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This paper is an empirical attempt to demonstrate the significance of capacity-building training which was conducted by the National Institute of Urban Affairs (NIUA) on behalf of the Ministry of Housing and Urban Affairs under the Swachh Bharat Mission-Urban (SBM-U). The paper focuses on sanitation and solid-waste management (SWM), two issues which are directly under the purview of urban local bodies (ULBs). The objectives of the SBM-U 1.0 are to make all cities and towns open defecation free and garbage free by 2 October 2019. Towards this end, NIUA has conducted training-cum-exposure workshops in 2016, 2017, 2018 and 2019 for ULBs. These comprise orientation, technical sessions as well as field visits. The pedagogy of these workshops is based on experiential learning theory (ELT), with suitable innovations, employed for educating through first-hand experience. An evaluation of the efficacy of the ELT model was carried out through a research questionnaire filled out by the participants during 2017-2018 and 2018-2019 of selected states and was analysed for the understanding and implementation of service-level processing parameters in their states.

Sustainable management of water and sanitation is inextricably linked with women's health and well-being. This paper investigates slippage in sanitation, experienced by women beneficiaries of the Swacch Bharat Mission Rural programme through Amartya Sen's conception of justice. A total of 135 individuals were interviewed from 49 households in Kanjadwa and Madhnagar Manoharpur Gram Panchayats, Shravasti, India, out of which 90 were women. As per findings, 30% of women practice open defaecation despite possessing toilets, resulting in slippage. The Sanitation Well-being framework is deployed to study slippage and its linkage with women's agency. Personal, cultural, and structural factors contributing to this are child marriage, denial of education and employment opportunities, slut shaming, victim blaming, domestic violence, and character assassination. These are made worse by the state adoption of misogynistic IEC messages that reinforce cultural stereotypes and worsen women's condition. In the quest to attain ODF status in Ikauna Block, UP, the current sanitation programme became a tool of suppression. Consequently, we understand that open defaecation among women is an outcome of the basic unfreedoms rather than a volitional choice that prevents them from experiencing sanitation well-being. [ABSTRACT FROM AUTHOR]

Despite the enactment of successive legislations in 1993 and 2013, the dehumanising occupational practice of manual scavenging still persists in India. As members of the Dalit community, manual scavengers continue to confront issues such as marginalisation and gross violation of their dignity. This paper critically examines the socio-legal status of manual scavengers in India by assessing key determinants including the legislative and regulatory measures, the role of the judiciary and civil society, as well as the widely celebrated Swachh Bharat Abhiyan. Additionally, the paper provides an empirical analysis of the struggles faced by manual scavengers as frontline workers during the unprecedented humanitarian crisis of COVID-19. [ABSTRACT FROM AUTHOR]

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Covid 19 has unleashed unprecedented challenges in terms of sharply dwindling employment and health care vulnerability in India, as never seen before. The closest parallel is Economic Depression of the 1930s. The Government of India has announced a series of fiscal stimulus to resuscitate the most vulnerable sections of Indian economy like peripatetic migrant laborers, Ministry of Micro, Small and Medium Enterprises (MSMEs), street vendors, small farmers and unskilled MNREGA workers. This paper specifically looks at the likely impact of Rs.41000/- crore additional allocations to by Finance Minister in April 2020 MNREGA in mitigating disruption caused to about 80 million migrant workers. It also takes stock of allocation to National Health mission; its poor impact on Human Development Index (HDI), high Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR) compared to global trends and suggests a way forward. The paper makes a strong case to eschew populist moves like relying on doles and Universal Basic Income (UBI), but instead opt for a strong push to neglected public sector investment in merit goods like good primary health care and quality grassroots education, sanitation and skilling. It makes a strong pitch to make right to health care a fundamental right and change our public policy discourse in health care from insurance based to building adequate health infrastructure, as is in vogue in NHS (National Health Scheme) of UK [ABSTRACT FROM AUTHOR]

Background: Although a good number of individual household latrines have been constructed in Bihar during the past few years, still, a huge task remains to be completed. The paper is based on the study of "concurrent monitoring of LSBA/SBM [G] in select districts of Bihar"., Objectives: The aim is to understand different dimensions of the sanitation situation in Bihar. The objective is to suggest policy based on the findings., Materials and Methods: This study is based on primary data collected at the household level and public institutions in six districts of Bihar., Results: The analysis reveals that except a few categories, socioeconomic indicators such as religion, economic condition, or educational attainments have no significant impact on having a latrine at the household level. The variations in the construction of latrines among different districts emphasize that the public program needs to be implemented more effectively. It is also found that women are more vulnerable in a situation of open defecation., Conclusion: The challenge is to encourage people for the sustained use of the constructed latrines. This puts emphasis on changing the behavioral pattern of the people. This requires organizing a continuous awareness generation program with the aim to change the behavior., Competing Interests: None

Sustainable development goals are important parameters mandated by United Nations to be achieved by the countries by 2030. Globally it is reported that numerous countries might not be able to achieve most of the SDG targets. India is also no different in real sense in this respect-in particular to the goals related to health and sanitation, i.e. SDG 3: Good Health & Well-Being, and SDG 6: Clean Water and Sanitation. India has achieved certain milestones related to clean and safe drinking water, but this has not reflected in overall health attainments, particularly in water-borne communicable diseases like diarrhea and resulting deaths. This has been a peculiar scenario in India despite its stated considerable progress of Swachh Bharat Abhiyan-i.e. the mission on clean India, and Jal Jeevan Mission-i.e. the mission on provisioning safe drinking water. This suggests presence of pertinent challenges in the impact of Swachh Bharat Abhiyan and Jal Jeevan Mission as public policies on health and sanitation, in spite of their achievements such as, improvement in sanitation coverage from 38.70 percent in 2014 to 100 percent at present, and increase in household tap water coverage from 16.65 percent in 2019 to 65.61 percent at present. The present paper analyses India's prospects of attaining sustainable development goals (SDGs) on health and sanitation, particularly through public programme intervention of Swachh Bharat Abhiyan and Jal Jeevan Mission. The research methodology followed is policy critique approach with secondary and quantitative research analysis. The findings indicate several challenges before these two programmes due to which India's SDG targets on health and sanitation achievement might be delayed. [ABSTRACT FROM AUTHOR]

