Sanitation in West Bengal - Epw

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Sep 30, 2017 - 49.9 (Polba-Dadpur). Jalpaiguri. 13. 48.8. 38.4 (Falakata). 76.7 (Nagrakata). Cooch Behar. 12. 39.2. 9.7 (Mathabhanga-II). 72.8 (Mekliganj).

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Sanitation in West Bengal Bangladesh Shows the Way Arabinda Ghosh

Literacy and public education rather than economic growth are integral to eradicating open defecation, suggests this study of sanitation practices in three districts of West Bengal and nine bordering districts of Bangladesh. While the number of households with a latrine on the premises grew by 15.1% in West Bengal from 2001 to 2011, Bangladesh made more rapid progress, highlighting the importance of the shame vs subsidy social marketing programme employed at the grass roots to improve sanitation coverage.

The author acknowledges the guidance of Sajal Chattopadhyay, Economic Advisor, Centers for Disease Control and Prevention, Atlanta, Georgia, US, in preparing this article. He also acknowledges the useful comments and suggestions of the editor and anonymous reviewer. The author’s conclusions are his own and do not necessarily represent the views of any organisation. Arabinda Ghosh ([email protected]), a member of the Indian Administrative Service, is additional secretary at the Department of Food and Supplies, Government of West Bengal.

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afe water, adequate sanitation and hygiene are cardinal prerequisites for the protection of health (PrüssUstün et al 2014). Childhood diarrhoea can be prevented by access to safe water and sanitation, along with the advancement of good hygiene practices, particularly handwashing with soap. The primary causes of diarrhoeal deaths today are unsafe water, inadequate sanitation and poor hygiene (Black et al 2003). Five thousand children die every day due to infectious diarrhoea, caused principally by inadequate sanitation (UN-Water 2008). There are also links between poor sanitation and acute respiratory infections (ARIs) (Mara 2010). Food intake, general health status and the physical environment determine levels of nutrition and malnutrition. Reduced absorption of nutrients takes place due to repeated diarrhoeal diseases and parasitic infestations caused by water contaminated by faecal waste, poor sanitation and insufficient hygiene. Levels of water and sanitation services have a considerable influence on weight-for-age Z-scores in infants (Spears et al 2013; Esrey et al 1992; Esrey 1996; Checkley 2004; Merchant 2003). Priority to sanitation must be based not only on its potential contribution to the eradication of disease transmission through human faecal pollution but also to tackling the enduring challenge of childhood stunting (Prüss-Üstün et al 2008; Fewtrell et al 2007). Besides improving morbidity and mortality outcomes, improved sanitation reduces costs in health systems, and days lost at work or school through illness or caring for an ill relative (Hutton et al 2007). In 2015, some 2,400 million people did not use an improved sanitation facility, and 946 million people still practised open defecation. Two-thirds of them live in Southern Asia, nearly three times as

many as in sub-Saharan Africa (UNICEF and WHO 2015). In spite of successes in the prevention of open defecation and promotion of sanitation and safe water, there are stark disparities across regions, and between the rich and the poor and marginalised (UNICEF and WHO 2015). More than 80% of the people practising open defecation live in just 10 countries (UNICEF and WHO 2015). Despite having the highest number of people practising open defecation (564 million), India has failed to make significant strides in reducing the practice. In spite of a national policy for “Total Sanitation for All,” there are large discrepancies in latrine coverage in different parts of India. The proportion of households with access to latrine facilities within the premises is 95.2% in Kerala and 79.3% in Punjab, but is as low as 22% in Jharkhand and Odisha. In urban India, 81.4% of households have latrine facilities on their premises, compared to 30.7% in rural India (Office of the Registrar General and Census Commissioner 2011). In West Bengal, a state with a population of 91.3 million, 58.8% of households overall have access to latrine facilities within their premises. However, only 46.7% of households in rural West Bengal have latrines within their premises, compared to 85% in urban West Bengal (Ghosh and Cairncross 2014). Therefore, there is an overwhelming need to formulate a strategy to make West Bengal free from open defecation and improve population health outcomes in the state. An analysis of access to sanitation and its rate of progress, particularly at the sub-district (development block) level, is crucial for the formulation of this strategy. The sub-district is the last administrative unit in India in general, and in West Bengal in particular, where a considerable number of government officials work to implement development programmes at the grass-roots level. An effective strategy to improve sanitation coverage demands a better understanding of the factors that affect access to sanitation, including per capita gross national income (GNI), change in per capita GNI, literacy, and population density.

