Correlates of access to sanitation facilities and benefits received from the Swachh Bharat Mission in India: analysis of cross-sectional data from the 2018 National Sample Survey

OBJECTIVE: Equitable and affordable access to improved sanitation facilities is linked to health and is among the priority areas of development programmes in a country like India. This study assesses the level of different sanitation facilities accessed by households and attempts to understand the socioeconomic characteristics of the households that received financial benefits from the Swachh Bharat Mission (Swachh Bharat Abhiyan), a Government of India flagship programme. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: The study extracted data from the 76th round (2018) of the National Sample Survey, consisting of 106 837 households in India. OUTCOME MEASURES: Sanitation services and benefits received from the Swachh Bharat Mission in the last 3 years preceding the survey were the two outcome variables of this study. Bivariate and multinomial logistic regression analysis were performed to identify factors associated with the outcome variables. RESULTS: Findings show the existence of state and regional disparities, along with rural–urban gaps, in the accessibility of sanitation facilities. Half of the households (52%, n=55 555) had access to safely managed sanitation facilities, followed by basic services (14.8%, n=15 812), limited services (11.4%, n=12 179) and unimproved services/open defecation (21.8%, n=23 290). Limited and unimproved facilities decreased significantly (p<0.001) with increase in economic status, although poor and less educated households received the maximum benefit from the Swachh Bharat Mission. CONCLUSION: The mission has been successful in increasing access overall; however, many people continue to lack access to improved sanitation and there remains a need to follow up poor and rural households to determine their usage of and the current state of their sanitation facilities.