Improving cleanliness of Healthcare facilities
In ancient times, surgical procedures were conducted near river banks during morning hours to benefit from clean water and air and Clean surroundings.
With passage of time our natural resources are getting exhausted because of urbanization and population growth which is adversely impacting human health and the nation’s economy.
According to an estimate, that in 2015 lack of access to sanitation cost loss of around US $ 222.9 million to the global economy
- For addressing the growing challenges of sanitation and hygiene the Ministry of Health and Family Welfare of Government of India has adopted a multi- pronged strategy and has launched many initiatives for improving hygiene and sanitation holistically.
- MoHFW’s Kayakalp initiative began in 2015 with the aim of improving infrastructure upkeep, hygiene and sanitation, and infection control practices in central government institutions and public health facilities in all 36 states and UTs.
- Health facilities are assessed and scored on a number of parameters and every year the highest scoring facilities at each level receive recognition through kayakalp awards.
- The kayakalp scheme has resulted in significant improvement in the level of the cleanliness, hygiene and infection control practices at Public Health Care facilities.
- MoHFW is also working to improve sanitation through a convergence of efforts with other One such joint initiative between MoHFW and the ministry of drinking water and sanitation is the Swachh Swasth Sarvatra that attempts to bring Synergy between the Swachh Bharat Mission (SBM) and kayakalp by enabling and awarding funds to Gram Panchayats where Kayakalp awarded Primary Health Centres (PHCs) and Community Health Centres (CHCs) are located to become open defecation free.
VISHWAS-A new initiative
· In 2017, as a part of its efforts to expand and strengthen sanitation and hygiene interventions, National Health Mission (NHM) has launched a new campaign VISHWAS-Village based Initiative to Synergise Health, Water, and Sanitation.
- Kayakalp Initiative for Health Facilities -The programme aims at including in public health facilities a culture of regular assessment and Peer review of performance related to hygiene, cleanliness and sanitation.
- The States and UTs are supported extensively in roll out of ‘Kayakalp’ initiative, as part of National Health Mission (NHM).
Impact of Kayakalp Programme
o After launch of Kayakalp scheme, there is significant improvement in the level of cleanliness, hygiene and infection control practices at public health facilities.
o The program has also built a culture of ongoing assessment and peer review of performance to promote hygiene, cleanliness and sanitation.
Swachh Swasth Sarvatra
· Swachh Swasth Sarvatra is a joint initiative of ministry of Health and Family Welfare and ministry of drinking water and sanitation to achieve better health outcomes through improved sanitation and increase awareness on Healthy lifestyles.
Its objective is to have more Synergy between two complementary programmes- Swachh Bharat Mission (SBM) and kayakalp.
Three broad objectives of this scheme are:-
- Enabling Gram Panchayat where kayakalp awarded PHCs is located to become open defecation free (ODF).
2. Strengthening community health centre (CHC) in ODF blocks to achieve a high level of cleanliness to meet kayakalp standards through a support of Rs 10 Lakhs under NHM.
3. Build capacity through training in water, sanitation and hygiene (WASH) to nominees from such CHCs and PHCs.
Swachhata Pakhwada an initiative of MoHFW conducts sanitation and hygiene campaigns at public health facilities and at the community level every year.
- The diverse intervention undertaken by MoHFW are making a decisive impact at the level of health facilities and they have also built a supporting and enabling environment at the community level for achieving the goals of sanitation and hygiene, behaviour change, well beyond the existing programmes.
- The kayakalp, and Swachh Swasth Sarvatra, have not only improved the cleanliness status of facilities, they have also helped in facilities becoming centres for community awareness on these issues.
- Community platforms of Village Health Sanitation & Nutrition Committee (VHSNC) and Mahila Arogya Samiti (MAS) and the newly launched VISHWAS campaign, are making significant contributions for building collective community efforts for the cause of sanitation and hygiene, in building awareness about their linkages with health outcomes, and in creating sustained behavior change.
- The wide reach, access and trust of Frontline workers of the health system, and the community based Institutions of VHSNC and MAS, is helping in building the Swachh Bharat and Swasth Bharat that we are all working for.
A Hygienic Environment for Mother and Child
“Sanitation in a community is more important than independence. Sanitation is a common spiritual effort in a community like ours and it is a basic human right”.-M.K.GANDHI
The above quote by Gandhiji portrays the sense of importance Bapu has bestowed on the need of sanitation for the survival of human race.