Access to water, sanitation, and hygiene (WASH) for all is fundamental for sustenance. Goal 6 of the UN's Sustainable Development Goals urges that 'universal access to drinking water, sanitation and hygiene' is fundamental as a response in the current post-COVID scenario. Despite Government of India's efforts through programs like Swachh Bharat (Clean India) Mission, there is a long way to go to integrate equity and inclusion in the sanitation facilities of the public realm. This paper is an attempt to understand the aspect of inclusion in sanitation systems of urban public spaces of India, limiting the study to Delhi and Noida, which are in the National Capital Region (NCR). The aim is to explore the contextual challenges of universal design in public sanitation and develop an understanding of what makes a public toilet inclusive in the urban Indian context. A field-based, mixed methods approach is followed which begins with a literature review of government policies & schemes and theoretical understanding of inclusion as well as the role of universal design as an approach to achieve inclusion. This is followed by on-ground studies involving ethnographic surveys, analysis of imagery and field observations. The results show an analysis of the inclusive aspects of sanitation under the thematic domains of public perception, usage preferences and issues in the public toilet experience. The sanitation facilities in urban public spaces are used by a diverse population and the results showcase a collection of the qualitative experiences of a varied set of user groups. The subjective challenges of inclusive sanitation are highlighted through the various stages and components of the entire sanitation system - the design & infrastructure, operations & maintenance, and behavioural patterns. This paper tries to raise new grounded questions to further explore the highlighted marginal distinctions between inclusion and accessibility in the urban public sanitation experience of India.

The perception of sanitation generally includes waste disposal, personal hygiene and household as well as environmental hygiene. It would not be incorrect to articulate that it barely describes the sanitary conditions as they acquire in the rural India. The majority of the citizens still defecate in the open space, the majority of the villages lack waste management and sewage systems and many in the villages are unaware about the outcomes of poor sanitation and insanitary conditions. As a result, many people suffer and even die of diseases caused by harmful practices of personal and ecological hygiene. Rural sanitation numbers significantly in the National Agenda for supremacy. At present the degree of hygiene coverage in India is around 98 percent of all rural households as per Government portal data. The nonexistence of secure sanitation contributes considerably to the poor quality of life as reflected by well accepted parameters like Infant mortality and morbidity rates. Rural sanitation is a National subject. The central governments execute the rural sanitation program under various policies. The central government supporting their efforts to providing monitory and scientific assistance through the centrally sponsored Rural Sanitation Program (Central Rural Sanitation Program). In this paper researcher will review various Government programs for promoting safe and sustainable sanitation to rural India & This paper specifically deals with the various guidelines of Government of India. [ABSTRACT FROM AUTHOR]

Sanitation change continues to be on the forefront of the global development agenda, even as it is becoming clear that the targets established in the Sustainable Development Goals will not be met. But since improving access to safely managed sanitation facilities remains a cost-effective and impactful measure to improve people's lives, it is still important to assess currently implemented policies to be able to learn from best practices and to understand how different approaches work under different contexts. This paper provides comparative analysis of country-level policies in India and Ethiopia, two countries that achieved notable progress in eliminating open defecation through distinct sanitation strategies, with the aim of confronting the advantages and disadvantages of both approaches. While in India the primary emphasis has been on the supply-side, i.e., provision of subsidized sanitation infrastructure, Ethiopian strategy prioritized the demand-side by addressing change in sanitation behavior through Community Total Led Sanitation. The analysis shows that neither of the strategies can fully achieve the sanitation change and a combination of both seems to be the most impactful approach in combating open defecation. It also argues that policymakers must consider not only local socioeconomic and budgetary constraints but also historical, institutional, sociocultural, and geographical specifics in deciding what type of subsidies would be the most fitting. At the same time, they also need to address the appropriate social norms to achieve the desirable change in sanitation behavior. [ABSTRACT FROM AUTHOR]

Sustainable Development in India is based on a centuries-old tradition of living in harmony with nature and all its elements and a commitment towards sustainability. In the old civilization of India (Sindhu Valley), toilet construction and waste management are based on scientific methods. This is not a borrowed concept from the west. Sustainable Development is recognized as a major force for change in India, which is reflected in its policies, programs, and other government and non-government initiatives. The Sustainable Development Goals (SDGs) emphasize the importance of sanitation, cleanliness, and hygiene. Swachh Bharat Mission is important in achieving the Sustainable Development Goals and fight against plastic use. Swachh Bharat Abhiyan acts as a catalyst for sustainable development. The present paper affirmed the successful implementation of Swachh Bharat Abhiyan during the first phase of its implementation. The mission's success has demonstrated that it is a true game-changer in the field of sanitation and hygiene. The success stories scripted under Swachh Bharat Abhiyan over its 7-year journey have poised India for its leap into the next level of 'Swachhata' i.e., Swachh Bharat Abhiyan Urban 2.0 and Swachh Bharat Abhiyan Grameen Phase II. The researcher also explored the expected outcomes of Swachh Bharat Abhiyan Urban 2.0 and the objectives of Swachh Bharat Abhiyan Grameen Phase II. In addition to it, the study manifested educational implications of Swachh Bharat Abhiyan. [ABSTRACT FROM AUTHOR]

Rural areas largely lack access to improved drinking water, sanitation, and hygiene (WaSH) facilities in India. This requires documentation of WaSH practices at the local level for better understanding and sustainable development. In this paper, a global positioning system (GPS)-based household survey was carried out in 67 villages of Phagi tehsil using individual questionnaires to evaluate the existing WaSH conditions spatially at the panchayat level. Three sub-indices were used for WaSH risk areas mapping and prediction with the integration of machine learning algorithms. Survey results indicate the improvement in the availability of toilet facilities; however, a gap was found between toilet ownership and its usage by villagers. Data show that only six panchayats have almost zero open defecation practices among the 32 panchayats of Phagi tehsil. The findings highlight that presence of toilets in house, water supply in toilets, and high literacy rate lead to an increase in toilet usage by the population. WaSH index scores indicate that panchayats like Mandawari, Mendwas, Chandma Kalan, and Rotwara have worst conditions and fall in the high-risk category. Moreover, support vector machine regression (SVMR) results reveal that WaSH scores are mainly affected by open defecation (r = 0.94), water supply in toilets (r = 0.92), and female members' participation in sanitation facilities decision-making (r = 0.53), followed by literacy rate (r = 0.33). Findings demonstrate the association between gender inequalities and WaSH conditions, and the potential of the WaSH index as a monitoring tool by local policymakers to shrink the WaSH gaps. [ABSTRACT FROM AUTHOR]