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Interestingly, Bangladesh, which shares a 2,217 km international border with West Bengal, has made remarkable improvements in latrine use and has reduced open defecation to 1% in 2015 (UNICEF and WHO 2015), in spite of a lower per capita income than West Bengal. Though split into different political states in 1971, these populations share cultural, geographical and agricultural factors (Ghosh et al 2014). A comparison of sanitation coverage rates at the sub-district level in these contiguous and similar areas of West Bengal and Bangladesh, therefore, may provide insights for effective strategies to make West Bengal free from open defecation. Community-led total sanitation (CLTS) and social marketing have played a pioneering role in making Bangladesh almost free from open defecation (Hadi 2000; Movik and Mehta 2010). The objectives of this study are therefore to (i) focus on the level of access to sanitation facilities in sub-districts of West Bengal; (ii) analyse the impact of per capita GNI, change in per capita GNI, literacy, and population density on access to sanitation; and (iii) make a comparison between bordering areas of West Bengal and Bangladesh to formulate an effective strategy to eliminate open defecation in West Bengal.

Figure 1: Proportion of Households with Latrine Facility within the Premises in Districts of West Bengal, 2011 Bankura

21.1

Bardhaman

58.3

Birbhum

24.8

Dakshin Dinajpur

60.8

Kolkata

99.3

Malda

33.5

Murshidabad Nadia

79.4

North 24 Parganas

The study uses data from the 2011 censuses of India and Bangladesh, World Bank data on GNI per capita based on purchasing power parity (PPP), and data from the WHO–UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation. Household reporting on availability of sanitation facility was recorded, but responses to the questionnaire were not checked by actual observation. This study focuses on sanitation facilities at the subdistrict level in West Bengal. Box plots illustrate access to latrine facilities in districts in West Bengal and provide a summary based on the median, quartile, mean and extreme values. In the econometric regression model, the dependent variable is the prevalence of households defecating in the open as a country-level percentage of households. The primary independent, or exposure, variable is the log of per capita national Economic & Political Weekly

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15.1

North 24 Parganas

16.2

Bardhaman

16.6

Murshidabad

18.2

Howrah

18.3

Hooghly

Purba Medinipur

88.4 12.8

19.2

Paschim Medinipur

22.9

South 24 Parganas

23.5

65.3 28.7

13.2 14.8

47.7

West Bengal

12.2

West Bengal

91.5

South 24 Parganas

11.5

Malda

Dakshin Dinajpur

41.3

Paschim Medinipur

Darjeeling

Jalpaiguri

Nadia

25.7

Cooch Behar 58.8

31.8 48.7

Purba Medinipur

income and its change. Linear regression was used to explore possible associations between the explanatory variable and the outcome. All statistical analyses were performed using Stata 12 software. Ethical approval was not required for this secondary analysis of publicly available aggregate data. Results

Methods

9.2

51.2

Cooch Behar

Uttar Dinajpur

8.7

Bankura

74.5

Jalpaiguri

3.6 8.3

79.2

Hooghly

2.9

Birbhum 70.2

Howrah

Purulia Kolkata Uttar Dinajpur 38.6

Darjeeling

Purulia

Figure 2: Progress in Proportion of Households with Latrine Facility within the Premises in Districts of West Bengal, 2001 and 2011

Figure 1 highlights the percentage of households in districts of West Bengal that had a latrine facility within their

premises in 2011. The proportion of households with a latrine was highest in Kolkata district at 99.3%, followed by North 24 Parganas with 91.5% and Purba Medinipur with 88.4%, and lowest in Purulia district at 12.8%. Figure 2 depicts the progress in sanitation coverage in West Bengal’s districts from 2001 to 2011. During this period, Medinipur district was reorganised and divided into Paschim Medinipur and Purba Medinipur districts. The remarkable disparity in progress in sanitation coverage

