Policy Lessons from the Implementation of India’s Total Sanitation Campaign

Ending widespread open defecation and pursuing feasible methods of safe excreta disposal must be the top policy priorities for India. This paper draws policy lessons from the first 10 years of latrine construction under India’s Total Sanitation Campaign (TSC), which was a flagship program of the Indian government. The TSC improved average health and human capital among Indian children where it was implemented, but sanitation coverage remains substantially incomplete. Indeed, the first 10 years of the TSC, on average, prevented an infant death for a few thousand dollars, a comparatively very inexpensive average cost. This initial success is in part due to the Clean Village Prize or Nirmal Gram Puraskar (NGP), an incentive for village governments. Heterogeneity in the intensity and effectiveness of TSC implementation suggests that the additional benefits of extending effective TSC implementation to the many remaining Indian children would probably substantially exceed the additional costs. Therefore, as the TSC becomes the Nirmal Bharat Abhiyan, India should not miss the opportunity to invest in successful principles of total sanitation: quality data, effective monitoring, and motivational ex post incentives