Kamal Kumar Gaur - MP (UNICEF) - Water & Sanitation Report

Water
Sanitation
A Situation Analysis of
MADHYA PRADESH
UNICEF Field Office for

Madhya Pradesh, India
Gregor von Medeazza,
WASH Specialist
Kumar Premchand,
SPPME Officer
Sonam Dhir,
Consultant
DevInfo Support Group

(Avalon Information Systems Pvt. Ltd., New Delhi)
Kamal Kumar Gaur,

Senior Technical Advisor
Gaurav Sharma,
Team Leader, Graphics
Bharat Kumar,
Data Management.
Printed:
September 2013
Water
Sanitation
A Situation Analysis of
MADHYA PRADESH
A SITUATION ANALYSIS OF MADHYA PRADESH
WATER & SANITATION
Foreword
PreFace
The present Water and Sanitation Situation Analysis for Madhya Pradesh brings
UNICEF Field Office Madhya Pradesh is very pleased to share the situation
forward the critical elements for policy, planning and budgeting needed to
analysis of Madhya Pradesh presenting the findings of the Water and Sanitation
accelerate the progress in the Water, Sanitation and Hygiene (WASH) sector. The
sector. This analysis presents both the laudable progress the state has achieved
present report was jointly prepared by the Government of Madhya Pradesh, the
between 2001 and 2011, especially in the water sector, and also identifies the
Directorate of Census Operations and UNICEF. Its main purpose is to provide
areas in which accelerated progress in urgently required, especially in terms of
the latest Census data in an analytical way, identifying the main gaps and areas
Dr. Aruna Sharma
eradicating open defecation throughout the state. The Millennium Development
for priority actions to be taken in the state. Such analysis is pinpointing the key
Additional Chief Secretary,
Goal targets are to halve the proportion of the population without access to safe
challenges the state faces in the water and sanitation sector and is essential for
Government of Madhya
drinking water and improved sanitation. While Madhya Pradesh has met its MDG
Pradesh, Panchayat & Rural
target for drinking water, over 72% of households are still using unimproved
Development Department
sanitation facilities, and around 50 million people still defecate in the open. Open
determining future policy directions.
With less than three years remaining before the 2015 mark of the Millennium
Defecation is worst form of sanitation practice, exacerbating the child morbidity
Development Goals, the present report presents a clear indication that progress
and mortality rates across the state.
must be accelerated, especially in terms of the elimination of Open Defecation

throughout the state. We are all aware that the access of sustainable improved
UNICEFs 2012 analysis showed that around 600 children under the age of five die
WASH facilities and services still represent a huge challenge for our state. Collective
every single day in India due to diarrhoea. This number is even more shocking
efforts are thus needed by the State and Central Governments together with our
-and indeed unacceptable- as we know that it can be significantly reduced
WASH sector partners to improve the wellbeing of all communities, with special
through adequate Water, Sanitation and Hygiene (WASH) services, potentially
focus on children, women, socially excluded and vulnerable families. In this
saving the lives of thousands of children across the country as well as in Madhya
context, the women-centred Madhya Pradesh State- level Sanitation Campaign
Pradesh, every year.
MARYADA (meaning Dignity in Hindi), strongly anchored in the principles of

Community Approaches to Total Sanitation such as CLTS and using the National
However, if the current trends continue, Madhya Pradesh will take another 90
Sanitation and Hygiene Advocacy and Communication Strategy (SHACS) offer
years after the 2015 MDG mark to meet its sanitation target. Efforts thus need to
the right framework to change the social norms and trigger collective behaviour
be sustained and indeed accelerate to bring about collective behavior change
change for the elimination of Open Defecation at community level. I thus
throughout the state to eliminate open defecation and mainstream key hygiene
encourage all stakeholders to support the states efforts of achieving universal
practices such as handwashing with soap, especially after defecation, and before
access to improved WASH facilities and services.
eating or touching food. Furthermore, while the MDG drinking water target has
been met, the main challenge of water quality as well as sustainability of water
UNICEF has been a long-standing partner of the Government of Madhya Pradesh
supplies throughout the day and the year, remains a challenge. The proportion
in providing valuable technical and financial support in implementing the
of households with access to tap water supply within their premise also remains
national flagship programmes in the state, with special focus on children, women
remarkably low in state.
and the most deprived communities. I am grateful to UNICEF for its continuous
support and for the present publication jointly elaborated with PRD and the
Finally, applying an equity lens, this present analysis reveals that the disparities
Office of Census Madhya Pradesh.
between rich and poor, urban and rural, as well as the different social and ethnic
groups are high for both water and sanitation. The Gender perspective is equally
I trust that this report will be a significant contribution for the improvement of
important, and despite the lack of disaggregated data in this regard, it is evident
the Water and Sanitation sector in the State.
that women and adolescent girls, carry the highest burden in the WASH sector.
Dr Tania Goldner
Chief of Field Office, UNICEF
Madhya Pradesh
(Jan 2010 - Jun 2013)
WATER & SANITATION

