Sanitation and Religion in South Asia: What Accounts for Differences across Countries?

Abstract

Exposure to open defecation has serious consequences for child mortality, health, and human capital development. South Asia has the highest rates of open defecation worldwide, and although the incidence declines as household income rises, differences across South Asian countries are not explained by differences in per capita income. The rate of open defecation in sub-national regions of Bangladesh, India and Nepal is highly correlated with the fraction of the population that identifies as Hindu, in part because certain rituals of purity and pollution discourage having latrines in close proximity to one’s home. Almost all open defecation occurs in rural areas, and this paper estimates how much the rate could be reduced if rural households in regions that have a higher fraction of Hindus, where open defecation is still common, altered their behaviour to reflect that of non-Hindu households in regions that are predominantly non-Hindu, where the rate of open defecation is much lower. Using nonparametric reweighting methods, this paper projects that rural open defecation in Bangladesh, India, and Nepal could be reduced to rates of between 6 and 8 per cent, compared to the prevailing level of 65 per cent.

Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households

“…Vyas and Spears (2017) use Demographic and Health Survey data from rural Bangladesh, India, and Nepal and project that open defecation in the region would be almost eliminated if Hindus in these countries had the same sanitation behavior as non-Hindus. Geruso and Spears (forthcoming) use 2005 National Family Health Survey data and find that within India, Muslims are 25 percentage points less likely to defecate in the open than Hindus, with important consequences for differences in child survival by religion.…”

“…Although a correlation between religion and switching to latrines is not a hypothesis of this paper, we present descriptive results separately for Hindu and non-Hindu households. This is because prior studies of National Family Health Survey data find very large differences in latrine use between Hindus and non-Hindus (Vyas and Spears, 2017; Geruso and Spears, forthcoming). Using the IHDS data, we find that holding other variables constant, whether or not a household is Hindu is a strong predictor of latrine adoption.…”

The Spectre of Superbugs: Waste, Structural Violence and Antimicrobial Resistance in India

“…Yet Coffey and Spears (2017) find the core reason to be caste and concepts of pollution. Drawing on comparative data and extensive fieldwork in India, they suggest the attitudes and preferences of rural populations for defecating outdoors persist because human waste is considered ritually polluting and toilets embody such pollution (see also Vyas and Spears 2018).…”

Touch Thee Not: Group Conflict, Caste Power, and Untouchability in Rural India

“…Geruso and Spears (2018) claim that the higher mortality rates observed among Indian Hindus can be accounted for by the different sanitation environments in which Hindu and Muslim children grow up. Religious beliefs and caste relations closely linked to the practice of Hinduism influence sanitation behaviour , Vyas and Spears 2018. Beliefs in purity and pollution contribute to the acceptability of widespread open defecation and the rejection of inexpensive latrines in rural India.…”