Housekeeping and sanitary workers are crucial for the functional efficiency and hygiene of healthcare facilities. In India, women from oppressed castes and backward classes are predominantly recruited in these occupations. The work, regarded as "polluting," is stigmatized, devalued, and lies at the historical and sociocultural intersections of caste, class, and gender. In the context of the COVID‐19 pandemic, this paper utilizes the concepts of "feminization of labor" and "care ethics" to read caste into an intersectional theoretical analysis of the organization of marginalized women's labor in such essential, yet invisibilized healthcare work. An exploratory narrative review of literature focusing exclusively on marginalized healthcare housekeepers and sanitation workers in India is undertaken and supplemented with a critical analysis of labor laws and policies to trace the sustained reproduction of the caste‐based sexual division of labor in these occupations. I propose that their exploitative terms and conditions are sustained by what I refer to as the "feminine caste contract" – a complex sociopolitical and legal arrangement of precarious, casteist, and gendered work conditions. Recognizing the exploitation inherent in this contract, recommendations are made for social work education and practice to play a key role in restructuring marginalized women's labor in essential care work. [ABSTRACT FROM AUTHOR]

Local government partnerships for producing services are ubiquitous in many countries. However, the approach has rarely been applied in India—likely owing to a history of centralized planning and independent urban and rural governance systems. Nonetheless, the country's transforming sanitation landscape could benefit from intergovernmental partnerships for scaling services with speed and efficiency. The ongoing national sanitation program has espoused the approach in theory but the body of practice to support its wide deployment is sparse. This paper critically reviews one of the first experiments with the approach for producing sanitation services in the Dhenkanal district, Odisha, India. We ask the question: what can Dhenkanal's case tell us about the challenges and opportunities for delivering sanitation services through local-level intergovernmental urban–rural partnerships in India? As part of our practice research, we supported the district government pilot the approach. The data, consultations, and observations underpinning the experiment form the basis of our insights. We find that the urban–rural partnership increased access to sanitation services among rural households within a short period, lowered service charges, and clarified institutional responsibilities. The experiment highlighted issues relating to planning, responsibility, accountability, and financing that need tackling in order to strengthen the model going forward. We recommend that evolving a definitive model(s) of intergovernmental partnerships would require experimenting with the approach in diverse institutional contexts and granting governments the flexibility to recreate and renegotiate the form of the partnership. [ABSTRACT FROM AUTHOR]

In cities of the Global South, faecal sludge management (FSM) has arisen as an acceptable and economical alternative for managing excreta. Shit flow diagram (SFD) has emerged as the preferred tool for the planning and advocacy of FSM services. Besides context-specific challenges, FSM planning, especially the use of SFD is impeded by the lack of data related to on-site sanitation systems (OSSs) and lack of capacity at the local level. This paper sets out to demonstrate how the capacity-building approach can be extended to overcome these two challenges in planning FSM with a substantial share of the information collected through household surveys. We argue that even the resource-constrained towns in the Global South have access to college students, smartphones and open source applications and demonstrate how they can be harnessed to collect the data in a cost-effective manner. Using the data collected by 150+ university students, participants of a summer school, we prepare a SFD for Alleppey, a town in Kerala, India. We argue such repeated exercises by subsequent batches of students can help understand local problems, arrive at context specific solutions and monitor them to instill better accountability of local governments. We also identify two issues with the current SFD preparation process and find it is necessary to contextualise the output of the tool to use it for planning. We suggest that the methods demonstrated here be incorporated in the future refinements to the SFD tool to make it more useful for planning city-wide FSM services., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

When sanitation is first conceived, its scope is restricted to the removal of human waste using methods such as cesspools, open ditches, pit latrines, bucket systems, and the like. Today, it refers to a more comprehensive concept that encompasses the elimination of solid and liquid waste, the hygiene of food, as well as personal, domestic, and environmental cleanliness. Sanitation is one of the fundamental factors that determines both quality of life and the indicator of human growth. Infections can be avoided altogether by adhering to proper sanitation practices, which stop the contamination of water and soil. As a result, the concept of sanitation is broadened to encompass not only personal hygiene but also the cleanliness of the home, the provision of clean water, the removal of waste products (including feces and urine), and the disposal of waste water. The government of India has implemented the Swachchatam Sarvekshan programme and begun developing protocols like as ODF, ODF+, and ODF++ in order to guarantee the long‐term viability of inclusive sanitation infrastructure and the efficient application of these facilities. In light of this, the purpose of the current article is to investigate the state of urban sanitation and the management of septage in a few select small towns in the Indian state of Uttar Pradesh. The information used in the paper has been collected through filed survey. [ABSTRACT FROM AUTHOR]

Over 70 per cent of India's surface water is polluted by human excreta and other waste and less than 35 per cent of urban wastewater is treated. This poses a severe risk to public and environmental health. Urban waterbody rejuvenation in India often focuses on aesthetic improvements rather than addressing its systemic interdependencies with sanitation. This paper establishes these systemic links through a mixed-methods study using water-quality testing and stakeholder interviews in the city of Bengaluru, India. A conceptual system dynamics model of technical, social, institutional and environmental factors is developed. Results show that sewage leaks into lakes via stormwater drains are a major pollution pathway, among others. Three system levers for positive change have been identified: coordination of government entities, adequate faecal sludge management and strong citizen involvement. Citywide inclusive sanitation (CWIS) is proposed as an approach to provide leverage and solve the intertwined issues of public and environmental health. [ABSTRACT FROM AUTHOR]

This paper quantitatively analyzes the spatial heterogeneity of district‐level correlates of open defecation in rural India. We employ standard non‐spatial regression, spatially explicit regressions and multi‐scale geographically weighted regression to compare the stability of measurable correlates of open defecation across these different methods as well as across analyzed spatial units. Attributes like ownership of household assets, drinking water inaccessibility and prevalent literacy rates were identified as the most stable district‐level correlates of open defecation. Our results also demonstrated the relevance of our hypotheses about (a) possible negative sanitation externalities stemming from the co‐concentration of Scheduled Caste communities and other communities in densely populated rural districts, and (b) possible positive sanitation externalities stemming from the co‐concentration of Muslim and non‐Muslim communities in densely populated districts. Overall, however, our analyses demonstrate notable spatial clustering and significant spatial non‐stationarity of examined variables. Therefore, in our opinion, research findings that ignore spatial heterogeneity of sanitation drivers provide incomplete information for policy development and implementation. [ABSTRACT FROM AUTHOR]

