In 2014, the Indian government launched the Swachh Bharat (Clean India) Mission (SBM) aimed at improving public sanitation. By 2020, the program had constructed 100 million toilets across the country. In SBM’s first five years, national rates of open defecation fell from 60% to 19% and toilet availability doubled. The program also stressed local community mobilization, following an Information, Education, and Communication approach in which weekly messages via SMS, phone calls and community workers were delivered to rural households with reminders on the importance of safe and hygienic sanitation practices.
In our recent paper published in Nature’s Scientific Reports, we found a clear association in the 2014-2020 time frame between toilet construction under the SBM program and infant and child mortality in India. We estimated that every 10% increase in toilets built through SBM is associated with an estimated reduction of 0.9 infant deaths per 1,000 live births, which scales to 67,235 fewer infant deaths per year given SBM coverage levels across Indian districts.