Table 1: Latrine Coverage in West Bengal Sub-districts, 2011 District

Bankura Bardhaman Birbhum Dakshin Dinajpur Darjeeling Howrah Hooghly Jalpaiguri Cooch Behar Malda Murshidabad Nadia North 24 Parganas Paschim Medinipur Purba Medinipur Purulia South 24 Parganas Uttar Dinajpur Total

No of Sub-districts According to Percentage of Households with Latrine Facility Available within Premises 20%&40%&60%&80 %&50%)

0 0 0 0 0 0 0 0 1 0 1 1 0 3 10 0 2 0 18 (5.3)

sub-districts. Purulia was the only district where no more than 20% of households had a latrine within the premises in all sub-districts. In 72% of the subdistricts in Purba Medinipur, the percentage of households with a latrine on the premises was above 80%, and in the remaining sub-districts it ranged from 60% to 80%. Table 2 illustrates the wide variations in rate of open defecation in the sub-districts of West Bengal. The highest open defecation rate among the districts of West Bengal was in Purulia at 87.2%. Manbazar-II sub-district of Purulia recorded the highest rate of open defecation among all sub-districts of West Bengal, at 95.7%. In Purulia, the lowest open defecation rate was 79.9% in Raghunathpur-I sub-district. Bankura district had the second highest open defecation rate in the state, with a high of 93.9% in Hirbandh sub-district and a low of 58.9% in Kotulpur sub-district. On the other hand, the open defecation rate was lowest in North 24 Parganas district at 8.5%. Barrackpore-II sub-district of North 24 Parganas had the lowest rate of open defecation among all subdistricts of West Bengal at 1.4%. Purba Medinipur district had the second lowest open defecation rate at 11.6%. Table 3 depicts the progress in coverage of households with latrines in the subdistricts of West Bengal from 2001 to 2011. The sub-districts have been divided into six categories according to their rates of progress. Two percent of the sub-districts made negative progress, 28.1% experienced very slow progress, and 31.4% slow progress. Only 18.2% of them made moderate progress. On the other hand, 9.7% of the sub-districts made good progress, 5.3% very good progress, and 5.3% excellent progress during this period. From 2001 to 2011, the best performing district in terms of progress was Purba Medinipur. On the other hand, the worst performing district in West Bengal was Purulia. In order to improve the sanitation scenario, policymakers in resource-poor economies sometimes prioritise overall economic growth rather than direct involvement in improvement of sanitation and access to latrine facilities.

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PERSPECTIVES Figure 3: Scatter Plot of Rate of Open Defecation in Countries against Log of Per Capita Income (PPP)

Change in rate of open defecation 1990–2012

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Open defecation (%)–2012

Open Defecation-2012 60

40 Fitted values 20

0 6

7 8 9 Log of per capita Gross National Income based on PPP-2012

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The trend line is based on ordinary least squares regression. R2 (Linear) = 0.302

Figure 3 highlights the rate of open defecation in 86 countries in 2012, plotted against log of per capita GNI based on PPP. The inverse relationship indicates that in countries with higher per capita GNI, open defecation was less prevalent. To follow the growth-led sanitation strategy it is also important to examine the impact of change in per capita income on the open defecation rate. Figure 4 highlights the change in rate of open defecation in these 86 countries, plotted against the log of change in per capita GNI based on PPP from 1990 to 2012. It is clear that economic growth had relatively little influence on the change in open defecation rate. Table 4 shows that all countries made considerable improvement in access to latrines in comparison to India, even though their per capita income was lower Table 4: Top 10 Countries with Highest Reduction of Open Defecation Rate since 1990 versus Change in Their Per Capita Income Country

% % Percentage Per Practising Practising Point Capita Open Open Reduction GNI Defecation, Defecation, in Practice (PPP), 1990 2012 of Open 2012 Defecation, 1990–2012