A city is a geographic entity and should be efficiently analysed and optimised through the use of geo-spatial technology. The certification for a city to be 'Smart' is measured on the basis of the liveable index, adequacy of water supply, assured supply of electricity, proper sanitation and solid waste management, efficient urban mobility, public transport, affordable housing, robust information technology connectivity, transparent and good governance, safety and security of citizens, modernised health and education infrastructure and citizen participation which will lead to sustainable development. Smart Cities require a perfect balancing of modernisation of city infrastructure and leveraging technology. Smart cities require Geo-smart mapping and visualization capabilities with applications for protecting groundwater resources, locating schools and health centres, locating garbage dumps and toilets, designing bus routes. The indigenously developed integrated platform of GIS, Image Processing, Photogrammetry and CAD, called IGiS has been leveraged by Scanpoint Geomatics Limited, Ahmedabad (SGL), India for implementing the Enterprise GIS for 7 smart cities in India. A centralised geo spatial database with a standard data model compliant set of maps/layers has been created for each city. The spatial layers are derived from 30cm resolution satellite data. Point data (locational information) is generated using DGPS surveys. The city assets are geographically mapped at a scale of 1:2000 and organised in a spatial database. Inputs required for operations and maintenance of every utility/facility are geo tagged and stored in the database. Web & Mobile GIS applications & Citizen portal are developed using the indigenous platform. Integration with other e-governance applications and spatial layer requirements of the Integrated Command and Control Centre are supported through RestAPI & OGC compliant web services. SGL's Mobile GIS framework named Qpad comes handy for spatial data verification. IoT devices are used to gain insights for real-time handling of critical situations or emergencies. Having laid the foundation for driving smart cities in terms of the spatial database at a scale of 1:2000, the stage is set to look forward to the results. Plugging revenue leakages, better traffic management, information at a click during peak of the Corona pandemic, effective usage of open spaces and barren areas, planning the utility requirements by the corporation to accommodate for the urban explosion is the kind of harvest that is anticipated with abated breath. This paper demonstrates the suitability and capability of the indigenously developed common platform for image processing and GIS (IGiS Enterprise Suite) in building Smart City Applications and quantifying the results. [ABSTRACT FROM AUTHOR]

Inaugurated in 2014, India's Swachh Bharat Mission (SBM) intends to eradicate open defecation in urban and rural areas by 2019. In cities, the scheme ranks municipalities for achieving open defecation-free status and other measures of cleanliness. In 2017, Indore was first nationally recognized with the national Cleanest City award. In the weeks before the city was evaluated, it sponsored a number of activities that demolished housing and sanitation infrastructures, singled out the female body for humiliation, and forced residents to revert back to the very sanitation practices the city was allegedly trying to eradicate. This paper traces the differing articulations of power at work between the extension and demolition of the city's infrastructure. It focuses particularly on latrines, the metrics, and the urban vision to make Indore the Cleanest City, but also gives attention to the additional infrastructures connected to latrine-making and unmaking, including housing. We specifically explore two dimensions of what we call the "infrastructural intersectionality" of the Clean City Mission, which discloses differing forms of compounding infrastructural violence that include the dissolution of both material and social infrastructures. Firstly, the intersectionality of gender/caste/class/race social identities and power relations that are embedded and reified through infrastructures and, secondly, the intersectionality of multiple infrastructures that are inter-connected and co-constituted through each other. We argue that bringing the lens of intersectionality is critical for recognizing the socially differentiated and gendered dimensions of sanitation infrastructure, the SBM, and its situated infrastructural violence. By exploring two themes related to infrastructure and intersectionality, we show the criticality of embodied and gendered approaches to analyzing the power of infrastructure in the everyday. [ABSTRACT FROM AUTHOR]

Background Ensuring universal access to safe sanitation by 2030 is a development priority for India. Doing so can help ensure improved physical and mental health outcomes. While the proportion of people in India with safe sanitation has risen dramatically over the past thirty years, much less is known about who has been most at risk for not having access to safe sanitation across India's states and Union Territories (UT) over this time period. We introduce the concept of zero-sanitation to fill this gap. Methods Data from five National Family Health Surveys (NFHS) conducted in 1993, 1999, 2006, 2016, and 2021 from 36 states and UT were used for this study. The study population consisted for all household individuals regardless of age in each survey round. Zero-sanitation was defined as those who have no access to a household toilet, and thus defecate in the open. We analyzed the percent prevalence of zero-sanitation in every state/UT at each time period in both urban and rural communities, as well as the population headcount burden in 2021. We calculated the absolute change on an annual basis to assess the change in percentage points of zero-sanitation across time periods at the all-India and state/UT levels. Results The all-India prevalence of zero-sanitation declined from 70.3% (95% confidence interval (CI)=70.2%-70.5%) in 1993 to 17.8% (95% CI=17.7%-17.9%) in 2021. The median percent prevalence of zero-sanitation across states and UTs was 65.9% in 1993. By 2021, the median percent prevalence of zero-sanitation across states and UTs was 5.7%. This reduction corresponded with a reduction in the between state/UT inequality in zero-sanitation. Nevertheless, as of 2021, the prevalence of zero-sanitation was still above 20% in Bihar, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, and Uttar Pradesh. Additionally, as of 2021, almost 92% of individuals who were defecating in the open were experiencing zero-sanitation. Zero-sanitation remains most common in states such as Bihar, Punjab, Uttar Pradesh, and Assam. Nevertheless, at this current rate of improvement, every state and UT except for Sikkim and Chandigarh are on track to end open defecation by 2030. Conclusions The concept of zero-sanitation is a useful tool in helping policy makers assess the extent to which sanitation coverage remains incomplete. When viewed through this lens, we see that open defecation remains most common among those who do not have a toilet. Addressing the myriad social determinants of sanitation access can help fill these gaps and ensure equitable sanitation coverage throughout India. [ABSTRACT FROM AUTHOR]

Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats—including heatwaves, drought, and floods—negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers. • Climate change is exacerbating many risks to informal workers' health and livelihoods. • WASH access may foster gender equality and decent work, while tackling heat stress. • Policymakers can partner with informal workers to create inclusive, multi-pronged interventions. [ABSTRACT FROM AUTHOR]

This article presents lessons learnt from the evolution and usage of rapid action learning methods developed to support the Swachh Bharat Mission – Gramin (the Clean India Mission – Rural) in India. The Mission, started in 2014, aimed to change the sanitation behaviours of over 530 million people across 706 districts in five years. Participatory, action-orientated research and learning methods were trialled with government implementers, development partners, and communities. It was found that these methods enabled both a greater understanding of impacts at the community level, horizontal learning across districts, and the capacity development of Mission implementers. [ABSTRACT FROM AUTHOR]