- Sanitation is beyond cleanliness. The concept of ‘Sanitation’ is a comprehensive one including effective management of human waste, solid waste, waste water, sewage effluents, industrial wastes and hazardous wastes.
- Lack of sanitation, has vital economic consequences and also serious social consequences.
Women and Child Care
Clean water, basic toilets and good hygiene practices are essential for the survival and development of children.
For children under five, water and sanitation related diseases are one of the leading causes of death. Every day over 800 children die from preventable diseases caused by poor water, and a lack of sanitation and hygiene.
Child care institutions and Anganwadis are considered as the centres in rural India where mothers and children converse almost every day and thus, these have turned into nodal units to spread awareness of Swachhata and disseminate the message of Sanitation.
To ensure that Swachhata activities are carried out by each and every citizen of India, ‘Shramdaan’ or contribution of labour is encouraged.
Shramdaan is an innovative action taken by the Ministry for offering voluntary swachhata activities starting from the level of minister to the anganwadi workers in their homes, surroundings and offices.
Poverty and malnutrition exacerbate the risk of infants and children to various infectious diseases like diarrhea and pneumonia and heighten the probability of death, particularly among children with low birth weight.
- Demographic and epidemiological studies have documented that poor economic status of household, low female literacy, poor nutritional status of mother, child marriage, large family size, low autonomy of women, and inadequate access to health care services typically lead to disproportionately higher risk for the health status of mothers and their children.
- Studies have also documented large socioeconomic and interstate disparities in the maternal and child health status.
- The practice of open defecation is the main reason as to why India reports highest diarrhea deaths among children below 5 in India. Children weakened by frequent diarrhea are more vulnerable to malnutrition, stunting and
- Malnutrition among children in rural India is a common problem mostly among the disadvantaged sections of the society. The ministry has also initiated POSHAN Abhiyan to reduce the problem of poor nutrition among children.
- Sanitation has direct impact on the health of women and children, leading to infant and female mortality issues.
- Women can be active agents for bringing behavioural change in the society. They play an important role in the socialization process of children. They are considered to be the carriers of culture, tradition and history and identified with shaping the behaviour of children.
- Therefore, the Ministry has contributed towards building a safe and hygienic environment to ensure good health for both mothers and children.
Ending Open Defecation
- Water, sanitation and hygiene are the three core issues which are grouped together to represent a growing sector. While each is a separate field of work, each is dependent on the presence of the other.
- For example, without toilets, water sources become contaminated; without clean water, basic hygiene practices are not possible.
- The country has set a target to become completely ODF at the earliest and this is a challenge that has to be met with all possible means by infrastructure, behaviour change and broader collective activities.
- In order to end open defecation, influential opinion leaders – such as the government, elected representatives, PRIs, Media etc should come together as they can play a key role in achieving the country’s target.
Sanitation revolution: Cleansing urban India
The Cost of Poor Sanitation
- Sustainable development goals (SDGs) place a significant emphasis on sanitation, cleanliness and hygiene.
- There is significant evidence globally that better sanitation, hygiene and cleanliness helps in effective control of various vector borne diseases, parasite infection and nutritional deficiencies.
- They have been studies linking cleanliness and hygiene with reduction in respiratory disorders, gastrointestinal diseases (especially diarrhea), psychological issues and allergic conditions.
- As per a UNICEF report (2011), almost 90% of child deaths from diarrheal diseases are directly linked to contaminated water, lack of sanitation or inadequate hygiene.
- The problem of solid waste management has been compounded due to high population growth rate and population concentration in urban areas.
- As per the India health report for nutrition security in India (PHFI, 2015), the north eastern state of Mizoram has reported a 13 percentage- point decline in stunting (below normal height for the age) and 5 percentage points decline in underweight children (underweight and short) between 2006 and 2014 due to improved access to sanitation.
- Improved sanitation also has significant impact on social and economic development, particularly in developing countries.
Solid waste management – a multi-pronged approach
- It has to be acknowledged that while the ODF objective in India is on the brink of success, addressing the issue of solid waste management poses for Greater challenge.
In India, an estimated 65 million tons of municipal solid waste is generated annually by around 400 million citizens residing in urban areas.
