Swachh Bharat Mission prevents 70,000 infant deaths annually: Study

A research carried out on the toilets constructed under Swachh Bharat Mission, a major public health campaign launched by the Indian Prime Minister Narendra Modi’s government revealed that the constructions could have saved 60,000–70,000 infants dying due to unhygienic sanitation conditions annually according to a research conducted by the Nature journal. Starting its operation in October, 2014, SBM is one of the largest sanitation corporations of the world in order to address the problem of open defecation across the country by constructing household toilets with hygiene campaigns throughout India.

The study titled “Toilet Construction under the Swachh Bharat Mission and Infant Mortality in India”, authored by Suman Chakrabarti, Soyra Gune, Tim A. Bruckner, Julie Strominger, and Parvati Singh, was published in Nature on September 2.

The infant mortality rate (IMR) and under five mortality rate (U5MR) were examined by the researchers from the International Food Policy Research Institute in the United states for 35 states and 640 districts in India in the period of 2011 to 2020. Infant mortality rate is defined as the number of children per year who die before reaching one year old,per 1000 lives.

The  findings of the study  highlighted that there was an inverse correlation between access to toilets and child mortality in India. In the wake of the Swachh Bharat Mission last launched in 2014, toilet construction has picked up, with over 117 million constructed through public investment exceeding ₹1.4 Lakh crore.The report stated “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.”

Key Factors in Swachh Bharat Mission’s Success

PM Modi shared the report on X and said “Happy to see research highlighting the impact of efforts like the Swachh Bharat Mission. Access to proper toilets plays a crucial role in reducing infant and child mortality. Clean, safe sanitation has become a game-changer for public health. And, I am glad India has taken the lead in this.”

It is evident from the study that with an increase of 10 percentage points in district level toilet access under SBM, there is a decrease in IMR by 0.9 points and the under-five mortality rate (U5MR) by 1.1 respectively.The study also affirms the existence of a threshold effect where districts with SBM toilet coverage of at least 30 percent exhibited reductions in the IMR and CMR levels. 

Districts surpassing this threshold experienced a decrease of 5.3 in the infant mortality rate (IMR) and 6.8 in the under-five mortality rate (U5MR). They recorded 10 points per 1,000 live births. In real terms, this translates to an estimated 60,000 to 70,000 infant lives saved each year. The findings were validated through robustness checks and falsification tests.

Unlike other Indian sanitation movements that were previously launched, SBM combined construction with more than a million latrines, significant investments in information, education, and communication activities and community participation making a significant difference from previous ineffective programs.

Using the data obtained for the study, a new set of figures based on the decline of IMR and CMR due to the holistic approach of Swachh Bharat Mission for the improvement of sanitation facilities across the country is presented here to highlight its impact on the health of the people.

It also points out that increased toilet access under SBM likely reduced exposure to fecal-oral pathogens, which in turn helped lower the rates of diarrhoea and malnutrition—two major factors contributing to child mortality in India.It also notes that due to SBM, more people have had access to toilets, which may have diminished contact with the faecal-oral pathogens that cause diarrhoea diseases and malnutrition—two leading causes of child mortality in India.

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