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The Swachh Bharat Mission-Rural (SBM-R) is a flagship programme aimed at ending open defecation in rural India. In this paper, we study institutions and processes using Amartya Sen's conception of justice. We review the outcomes by assessing agencies, actions and processes involved in the implementation of the SBM-R programme. The findings are analysed using the Sanitation Well-being Framework. Sanitation well-being is achieved when an individual is able to experience the sanitation life cycle stages of acceptance, construction, utilisation and maintenance of safe disposal, which are part of the framework. The capability factors grouped under personal, cultural, structural, environmental and service elements of the framework determine the sanitation environment facilitated by the state. Failure in experiencing one of the life stages leads to slippage in sanitation, where people resume open defecation, despite possessing toilets. The paper presents a review of literature on the political, technological and structural issues in programme implementation, followed by an analysis of 42 interviews and 12 focused group discussions of state and non-state actors conducted in rural Shravasti, Uttar Pradesh, India. We found that slippage is prevalent in the field site and identified 26 capability factors (expansion and constraints) that led to slippage in sanitation. [ABSTRACT FROM AUTHOR]