Ethiopia Nepal Vietnam Cambodia Angola Bangladesh Pakistan Haiti Peru Benin India

92 86 39 88 57 34 52 48 33 80 74

37 40 2 54 24 3 23 21 6 54 48

55 1110 46 1470 37 3620 34 2330 33 5400 31 2030 29 2880 27 1220 27 10090 26 1550 26 3820

Change in Per Capita GNI (PPP), 1990– 2012

720 930 2930 1650 3640 1490 1640 NA 6950 770 2950

GNI = gross national income; PPP = purchasing power parity. Economic & Political Weekly

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Figure 4: Scatter Plot of Change in Rate of Open Defecation in Countries against Change in Log of Per Capita Income (PPP) from 1990 to 2012 60 Change in OD

40 Fitted values 20

0

-20 4

6 8 Log of change in per capita Gross National Income (PPP) 1990–2012 The trend line is based on ordinary least squares regression. R2 (Linear) = 0.008

than India’s (with the exception of Angola and Peru). Bangladesh made significant strides towards total sanitation in spite of its poor per capita income. Both India and Bangladesh have a national policy and target for total sanitation (UN-Water 2012). Still, there was uneven progress in access to latrines in Indian districts (Ghosh and Cairncross 2014). Open defecation in Purba Medinipur district was as low as 11.6% against 52.3% in Paschim Medinipur (these two districts were created after bifurcation of Medinipur district in the late 1990s). An anecdotal reason for such inequality in access to latrine facility was the low population density in Paschim Medinipur (569 per square km compared to 1,008 per square km in Purba Medinipur). On the other hand, literacy had a strong positive influence on access to latrine facilities; with higher female literacy rates, specifically, open defecation was markedly less (Ghosh and Cairncross 2014). A regression analysis was conducted on 615 Indian districts to identify the impact of literacy and population density on open defecation rate. The regression result as shown in Table 5 indicates that a 1% gain in literacy would reduce the open defecation rate by 0.591%, holding population density constant. On the other hand, every 1% rise in population density would reduce open defecation by 0.067%, holding the

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literacy rate constant. The relative importance of literacy in reducing open defecation was very high, and the p-value indicated its statistical significance beyond the 1% level, while the population density coefficient was significant only at the 5% level. Lack of access to water is also assumed to be a reason why so many people in India do not use latrines. However, Coffey et al (2014) in their recent study have concluded that access to water is not at all a limiting factor for latrine use. West Bengal and Bangladesh have separate administrative and political structures but share a homogeneous demographic, cultural, and geographic identity. A comparison between bordering areas of West Bengal and Bangladesh, with almost identical conditions on income growth, literacy, and population density, may throw additional light on strategy formulation for eliminating open defecation in West Bengal. The Rajshahi division, which is composed of eight districts of Bangladesh— Bogra, Chapai Nawabganj, Joypurhat, Naogaon, Natore, Pabna, Rajshahi and Sirajganj—and three districts of West Bengal—Dakshin Dinajpur, Malda and Murshidabad—is covered under this study. In the Bangladesh study area, there are 66 upazillas (sub-districts) with a population of 18.484 million. The minimum

Table 5: Linear Regression of Open Defecation Rate (N = 615, adjusted R2 = 0.357, Durbin–Watson statistic = 0.915, F = 171.155) Variables

Standardised  Coefficients

Std Error

t-statistics

p-value

95.0% Confidence Interval Lower bound Upper Bound

Collinearity Statistics Tolerance VIF

Population density

–.067

.001

–2.069

.039

–.005

.000

.996

1.004

Literacy

–.591

.086

–18.219

.000

–1.731

–1.394

.996

1.004

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PERSPECTIVES Figure 5: Box Plots of Open Defecation in Study Area (Upazilla/ Block) by Districts (2011), Showing Medians, Quartiles, Extremes and Outliers 80

