Nature's Call: Impacts of Sanitation Choices in Orissa, India

A randomized intervention in Bhadrak district, Orissa, was conducted between 2005 and 2006. Bhadrak was chosen because it still had a sufficiently large number of blocks and villages where the government of India's existing Total Sanitation Campaign interventions had not been implemented. Second, the use and maintenance of latrines in the area remained unsatisfactory despite adequate water availability, and third, the Government of Orissa agreed that no special water, sanitation, or hygiene programs would be implemented in control villages during the study period. In order to assess the impact of the sanitation intervention on household sanitation behaviors, child health outcomes, and welfare measures, a repeated-measures cohort design was implemented. Qualitatively, treatment villages appear to be slightly worse off initially in terms of a few indicators, treatment villages had somewhat lower levels of population density and of TVs and, most notably, latrines in 2005. Adults in these households also reported spending more time walking to defecation sites and expressed lower levels of satisfaction with their sanitation conditions. The Bhadrak sanitation campaign placed much emphasis on the non-health benefits of latrine use. In particular, messages about latrines' convenience highlighted the potential time savings households could enjoy from changing their sanitation behaviors.