Sanitation strategies for reducing open defecation in rural areas of India and Ethiopia

Sanitation change continues to be on the forefront of the global development agenda, even as it is becoming clear that the targets established in the Sustainable Development Goals will not be met. But since improving access to safely managed sanitation facilities remains a cost-effective and impactful measure to improve people’s lives, it is still important to assess currently implemented policies to be able to learn from best practices and to understand how different approaches work under different contexts. This paper provides comparative analysis of country-level policies in India and Ethiopia, two countries that achieved notable progress in eliminating open defecation through distinct sanitation strategies, with the aim of confronting the advantages and disadvantages of both approaches. While in India the primary emphasis has been on the supply-side, i.e., provision of subsidized sanitation infrastructure, Ethiopian strategy prioritized the demand-side by addressing change in sanitation behavior through Community Total Led Sanitation. The analysis shows that neither of the strategies can fully achieve the sanitation change and a combination of both seems to be the most impactful approach in combating open defecation. It also argues that policymakers must consider not only local socioeconomic and budgetary constraints but also historical, institutional, sociocultural, and geographical specifics in deciding what type of subsidies would be the most fitting. At the same time, they also need to address the appropriate social norms to achieve the desirable change in sanitation behavior.