• On-demand recycling startups have proliferated in urban India over the past decade. • A host of seemingly disparate policies have together enabled this rise. • Startups rely primarily on aggregation of materials to make a profit in this sector. • Traditional informal actors (kabadiwalas) are likely to be displaced as a result. • To protect livelihoods, collective organizing and state intervention are needed. Over the past decade, urban India has seen the emergence and proliferation of startups that are offering on-demand recycling services using web- and mobile-based platforms. These firms replicate the services of informal workers known as kabadiwalas who have historically made their livelihoods through trade in recyclable materials. Existing analyses of platformization in developed world contexts fail to explain the rise of platformization in India because of the particularity of the relationship between platform firms and the informal economy. This paper contextualizes the rise of platform recycling startups within a generally conducive policy environment focused on improving sanitation, encouraging entrepreneurship, and expanding the use of information technology in India. An examination of business models deployed by these firms reveals how and why the structure of recycling markets does not allow for a 'lean' model typically adopted by platform firms in other sectors. Rather than merely connecting service providers to consumers, these startups rely on aggregating recyclable materials and dispossessing intermediaries such as kabadiwalas in order to generate surplus value in an otherwise saturated market. Relying on an analysis of online content about these new firms, this paper examines the strategies that firms use to legitimize themselves and delegitimize kabadiwalas in an attempt to displace and dispossess them from the market space. [ABSTRACT FROM AUTHOR]

In recent decades, the world has witnessed a sudden rise in population and rapid urbanization. This has led to an increase in the water demand and consequently an upsurge in wastewater. Water scarcity, coupled with untreated wastewater, has become a major concern throughout the world. Municipalities are challenged with the task of treating wastewater and meeting domestic, agricultural, and industrial demands. Mismanagement of wastewater results in economic, social and environmental loss. The high concentration of population, lack of sanitation and water security, reduced awareness, and evident pollution have made India a home full of opportunity and innovation in the wastewater management (WWM) business. The paper gives a comprehensive review to understand the wastewater management and business approach. The research uses Total Interpretive Structural Modelling (TISM) to identify, acknowledge, and interpret the major factors for the stakeholders and for future companies who wish to venture into the wastewater management business. The study provides insight into developing a circular economy solution and gives a vivid framework highlighting the relevant factors for a successful WWM business. The study also provides direction to the practitioners who are involved in the WWM industry and helps evaluate their options, prioritizing resource-efficient solutions. [Display omitted] • Develop a strategy for an efficient wastewater management business framework. • Identifying the factors crucial for the success of a wastewater management business. • An integrated multi-attribute interpretive structural decision approach is proposed. • Provides a pragmatic business framework with dependent and driving factors. • Managerial implication & policy insights for implementing the model are discussed. [ABSTRACT FROM AUTHOR]

This paper studies the differences and determinants of handwashing practices in India and identifies sections of the population with poor handwashing practices who are relatively more vulnerable during the COVID-19 pandemic. We have used the data from the recent National Sample Survey (NSS, 76th round) for India (2018). Bivariate and logistic regression analyses have been performed to predict the determinants of handwashing practices across states and socio-economic groups. Levels of education of the household head, Usual Monthly Per Capita Expenditure (UMPCE) of the household, access to water (other than drinking water) resources and sanitation facilities, and the availability of water with soap in and around latrines are major socio-economic and demographic factors that impact handwashing practices. Higher access to principal sources of water for drinking and other purposes, access to bathrooms and latrines with soap, and the availability of water in or around latrines increase the likelihood of handwashing among the people. Universal handwashing across different sections of the population will be effective to prevent further infection. The available data help us to identify the vulnerable sections of the population which are towards the lower end of the handwashing compliance spectrum. The policymakers can outline specific planning and strategy implementation for them. [ABSTRACT FROM AUTHOR]

This study investigates the demographic, social and economic factors as key determinants of green toilet adoption among rural households in India. The Rural Impact Survey data of the World Bank have been used for this study, covering 2731 rural households from Bihar, Madhya Pradesh, and Uttar Pradesh. The chi-square test and regression analysis with marginal estimate have been used to analyze the data. Result of the analysis indicates that about 36.2 percent surveyed rural households have reported access to green toilets having proper effluent discharge systems as per the environmental norms. Further, there is a significant association between the adoption of green toilets and demographic, social and economic characteristics of rural households. Finally, the regression analysis indicates that a number of demographic, social and economic factors i.e., age, education, income, social category, access to information, access to drinking water, and asset ownership have a significant marginal effect on the adoption of green toilets in rural India. Considering the importance of ensuring total sanitation and commitment under the Sustainable Development Goals (SDGs) of the United Nations for eradicating open defecation for all by 2030 in the country, the results of the study provide useful policy directions for enhancing the adoption of green toilets among the rural households in India. [ABSTRACT FROM AUTHOR]

Introduction: Safe disposal of feces is ensured when it is deposited into a toilet, whereas unsafe disposal of child's feces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. Objective: To determine the effect of positive deviance (PD) approach on safe disposal of child's feces among households who owned a toilet. Materials and Methods: A community-based quasi-experimental study was conducted in the four field practice villages of the Urban Health Training Center, Villupuram, for 18 months. Households who owned a toilet and had a child less than 5 years old were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for 6 months to promote safe disposal practices in the study villages. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 24). The Chi-square test was used to determine the significance of difference between baseline and endline data. The effect size was calculated to estimate the magnitude of difference between baseline and endline data. Results: Before intervention, only 3% of households disposed the feces into a toilet, while after intervention, almost 38% of households disposed in the toilet (χ² = 37.39; df = 1; P = 0.001). The effect size (Cramer's V) was found to be 0.43. Conclusion: PD approach demonstrated considerable improvements in safe disposal of child's feces in rural settings. Further, to sustain the behavior change, frequent reinforcement of key messages at frequent intervals needs to be emphasized. [ABSTRACT FROM AUTHOR]

Context: Due to water scarcity, wastewater is used in agriculture in peri-urban areas. Aims and Settings: We aimed to assess the hazards associated with wastewater farming and develop an incremental improvement plan for the sanitation system of wastewater use for agriculture using Sanitation Safety Planning (SSP) in Bangalore urban district, India. Methods: Interviews and observations were conducted among 100 farmers in the Mugalur Gram Panchayat area. Results: Direct ingestion and ingestion after contact with wastewater due to inadequate hand hygiene are the routes of contact with wastewater. The control measures followed in the community are the cultivation of crops, which do not have direct contact with wastewater, furrow and drip irrigation, and restricted irrigation. Methods to mitigate the hazards are the provision of interval between final irrigation and consumption,washing of produce with freshwater before transportation to market, and hygienic cooking. Conclusion: Occupational hazards and risks associated with wastewater farming can be mitigated through the adoption of locally acceptable preventive measures. [ABSTRACT FROM AUTHOR]

