Articles by Diane Coffey

Since October 2014, the Government of India has worked towards the goal of eliminating open defecation by 2019 through the Swachh Bharat Mission. In June 2014, the results of a survey of rural sanitation behaviour in North India were first reported. The results from a late 2018 survey that revisited households from the 2014 survey in four states—Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh—are presented. Although rural latrine ownership increased considerably over this period, open defecation remains very common in these four states. There is substantial heterogeneity across states in what the sbm did and how. These outcomes suggest the need for a transparent, fact-based public dialogue about the sbm, its costs and benefits, and its accomplishments and means.

Through the use of new survey data, the experiences and perceptions of discrimination among Dalits and Muslims have been quantified. One important result is that many respondents report experiencing discrimination at school and in interactions with government officials. These results are even more worrisome when we consider that self-reports of discrimination perhaps underestimate the true extent of the problem.

The Government of India’s NFHS–4 offers the best new data on open defecation in rural India to be eleased in over a decade. Although open defecation has become less common than it was 10 years ago, it is still highly prevalent, with more than half of rural households reporting open defecation. On average, change has been slow, even during the period of the Swachh Bharat Mission.

India has far higher open defecation rates than other developing regions where people are poorer, literacy rates are lower, and water is relatively more scarce. In practice, government programmes in rural India have paid little attention in understanding why so many rural Indians defecate in the open rather than use affordable pit latrines. Drawing on new data, a study points out that widespread open defecation in rural India is on account of beliefs, values, and norms about purity, pollution, caste, and untouchability that cause people to reject affordable latrines. Future rural sanitation programmes must address villagers’ ideas about pollution, pit-emptying, and untouchability, and should do so in ways that accelerate progress towards social equality for Dalits rather than delay it.

What are the relationships between wealth and children's health in India's states that are as populous as many other countries? Presenting a state-level analysis of the association between state net domestic product per capita and three children's health indicators, this paper describes how these relationships differ in the last two rounds of the National Family Health Survey. It finds evidence that the cross-sectional relationships between aggregate wealth and children's health indicators are positive, yet the association was less steep in the mid-2000s than in the late 1990s. It also finds a negative relationship between growth in SNDP per capita and improvement in state-level children's health indicators. These findings are consistent with the hypothesis that the kinds of investments which improve health may lead to economic growth, rather than vice versa.