- We are also losing 1,250 hectares of additional precious land every year to accommodate dumping of un-processed municipal solid waste.
- Therefore, MoHUA has adopted a multi- pronged approach to address the complex issue of scientific waste management in urban areas of India.
This includes policy and regulatory changes to encourage processing of waste to Value Added products on the one hand, along with mission initiatives such as swachh survekshan to inculcate a spirit of healthy competition, and star rating for garbage free cities to ensure long term sustainability.
Swachh Survekshan – a Tool for Mission Monitoring and Governance
Under the SBM urban, MoHUA has been conducting the swachh survekshan an annual survey to rank cities on various sanitation and cleanliness parameters.
The survey has been successful in enthusing cities with a spirit of healthy competition towards the concept of swachhata.
Star Rating for Garbage Cities
- The ministry has introduced a new innovative initiative for evaluating the garbage free status of cities and awarding the “garbage free City stars” to the city.
- The star rating protocol, properly implemented, can prove to be a game changer and revolutionize the way solid waste is managed in India.
- As more and more cities get certified as ‘stars’ it may well emerge as a key differentiator in the administrative/ political fabric of the country, where ‘number of stars’ for their city can be one of the parameters for evaluating effectiveness of Administration and elected representatives in achieving swachhata.
Success stories from states and cities:
- Kerala has been leading the way in the decentralized waste management with most of it cities having installed pipe compost and biogas plants at the household level.
- Alappuzha in Kerala is among the top 5 cities in the world recognized by the United Nations environment programme (UNEP) in its efforts to tackle the problem of solid waste.
- Goa has proven how waste can be an asset through its source segregation into 5 fractions. The city claims 100 percent door to door collection.
- 100 percent of waste in Gangtok is being segregated at sources and being processed.
- Nagpur has introduced an innovative watch which helps the ULB to monitor attendance of sanitary workers through Geo-tagging of their locations during their working hours.
- Aligarh has introduced ‘magic Bricks’ made out of dry waste which can be used in construction activities.
- In Maharashtra by ”innovative colour coding of households” (red, yellow, and green) –denote households that do not segregate their waste, segregate occasionally, and regularly segregate respectively.
- Moving towards a ‘Janandolan’
In the last 4 years, along with infrastructural and regulatory changes, a parallel social movement has been steadily gathering Momentum among citizens.
- Today, we have more than 50 such brand ambassadors who are inspiring citizens to become partners with the government in our collective journey towards swachhata.
- Through other initiatives such as thematic drives with citizen participation, engaging students and self-help groups to be the agents for social behaviour change, engaging swachhagrahis across the country to drive behaviour change, running multimedia community campaigns.
- There is now a growing appreciation among people that sanitation and cleanliness is not the sole responsibility of the government, and that each of us is equally responsible for maintaining cleanliness of our surroundings.
Social and Economic Impacts of Swachh Bharat Mission: A Few Examples
- A recent study by the Indore Municipal Corporation has found that vector borne diseases have reduced by 70% due to sanitation interventions under Swachh Bharat mission. The number of patients affected by jaundice, cholera, vomiting, diarrhea, hepatitis and malaria in Indore has reduced.
- As a result, the sale of medicine across Indore has dropped by INR 20 crores, which has contributed in controlling Healthcare related costs in the City.
- State of Chhattisgarh has reported a dramatic reduction in contamination and incidences of diseases such as diarrhea, typhoid etc., in the last 2 years.
- The Ambikapur model of Solid Liquid Resource Management has provided jobs to thousands of self-help groups (SHGs) women members leading to improving their quality of life.
Today the concepts of cleanliness and swachhata have come to embody the spirit of empowerment and quality of life.
Investments in sanitation and garbage free cities can significantly impact our lives and the larger environment – by providing a better quality of life for all, especially the economically weaker sections, ensuring dignity and safety of women and children, positively impacting health outcomes, providing enhanced livelihood opportunities and greater earning potential for rag pickers and other informal sectors, opening up entrepreneurial opportunities in the waste management sector, and improving tourism potential and resultant foreign exchange inflow, thus positively impacting the GDP of the country and contributing to a cleaner the environment.
A swachh environment will lead to a ‘Swasth, Samarth, and Samriddh’ Bharat and pave the way for new India -2022.