Purpose: The present study intends to highlight the issues and challenges pertinent to sanitation practices among urban slum women in India. Design/methodology/approach: The primary qualitative data has been collected from 100 households sampled by stratified random and purposive sampling through in-depth interviews, and a structured interview schedule and themes were developed accordingly. Findings: The main theme-based results of the study included the challenges of open defecation in slums, public toilets as an alternative, sanitation-related stress in slum women, compromised state of health of women and children, menstrual hygiene among women in slums and increasing burden on women in terms of water management. The study recommends the creation of toilets in every slum locality with maintenance and awareness to be raised. Originality/value: Urban sanitation has received less research than rural sanitation. The present study focused on the issues of urban sanitation, which are often neglected. To ensure the study's uniqueness, researchers visited and mentioned each open defecation site to understand the situation. Peer review: The peer-review history for this article is available at: https://publons.com/publon/10.1108/IJSE-12-2022-0782 [ABSTRACT FROM AUTHOR]

While the disparities between women and men in respect of healthcare, education, nutrition, livelihood opportunities, and political participation are global phenomena, development of human and social capitals is crucial in this regard. In particular, emphasis on improvement in female education is imperative for bridging such gaps towards a gender indifferent society. Accordingly, policy initiatives and institutional arrangements have been made to promote female education, especially in the developing and underdeveloped countries. Nonetheless, it is uncertain whether such initiatives can necessarily improve female education. For example, the initiatives in India have mostly focused on improving physical infrastructure and other amenities in schools, raising awareness, improving nutrition, and providing financial and other supports. While such interventions are crucial, lack of basic amenities at home can also potentially hinder female education in various ways, particularly in rural areas. This paper examines how household basic amenities influence female education in rural India. Based on secondary data and applying panel data estimation techniques for Indian states, it is found that sanitation facilities at home, access to electricity, use of cleaner cooking fuels, time taken to collect water, and girl sex ratio have significant impact on school attendance of girl child and female literacy rate. While time take to collect water affects female education adversely, the rests have positive impact on the same. Furthermore, public spending on education also impacts female literacy and female literacy relative to the male literacy rate positively, though they do not have any significant influence on school attendance of girls. Further, poverty does not have any significant impact on female education. The findings, therefore, suggest that success of development policies requires inclusive and comprehensive approach to explore the complementarity across the interventions. In addition to development of school infrastructure and provision of other services, emphasis should also be given on improving household basic amenities for better outcome on female education. [ABSTRACT FROM AUTHOR]

Sanitation work in India is largely carried out by the historically marginalized Dalits, formerly known as untouchables, without proper devices or safety gear, as so-called 'manual scavenging'. To counter manual scavenging, non-governmental organizations (NGOs) have turned to courts and litigation as a form of resistance. This brought about some successes: manual scavenging was repeatedly outlawed, and several high-profile court cases have ordered local governments to take very explicit steps to eradicate it. However, manual scavenging persists rampantly, leading several authors to argue that litigation has failed in its purpose. We critically evaluate this claim by examining the underlying root question: what purpose do NGOs ascribe to litigation in their efforts to eradicate manual scavenging in the first place? Our analysis is based on a multi-method, qualitative research approach combining analysis of documents of, and interviews with, a total of 23 NGOs. Using the lens of active citizenship, we conclude that NGOs seek to shift responsibility to the government, of which it has absolved itself under neoliberalism, remind the government of its duty to serve its citizens, and overall participate politically. Specific features of courts, such as mandamus and a mediation-oriented approach, were mentioned as uniquely enabling petitioners to exercise active citizenship and force government officials to at least consider manual scavengers' interests. [ABSTRACT FROM AUTHOR]

Although India declared itself "open defecation free" in 2019, critics charge that its national urban sanitation campaign, Swachh Bharat Mission–Urban (SBM-U), has failed. SBM-U provided community toilets in informal settlements where household latrines were unviable, delegating their upkeep to local governments and users. Initially, these community toilets were used. However, the failure to maintain and repair them resulted in a reversion to open defecation, forcing the state to reconsider its decision to withdraw after construction. We use the SBM-U to develop a framework of "sanitation citizenship", which emerges through sanitation infrastructure's use and disuse, and emerges over its life course. We trace how mutual expectations and everyday practices of citizenship by the state and users aligned and fractured during the construction, maintenance and repair phases of community toilets. We argue that the changing material condition of infrastructure is critical to negotiations over mutual obligations and definitions of the citizenship contract. [ABSTRACT FROM AUTHOR]

Vertical flow-constructed wetlands (VFCW) are well-established, cost-effective, and sustainable options for wastewater treatment. Along with organic matter removal, wetlands are helpful in the removal of microbial pathogens. This study focuses on understanding the bacterial pathogen removal efficacy of three different design types of VFCWs and understands the best designs for the efficient removal of pathogens in a tropical climate. The three wetlands studied for removal efficiency were (a) two-stage vertical flow constructed wetland (TSVFCW), (b) Single-stage vertical flow constructed wetland (SSVFCW), and (c) single-stage saturated vertical flow constructed wetland (SSSVFCW). Results revealed that all three types of wetlands were effective in removing pathogenic bacteria. Still, TSVFCW was found to be more efficient in pathogen removal (Total Coliforms, Shigella spp., Salmonella spp., Pseudomonas spp., Vibrio spp., Enterococcus faecalis) 7.04 ± 0.17, 6.53 ± 0.08, 4.0 ± 0.42, 7.67 ± 0.08, 5.73 ± 0.70 and10 5.23 ± 0.96 Log10 reductions respectively compared to SSVFCW (5.28 ± 0.18, 5.18 ± 0.09, 3.74 ± 0.74, 6.98 ± 0.01, 3.97 ±0.32, 4.74 ± 1.08 Log10 reductions respectively) and SSSVFCW (4.48 ± 0.46, 4.83 ± 0.15, 2.74 ± 0.44, 6.71 ± 0.03, 4.31 ± 0.49, 5.03 ± 1.20 Log10 decreases respectively). For abiotic factors (Chemical oxygen demand, total Kjeldahl nitrogen, and phosphorus) also TSVFW shows better efficiency (45 ± 8.7, 24.7±4.5 and 3.1, ± 0.2 g.m-2, respectively) than SSVFCW (12 ± 1.3, 7.6 ± 0.4 and 1.8 ± 0.2 g.m-2 respectively) and SSVFCW (6.3 ± 1.1, 7.7 ± 0.1 and 1.2 ± 0.1 g.m-2 respectively). However, the removal efficiency of both single-stage wetlands was comparable. [ABSTRACT FROM AUTHOR]

