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Major causes of water-borne disease amongst the region’s rural population, and of malnutrition amongst children under five, are open defecation and poor sanitation facilities. Annually, around 40-70% of families in the region are affected by water-borne diseases, with the highest prevalence amongst children of up to nine years. 61% of children under five in our area are underweight.

Defecation in the open has been a practice in many parts of India, and the same is true in our work area. It is particularly prevalent in rural areas, although it is still an issue in urban areas. This affects health and hygiene, since water sources are contaminated by faeces found in the open or in badly designed toilets close to homes. A study conducted in partnership with one research institute found that 35-75% of households had problems

with toilet design, resulting in low levels of use of existing toilets.

Along with the access to and design of toilets, it is critical to get the communication about their use right. There has been an emphasis on women’s safety and honour, but there is also a need to give sufficient focus to health and hygiene, and to persuasion and motivation.

Seva Mandir focuses on a holistic approach to the sanitation problem in the region by incorporating three critical areas: access, design and usage.

To ensure access and appropriate design, Seva Mandir works through community institutions which identify families who need access to toilets in a village. With Seva Mandir’s technical support, the community decides on the type of toilet to be installed. Seva Mandir provides three types of toilet: Ecosan (dry) latrines, twin-pit (water-based) toilets and toilets with septic tank. The choice of toilet type is made according to the needs of the community, and land and water availability. Individual families contribute through labour and provision of local materials like sand and stones. Seva Mandir periodically seeks feedback and inputs from local women to help improve the design of the toilets.

Seva Mandir also works with the community institutions to identify families who do not use existing toilets made under government and other interventions because of bad design or incomplete construction. We make adjustments to toilet design, including pit size, proper ventilation and doors, and we help families finish incomplete toilets.

To ensure behavioural change and usage, Seva Mandir works with community institutions, women’s groups and community-based workers (Balsakhis, Balwadi Sanchalikas, Shiksha Kendra teachers etc), taking the time to talk to families about correct usage of toilets, to educate them through informative material and community events, and using role models in the community to help convey a positive message and encourage usage.


As a result of Seva Mandir’s intervention on sanitation since 2010, nearly 1,800 families now have access to functional toilets with 78% of the toilet facilities being regularly used at the household level, and 56% being used by all members of the household. A major result has been that the prevalence of water-borne disease amongst families with access to clean drinking water and toilets has reduced by 30-60%.

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