Open Defecation Rate

60 Dakshin Maldah Dinajpur 40

Murshidabad

20 Joypurhat

0

Bogra ChapaiNawabganj

Naogaon Natore Rajshahi Pabna Sirajganj

Bangladesh

level of open defecation in these upazillas of Bangladesh was 2.1%, the maximum level of open defecation 50.9% and the average 13.8%. On the other hand, in the West Bengal study area, there are 49 blocks (sub-districts) with a population of 12.769 million. The minimum, maximum and average levels of open defecation among the studied blocks in West Bengal were 29.3%, 82.9% and 68.1%. In Figure 5, box plots are used to further illustrate the wide range in open defecation practices in the sub-districts of each district under study. They provide a summary based on the mean, median, quartile and extreme values and represent the inter-quartile range that contains the middle 50% of the values. The lower and upper horizontal lines represent the minimum and maximum values. This is true only in the absence of outliers which are data values below Q1 minus 1.5 IQR (interquartile range Q3–Q1) or above Q3 plus 1.5 IQR. In the case of outliers, these lines (whiskers) represent values within a reasonable distance of the box. A line across the box indicates the median, and the centre of the circle within the box indicates the mean. It is clear that open defecation was much higher in the study area of West Bengal compared to Bangladesh. In Bogra district of Bangladesh, the open defecation rate of the upazillas varied from 6.0% to 24.3%. The open defecation rate in the upazillas of Pabna district varied between 2.1% and 5.4%, which was the lowest in the study area. In upazillas of Naogaon district, it varied from 9.4% to 50.9%. On the 34

West Bengal

other hand, in West Bengal, the open defecation rate in the sub-district of Dakshin Dinajpur varied from 58.2% to 80.9%, in Malda from 55.9% to 82.7%, and in Murshidabad from 29.3% to 82.9%. Discussion Understanding the reasons for poor progress in access to sanitation facilities will help us identify policies to accelerate the rate of progress towards sanitation for all areas in West Bengal. The analysis of the open defecation scenario and economic growth of 86 selected countries reveals that economic growth does not necessarily ensure elimination of open defecation. Low population density may not be a serious impediment either. On the other hand, literacy plays an important role in eradicating open defecation. Bangladesh has made rapid and remarkable strides in making the country free from open defecation. The progress in sanitation was rather slow during the 1980s and 1990s, with the sanitation coverage growth rate at a mere 1% per annum although a national sanitation goal of “100% sanitation by 2010” was initially set (Government of the People’s Republic of Bangladesh 2011). It is interesting to note how adjoining areas of West Bengal and Bangladesh were performing differently even with almost identical conditions of income growth, literacy, and population density. Six interlocking barriers help explain the slow progress of sanitation—national policy, behaviour, perception, poverty, gender and supply (UNDP 2006). It is true that availability of a latrine within

household premises does not necessarily ensure an end to open defecation (Coffey et al 2014). Quitting open defecation, the first step on the sanitation ladder, requires the breaking of behavioural and perception barriers. The construction of latrines is not sufficient to reduce open defecation substantially. Unless preferences are changed, a considerable number of people would still be defecating in the open even if the government were to build a latrine for every household that does not have one (Coffey et al 2014). The collaborative efforts of the international non-governmental organisation (NGO) WaterAid and a reputed Bangladeshi NGO called the Village Education Resource Centre (VERC), initiated particularly in Rajshahi and Naogaon districts, emphasised the inner strength and self-respect of the villagers to stop the shameful practice of open defecation, rejecting subsidies. The innovative approach, known as CLTS, introduced by Kamal Kar, an Indian consultant working with VERC, and supported by WaterAid, played a remarkable role in social mobilisation (Chambers 2009). The Government of Bangladesh adopted the CLTS approach for its National Sanitation Programme. Using participatory rural appraisal (PRA) methods, community members evaluate their own sanitation status, including the extent of open defecation and the spread of faecal– oral contamination that detrimentally affects everyone. The CLTS approach ignites a sense of disgust and shame once people collectively realise the adverse impact of open defecation. This realisation mobilises them to initiate collective action to eradicate open defecation and improve the sanitation situation (Government of the People’s Republic of Bangladesh 2013). The spectacular improvement in many social development indicators in Bangladesh is aided by the strong presence of NGOs and the density of settlements and their accessibility via an extensive network of rural roads (Wahiduddin et al 2013). Expertise in social marketing is a prerequisite for success in breaking the primary barriers of behaviour and perception. When international NGOs, with expertise in social marketing, work in