Access to improved toilets can enhance physical and mental security among women. Therefore, it becomes critical to incorporate and understand their decisions on household toilet construction. Using survey data from 2528 households across urban slums, peri-urban and rural areas from the state of Bihar in India, we study two particularly relevant aspects surrounding women's decision making in sanitation. First, we examine if exclusive usage of toilets is systematically higher when the decision of its construction is taken solely by a woman. Secondly, we assess the potential household-level factors associated with women-led decision making. The findings, after accounting for the unobserved heterogeneity surrounding the selection of households with toilets, indicate a statistically insignificant increase in the likelihood of its exclusive usage in households where decision of its construction had been solely led by women. When we look at the settlement types individually, this relationship is found to be significant in the peri-urban areas. Additionally, among households with toilets, poorer women are more likely to take sole decisions about its construction. This, we argue is potentially because of sanitation interventions over the years that have been relatively successful in motivating poor women to influence toilet construction. [ABSTRACT FROM AUTHOR]

Background: India implemented a basket of public health developmental packages to achieve the Sustainable Development Goal (SDG) 6dproviding access to clean water and adequate sanitation for all by 2030. Though the country is getting closer to being free of open defecation, the pace of progress varies spatially. Therefore, the current study is relevant to explore determinants of practicing open defecation at the small area level in India. Methods: The present study included the latest National Family and Health Survey (2019-21) and applied both non-spatial (bivariate statistics with x² test and multivariate logistic regression) and spatial analyses (Univariate and bivariate LISA Moran I, OLS, SLM, and SEM) to assess the national level predictors and spatially auto-correlated determinants of practicing open defecation. Results: In India, almost one-fifth of households practiced open defecation, mainly clustered in the Middle Ganges Plain, central, and eastern region. A significant rural-urban and poor-rich gap in open defecation practice was also observed. The spatial clusters of lower-educated individuals, poorest wealth quintile, backward social groups, and rural residence were found to be prone to open defecation practice. Housing condition and water supply with the house were also significantly auto-correlated with open defecation practice. Conclusion: Open defecation remains a public health challenge in India, particularly in the north and central parts, among rural populations, and in socioeconomically deprived areas. It is crucial to focus on small area-level program implementation and assessment approaches to eliminate open defecation in India by 2030. [ABSTRACT FROM AUTHOR]

Background: Clean water and sanitation are global public health issues. Safe drinking water and sanitation are essential, especially for children, to prevent acute and chronic illness death and sustain a healthy life. The UN General Assembly announced the 17 Sustainable Development Goals (SDGs) and 169 targets for the 2030 Agenda on 25 September 2015. SDG 6 is very important because it affects other SDG (1, 2,3,5,11,14 and 15). The present study deals with the national and state-wise analysis of the current status and to access deficiency of India's achievement towards SDG 6 (clean water and sanitation for all) for the 2030 agenda based on targets 6.1, 6.2,6.4,6.6 from 2012 to 2020.Materials and Methods: Data of different indicators of SDG 6 are collected from different secondary sources-NSS 69th (2012) and 76th (2018) round; CGWB annual report 2016-2017 and 2018-2019; NARSS (2019-2020); SBM-Grameen (2020). To understand overall achievement towards SDG 6 in the 2030 agenda, the goal score (arithmetic mean of normalised value) has been calculated.Major Findings: According to NSS data, 88.7% of Indian households had enough drinking water from primary drinking water sources throughout the year, while 79.8% of households had access to toilet facilities in 2018. As per the 2019-2021 goal score for States and UTs in rural India based on SDG 6 indicator, SDG 6 achiever States and UTs (100%) are Sikkim, Himachal Pradesh, Andaman and Nicobar Islands.Conclusion: Drinking water and sanitation for all ensure a healthy life. It is a matter of concern for the government, policymakers, and people to improve the condition where the goal score and indicator value of SDG 6 are low. [ABSTRACT FROM AUTHOR]

We highlight an overlooked channel of disease transmission in developing countries: dirty drains. We make the case that sanitation efforts should move to improve the condition of drains to build on increased toilet provision since they are a key transmission channel for waterborne diseases. We develop an economic model of sanitation externalities that incorporates the role of drains and then empirically examine the relationship between the sanitary quality of neighborhood drains and household ill‐health incidence using a primary survey of 1,530 households from rural Uttarakhand, India. We find a strong and positive association between household ill‐health incidence and dirty neighborhood drains, controlling for household toilet usage, community‐level toilet availability, and an array of other household attributes. We employ a variety of robustness checks to validate our findings. Our findings suggest that bringing the policy focus to overall sanitation infrastructure will have substantial health returns. [ABSTRACT FROM AUTHOR]

Over the last decade, many countries have adopted policies addressing menstrual needs. Our research explores the opportunities and challenges that have shaped these initiatives and critically examines their scope and substantive focus. Our study analyses developments in four countries: India, Kenya, Senegal, and the United States. It is based on an analysis of 34 policy documents and interviews with 85 participants active in policy-making or advocacy. Across countries, we found a predominant policy focus on tangible and material outcomes, such as menstrual products and facilities, that is informed by a narrow perception of menstrual needs as the management of bleeding. A number of drivers influenced policy-makers to keep this focus, especially the key narrative around menstrual pads as a perceived solution to school absenteeism combined with sensationalisation in the media and the quest for quantifiable results. Menstrual stigma is so ingrained that it continues to constrain policy-makers and advocates themselves by perceiving and presenting menstruation as a problem to be fixed, managed, and hidden. When considering new policy directions, we need to create capacity for a holistic menstrual policy landscape that overcomes systemic barriers to addressing the needs of menstruators that are largely rooted in menstrual stigma. [ABSTRACT FROM AUTHOR]

Pollution of water resources and a lack of potable water are two important issues that city dwellers in India encounter. The passage of untreated sewage down municipal drains is one of the most significant sources of water resource pollution. In densely populated areas, effective sanitation and wastewater management is becoming increasingly difficult. In many developing nations, centralized sewage and wastewater treatment facilities serve only a section of big cities, and on-site sanitation is frequently insufficient in heavily populated areas. There is a demand for complementary and intermediate solutions. DEWATS (community-managed anaerobic decentralized wastewater treatment systems) is a good option for the possibility of relatively fast sanitation improvements in high-priority neighbourhoods where the local authority is not providing a full sanitation service. The following technical treatment modules are typically seen in DEWATS. The primary treatment consists of sedimentation ponds, settlers, septic tanks or bio digester, secondary treatment consists of anaerobic baffled reactors, anaerobic filters or anaerobic and facultative pond systems, secondary aerobic/facultative treatment consists of horizontal gravel filters and post-treatment consists of aerobic polishing ponds. The experience of India in establishing community-managed DEWATS on a large scale is examined in this review. [Display omitted] • DEWATS have been implemented in different places with suitable treatment methods matching with the community needs. • DEWATS which are connected to communal sanitation centres have the ability to bridge the gap between on-site and centralized wastewater treatment systems. • Very little data is available about the practice of DEWATS other than the handbooks available by different DEWATS implementation agencies. • This paper gives a review on the different DEWATS methods adopted in India which will impart a knowledge on the selection and implementation of different unitary process to be adopted for DEWATS process. [ABSTRACT FROM AUTHOR]

