Spatial clustering and drivers of open defecation practice in India: Findings from the fifth round of National Family Health Survey (2019-21)

Q1 Social Sciences
Avijit Roy , Margubur Rahaman , Rohit Bannerji , Mihir Adhikary , Nanigopal Kapasia , Pradip Chouhan , Kailash Chandra Das
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Abstract

Background

India implemented a basket of public health developmental packages to achieve the Sustainable Development Goal (SDG) 6—providing access to clean water and adequate sanitation for all by 2030. Though the country is getting closer to being free of open defecation, the pace of progress varies spatially. Therefore, the current study is relevant to explore determinants of practicing open defecation at the small area level in India.

Methods

The present study included the latest National Family and Health Survey (2019–21) and applied both non-spatial (bivariate statistics with 2 test and multivariate logistic regression) and spatial analyses (Univariate and bivariate LISA Moran I, OLS, SLM, and SEM) to assess the national level predictors and spatially auto-correlated determinants of practicing open defecation.

Results

In India, almost one-fifth of households practiced open defecation, mainly clustered in the Middle Ganges Plain, central, and eastern region. A significant rural-urban and poor-rich gap in open defecation practice was also observed. The spatial clusters of lower-educated individuals, poorest wealth quintile, backward social groups, and rural residence were found to be prone to open defecation practice. Housing condition and water supply with the house were also significantly auto-correlated with open defecation practice.

Conclusion

Open defecation remains a public health challenge in India, particularly in the north and central parts, among rural populations, and in socioeconomically deprived areas. It is crucial to focus on small area-level program implementation and assessment approaches to eliminate open defecation in India by 2030.

印度露天排便的空间聚集和驱动因素:第五轮全国家庭健康调查结果(2019-21)
背景印度实施了一篮子公共卫生发展一揽子计划,以实现可持续发展目标6——到2030年为所有人提供清洁水和充足的卫生设施。尽管这个国家离摆脱露天排便越来越近,但进步的步伐在空间上各不相同。因此,目前的研究与探索印度小面积露天排便的决定因素有关。方法本研究包括最新的全国家庭和健康调查(2019-21),并应用非空间(双变量统计ꭔ2检验和多变量逻辑回归)和空间分析(单变量和双变量LISA-Moran I、OLS、SLM和SEM),以评估国家水平的露天排便的预测因素和空间自相关决定因素。结果在印度,近五分之一的家庭露天排便,主要集中在恒河中平原、中部和东部地区。在露天排便实践中,也观察到了显著的城乡和贫富差距。研究发现,受教育程度较低的个人、最贫穷的财富五分之一、落后的社会群体和农村居民的空间集群容易出现露天排便行为。住房条件和房屋供水也与露天排便行为显著相关。结论露天排便在印度仍然是一项公共卫生挑战,特别是在北部和中部、农村人口和社会经济贫困地区。重点关注小面积项目的实施和评估方法,以在2030年前消除印度的露天排便,这一点至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Global Transitions
Global Transitions Social Sciences-Development
CiteScore
18.90
自引率
0.00%
发文量
1
审稿时长
20 weeks
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