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close collaboration with national or local NGOs, their knowledge and skills in social marketing are transferred to the people working at the grass-roots level. The experience of Bangladesh in sanitation corroborates this strongly, as social marketing has played an important role in improving sanitation in Bangladesh. Social marketing is a systematic approach to public health problems. It goes beyond marketing. It is not motivated by profit alone but is concerned with achieving a social objective. Social marketing is therefore concerned with how the product is used after the sale has been made. The aim is not simply to sell latrines, for example, but to encourage their correct use and maintenance. (DFID 1998)

Bangladesh has used the concept of “shame vs subsidy” as a social marketing strategy to eradicate open defecation. Open defecation is considered shameful. People were motivated to install low-cost latrines without waiting for a subsidy (Kar 2003). Conclusions Effective sanitation means sanitation for all. There will be inequality in access to sanitation based on geographical, social and economic conditions until the target of full sanitation is achieved. West Bengal’s neighbouring country Bangladesh has almost achieved total sanitation. Implementation strategy at the grass-roots level plays a significant role in achieving sanitation for all. In West Bengal, a minority of blocks have made considerable progress towards achieving sanitation for all. Social marketing can be used in West Bengal to conduct large-scale campaigning to remove open defecation, promote low-cost latrines, and reduce dependency on subsidy. References Black, R E, S Morris and J Bryce (2003): “Where and Why Are 10 Million Children Dying Every Year?,” Lancet, Vol 361, No 9376, pp 2226–34. Chambers, R (2009): “Going to Scale with Community-led Total Sanitation: Reflections on Experience, Issues and Ways Forward,” IDS Practice Paper 1, Institute of Development Studies. Checkley, W et al (2004): “Effect of Water and Sanitation on Childhood Health in a Poor Peruvian Peri-urban Community,” Lancet, Vol 363, No 9403, pp 112–18. Coffey, D et al (2014): “Revealed Preference for Open Defecation: Evidence from a New Survey in Rural North India,” Economic & Political Weekly, Vol 49, No 38. DFID (1998): “Guidance Manual on Water Supply and Sanitation Programmes,” Department for Economic & Political Weekly

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International Development, UK, http://www. lboro.ac.uk/well/resources/Publications/ guidance-manual/prelims.pdf. Esrey, S A (1996): “Water, Waste, and Well-being: A Multi-country Study,” American Journal of Epidemiology, Vol 143, No 6, pp 608–23. Esrey, S A, J P Habicht and G Casella (1992): “The Complementary Effect of Latrines and Increased Water Usage on the Growth of Infants in Rural Lesotho,” American Journal of Epidemiology, Vol 135, No 6, pp 659–66. Fewtrell, L et al (2007): “Water, Sanitation and Hygiene: Quantifying the Health Impact at National and Local Levels in Countries with Incomplete Water Supply and Sanitation Coverage,” WHO Environmental Burden of Disease Series No 15, World Health Organization, Geneva. Ghosh, A, A Gupta and D Spears (2014): “Are Children in West Bengal Shorter Than Children in Bangladesh?,” Economic & Political Weekly, Vol 49, No 8. Ghosh, A and S Cairncross (2014): “The Uneven Progress of Sanitation in India,” Journal of Water, Sanitation and Hygiene for Development, Vol 4, No 1, pp 15–22. Government of the People’s Republic of Bangladesh (2011): “Sector Development Plan (FY 2011–25): Water Supply and Sanitation Sector in Bangladesh,” Ministry of Local Government, Rural Development and Cooperatives, Government of the People’s Republic of Bangladesh. — (2013): “Fifth South Asian Conference on Sanitation (SACOSAN-V): Bangladesh Country Paper,” Ministry of Local Government, Rural Development and Cooperatives, Government of the People’s Republic of Bangladesh. Hadi, A (2000): “A Participatory Approach to Sanitation: Experience of Bangladeshi NGOs,” Health Policy and Planning, Oxford University Press, Vol 15, No 3, pp 332–37. Hutton, G L Haller and J Bartram (2007): “Economic and Health Effects of Increasing Coverage of Low-Cost Household Drinking-water Supply and Sanitation Interventions to Countries Offtrack to Meet MDG Target 10,” World Health Organization, Geneva. Kar, K (2003): “Subsidy or Self-respect? Participatory Total Community Sanitation in Bangladesh,” IDS Working Paper 184, Institute of Development Studies. Mara, D et al (2010): “Sanitation and Health,” PLoS Med, Vol 7, No 11.