The provision of urban service and citizens' satisfaction is an important key issue in urban planning. Importance-performance analysis (IPA) is an effective and widely applicable technique to explore consumer's satisfaction. IPA helps to prioritize the management strategies for urban services using the IPA. Purpose of the present study is to assess the performance of urban services and citizen's satisfaction level of Panskura municipality using IPA models and improvement index. A total of 629 valid household responses are collected with the help of the door-to-door primary survey technique. The study reveals that all the selected seven urban services have significant importance-performance gap except water supply. Residents of the Panskura municipality are very much satisfied with the water supply service because of the very minimum improvement score. The combined result of IPA matrices and improvement index suggests residents are dissatisfied to a great extent with the performance of four urban services, i.e. health, economy, transportation and sanitation. These urban services require a problem-solving urgent action for restoration of the performance status. The improvement and prioritization of urban service are also required to fulfil the demand of target groups. [ABSTRACT FROM AUTHOR]

This study analyzes the changes in access to basic services and maps the inter-regional differences in the slums over a period of 5 years in India by using the 2012 NSSO Slum Survey. This study uses the Multidimensional Wellbeing/Deprivation Index (MWD) towards the assessment of accessibility and availability of basic amenities like education, health, sanitation, electricity, and water facilities. The findings reflect that there is an apparent mutuality among different dimensions of deprivation. This situational inspection of slums has a direct policy imperative for intervention to address the regional imbalance in urban living. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is the deadliest infectious disease across the world, with the greatest burden occurring in India. Pregnant women and children are especially vulnerable to adverse effects from infection, and they tend to have diminished ability to protect themselves. Malnutrition, HIV, and other causes of immune suppression such as exposure to air pollution make one more prone to serious illness or death from TB infection. Risk factors are influenced by maternal education, access to health care, poverty, nutrition, healthcare stigma, and sanitation, among others. Current literature is heavily clinical, lacking focus on upstream factors, with a skew toward secondary and tertiary prevention strategies (i.e., case finding and treatment), and less emphasis on primary prevention (e.g., wealth equity and environmental regulation). Given concerns with extremely drug resistant TB and because infectious diseases can permeate National borders, public health nurses, and other healthcare professionals must educate themselves and advocate on behalf of vulnerable populations such as children in India. Improved sanitation, air quality monitoring, women’s education, and increased access to health care are cost-effective and evidence-based strategies to address pediatric TB in India, a challenge which is grounded in human rights and justice. [ABSTRACT FROM AUTHOR]

Agricultural land degradation, urban migration, increasing food demand and waste, and inadequate sanitation systems all affect farmers, local society, and the environment in South India. Joint recycling of biodegradable secondary household resources to close nutrient cycles between urban and rural regions can address all these challenges and thus several SDGs at the same time. Efforts are being made to this end, but many attempts fail. The central research question is, therefore: how can co-recycling concepts be evaluated in this context? For this purpose, composting plants, biogas fermenters, and a high-tech concept to produce plant charcoal, design fertilizer, and biopolymers are considered. The aim of this study is to evaluate the recycling concepts from the stakeholders' perspective to avoid gaps between theory and practice. Six expert and one focus group interviews on two successful on-site case studies and 15 online expert interviews with thematic actors were qualitatively evaluated and presented in a social network analysis to identify preferences and indicators for the further evaluation of co-recycling concepts. The results show that the focus is on mature technologies such as compost and biogas. High-tech solutions are currently still in rudimentary demand but will play a more important role in the future. To evaluate such concepts, seven key indicators and their measured values were identified and clustered into the categories ecological, social, technical, economic, and connective. The results show that this methodology of close interaction with stakeholders and the evaluation of successful regional case studies minimize the gap between practice and theory, contribute to several goals of the SDGs, and thus enable such concepts to be implemented sustainably. [ABSTRACT FROM AUTHOR]

This article examines the political economy of health inequalities and inequities in the public health care system in India and identifies potential areas for interventions to promote equal and equitable health care for marginalized people. Drawing on the Political Economy of Health Model of Research, this article reiterates the inadequacy of policy frameworks and programs in ensuring accessible, affordable, and quality public health care services to all. We argue that for policies to be successful, policymakers should consider the diverse social registries of class, caste, religion, gender, region, ethnicity, and age, as well as their intersections. We also argue that health care policies and programs need to be: (a) dynamic and flexible, (b) intersectional and backed up by sufficient grassroots research, and (c) equitable at every stage of policy formulation, implementation, and evaluation. [ABSTRACT FROM AUTHOR]

Background: Worldwide, more than 1.2 billion population is adolescents. Nutrition, physical activity, psychological health, and sanitations are few areas that affect adolescents, making them more vulnerable to diseases and contributing in disease burden. The present study was part of the Indian Council of Medical Research's (ICMR) school based health program Mission SHAKTTI which focused, and reported on adolescents' awareness and health literacy about nutrition, physical activity, and sanitation in Delhi. Methods: A cross-sectional qualitative study was conducted with students (aged 11-19 years), and the Mission SHAKTTI program was devised using the pillars of Gandhi's teachings for good health. Data were collected using a pre-tested open ended questionnaire (n=1796). For data analysis, deductive approach was adopted, and thematic content analysis was done with 95% confidence intervals (CI). Results: The study showed that students were somewhat aware of various healthrelated issues pertaining to Mahatma Gandhi's ideology of health, with 49.5% (CI: 46.72-51.39) reported that Gandhiji's mantra for staying healthy was simply a clean environment and proper sanitation. A gap between their understanding and perceptions of a balanced diet was observed, since many felt that merely eating enough food could labelled as balanced diet (36.46%; CI: 34.24-38.74). Conclusions: Findings may be useful in developing a suitable health-based educational program to inculcate knowledge about healthy practices among school-aged children through Gandhian health ideology. This may also help in forging a stronger and more aware foundation of nation leading to prevention of numerous diseases in the near future. [ABSTRACT FROM AUTHOR]