders at the district-level to estimate the association between toilets constructed and child mortality. Toilet access and child mortality have a historically robust inverse association in India. Toilets constructed increased dramatically across India following the implementation of SBM in 2014. Results from panel data regression models show that districts with > 30% toilets constructed under SBM corresponds with 5.3 lower IMR (p < 0.05), and 6.8 lower U5MR (p < 0.05). Placebo, falsification tests and robustness checks support our main findings. The post-SBM period in India exhibited accelerated reductions in infant and child mortality compared to the pre-SBM years. Based on our regression estimates, the provision of toilets at-scale may have contributed to averting approximately 60,000–70,000 infant deaths annually. Our findings show that the implementation of transformative sanitation programs can deliver population health benefits in low- and middle-income countries. |
| format | Journal Article |
| id | CGSpace151971 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1519712024-11-15T08:52:20Z Toilet construction under the Swachh Bharat Mission and infant mortality in India Chakrabarti, Suman Gune, Soyra Bruckner, Tim A. Strominger, Julie Singh, Parvati hygiene infants mortality water Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program initiated in 2014—and infant (IMR) and under five mortality rates (U5MR) in India. We analyzed data from thirty-five Indian states and 640 districts spanning 10 years (2011–2020), with IMR and U5MR per thousand live births as the outcomes. Our main exposure was the district-level annual percentage of households that received a constructed toilet under SBM. We mapped changes in IMR and U5MR and toilet access at the district level over time. We fit two-way fixed effects regression models controlling for sociodemographic, wealth, and healthcare-related confounders at the district-level to estimate the association between toilets constructed and child mortality. Toilet access and child mortality have a historically robust inverse association in India. Toilets constructed increased dramatically across India following the implementation of SBM in 2014. Results from panel data regression models show that districts with > 30% toilets constructed under SBM corresponds with 5.3 lower IMR (p < 0.05), and 6.8 lower U5MR (p < 0.05). Placebo, falsification tests and robustness checks support our main findings. The post-SBM period in India exhibited accelerated reductions in infant and child mortality compared to the pre-SBM years. Based on our regression estimates, the provision of toilets at-scale may have contributed to averting approximately 60,000–70,000 infant deaths annually. Our findings show that the implementation of transformative sanitation programs can deliver population health benefits in low- and middle-income countries. 2024-09 2024-09-03T21:17:44Z 2024-09-03T21:17:44Z Journal Article https://hdl.handle.net/10568/151971 en Open Access Springer Chakrabarti, Suman; Gune, Soyra; Bruckner, Tim A.; Strominger, Julie; and Singh, Parvati. 2024. Toilet construction under the Swachh Bharat Mission and infant mortality in India. Scientific Reports 14(2024): 20340. https://doi.org/10.1038/s41598-024-71268-8 |
| spellingShingle | hygiene infants mortality water Chakrabarti, Suman Gune, Soyra Bruckner, Tim A. Strominger, Julie Singh, Parvati Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title | Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title_full | Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title_fullStr | Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title_full_unstemmed | Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title_short | Toilet construction under the Swachh Bharat Mission and infant mortality in India |
| title_sort | toilet construction under the swachh bharat mission and infant mortality in india |
| topic | hygiene infants mortality water |
| url | https://hdl.handle.net/10568/151971 |
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