Merchant, A T et al (2003): “Water and Sanitation Associated with Improved Child Growth,” European Journal of Clinical Nutrition, Vol 57, pp 1562–68. Movik, S and L Mehta (2010): “The Dynamics and Sustainability of Community-led Total Sanitation (CLTS): Mapping Challenges and Pathways,” STEPS Working Paper 37, Brighton: STEPS Centre. Office of the Registrar General & Census Commissioner (2011): “Percentage of Households to Total Households by Amenities and Assets,” Census of India, Ministry of Home Affairs, Government of India, http://www.censusindia.gov.in/2011census/hlo/Houselisting-housing-PCA.html. Prüss-Ustün, A et al (2014): “Burden of Disease from Inadequate Water, Sanitation and Hygiene in Low- and Middle-Income Settings: A Retrospective Analysis of Data from 145 Countries,” Tropical Medicine & International Health, Vol 19, No 8, pp 894–905. Prüss-Üstün, A, R Bos, F Gore and J Bartram (2008): “Safer Water, Better Health: Costs, Benefits and Sustainability of Interventions to Protect and Promote Health,” World Health Organization, Geneva. Spears, D, A Ghosh and O Cumming (2013): “Open Defecation and Childhood Stunting in India: An Ecological Analysis of New Data from 112 Districts,” PLoS ONE, Vol 8, No 9. UNDP (2006): Human Development Report 2006: Beyond Scarcity: Power, Poverty and the Global Water Crisis, United Nations Development Programme. UNICEF and WHO (2015): “Progress on Sanitation and Drinking-water: 2015 Update and MDG Assessment,” UNICEF and World Health Organization. UN-Water (2008): “Sanitation Is Vital for Human Health,” Factsheet, https://esa.un.org/iys/ docs/IYS%20Advocacy%20kit%20ENGLISH/ Fact%20sheet%201.pdf. — (2012): GLAAS 2012 Report: UN-Water Global Analysis and Assessment of Sanitation and Drinking-water: The Challenge of Extending and Sustaining Services, World Health Organization. Wahiduddin, M, M N Asadullah and A Savoia (2013): “Bangladesh Achievements in Social Development Indicators: Explaining the Puzzle,” Economic & Political Weekly, Vol 48, No 44.

EPWRF India Time Series Expansion of Banking Statistics Module (State-wise Data) The Economic and Political Weekly Research Foundation (EPWRF) has added state-wise data to the existing Banking Statistics module of its online India Time Series (ITS) database. State-wise and region-wise (north, north-east, east, central, west and south) time series data are provided for deposits, credit (sanction and utilisation), credit-deposit (CD) ratio, and number of bank offices and employees. Data on bank credit are given for a wide range of sectors and sub-sectors (occupation) such as agriculture, industry, transport operators, professional services, personal loans (housing, vehicle, education, etc), trade and finance. These state-wise data are also presented by bank group and by population group (rural, semi-urban, urban and metropolitan). The data series are available from December 1972; half-yearly basis till June 1989 and annual basis thereafter. These data have been sourced from the Reserve Bank of India’s publication, Basic Statistical Returns of Scheduled Commercial Banks in India. Including the Banking Statistics module, the EPWRF ITS has 16 modules covering a range of macroeconomic and financial data on the Indian economy. For more details, visit www. epwrfits.in or e-mail to: [email protected]

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