NBAs implementation at state level through the women-centred Madhya Pradesh Sanitation Campaign
Message
MARYADAbased on Community Approaches to Total Sanitation, such as CLTS, is embedded in intensive Social and
Behaviour change communication, in line with the National Sanitation and Hygiene Advocacy and Communication
Strategy 2012-2017 (SHACS) developed by MDWS, GoI.
Water and Sanitation is a critical issue for the state of Madhya Pradesh. It bears
both direct as well as indirect linkages with health and education of individuals.
With the present report, UNICEF reaffirms its commitment to support the Government of Madhya Pradesh in
accelerating the progress of the WASH sector, given its impacts on health, nutrition, education and other key socioeconomic indicators, as well as its critical importance for upholding the rights, development and dignity of children
and women. I take this opportunity to thank Dr. Aruna Sharma, Additional Chief Secretary, Government of Madhya
Pradesh for her leadership in improving the WASH services in the state, and Mr. Sachin Sinha, Director, Directorate
Census of India provides data related to water and sanitation facilities upto tahsil
level. Availability of such data is pivotal in the process of planning and budgeting
at the micro level. To unravel WATSAN data to a greater extent, Census 2011 has
collected further segregated data which includes figures for treated/untreated
tap water and covered/ uncovered well; along with types of toilet facilities.
of Census Operations, Government of India, Madhya Pradesh, for his partnership in the preparation of the present
report.
Directorate of Census Operations, Madhya Pradesh is working closely with

UNICEF Madhya Pradesh office towards envisaging and bringing out several
technical thematic publications. The Water and Sanitation Situation Analysis of
Madhya Pradesh 2013 is a collaborative effort to embark towards accelerating the
progress of the water and sanitation sector in Madhya Pradesh. For the purpose
of the present publication, data has been analysed and comparisons have been
drawn within the country, among EAG (Empowered Action Group) states and at
the district level.
This is first time in the history of census of the state that such thematic reports are
being designed. I am thankful to UNICEF and their partner Avalon Information
Systems Pvt. Ltd., New Delhi for their collaborative effort in creating such a
vital and guiding document. I especially appreciate the interest and technical
guidance of Dr. Gregor von Medeazza and Mr. Kumar Premchand to bring out
this special publication.
I sincerely hope that the outcome of the report will be translated into action
points for a better future for the state, especially in regard to the health of children
and women in Madhya Pradesh. I am sure the publication will be of tremendous
value to Government of Madhya Pradesh, policy makers, field administrators,
NGOs & other data users.
Mr. Sachin Sinha, IAS

Director
Directorate of Census
Operations
Madhya Pradesh
WATER & SANITATION
List oF Figures
content
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Figure 1.1:
Planned investment (Rs. crores) in water and sanitation sector and

its share (per cent) in total plan outlay, India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Figure 2.1:
Share of households with no access to improved drinking water sources, 2011. . . . . . 10
Figure 2.2:
Trends in improved and unimproved sources of drinking water in
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
International Commitments on Water and Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
EAG states, 1990-2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
National Commitments on Water and Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Rationale of the Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Figure 2.3:
Trends in drinking water sources for the different divisions of

Madhya Pradesh, 2001-2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2. Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Figure 2.4:
Drinking Water Trends and Diferentials in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Proportion of households using improved drinking water sources in the districts of

Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Location of Drinking Water Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Applying the Equity Lens: Disparity between Urban-Rural and Social Groups . . . . . . . . . . . . . . . .15
Figure 2.5:
Proportion of households using improved drinking water sources in the sub-districts of

Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Inequity by Wealth and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Water Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Figure 2.6:
Proportion of households by location of drinking water source in Madhya Pradesh . . 14
Summary of Findings: Drinking Water in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Figure 2.7:
Proportion of households having access to drinking water away from their premises
in the districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3. Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Figure 2.8:
Progress Towards the MDG Sanitation Target . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Urban-Rural disparities of households with improved drinking water coverage in the

districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Sanitation Trends and Diferentials in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Applying the Equity Lens: Disparity Between Urban-Rural and Social Groups . . . . . . . . . . . . . . . .32
Figure 2.9:
Inequality by Wealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Summary of Findings: Sanitation in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
Proportion of households with improved drinking water coverage by social groups
Figure 2.10: Proportion of households with improved drinking water coverage by social groups
4. Correlation between Water & Sanitation . . . . . . . . . . . . . . . . . . . . 38
Figure 2.11: Improved drinking water source by wealth quintile, Madhya Pradesh, 2006 . . . . . . . . 19
Correlation between Location of Drinking Water and Open Defecation . . . . . . . . . . . . . . . . . . .39
Figure 2.12: Time spent to get water by the household members, Madhya Pradesh, 2006 . . . . . . 19
5. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Figure 2.13: Disparities in improved drinking water facilities by location and social
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
groups in Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
6. Annexures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Figure 3.1:
State wise achievement of the MDG sanitation target . . . . . . . . . . . . . . . . . . . . . . 24
Annexure - 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Figure 3.2:
Number of households and percentage practicing open defecation in India, 2011 . . . 25
Annexure - 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Figure 3.3:
Share of open defecation in the states of India, 2011 . . . . . . . . . . . . . . . . . . . . . . . 25
Annexure - 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Figure 3.4:
Trend in improved sanitation in EAG states, 1990-2015 . . . . . . . . . . . . . . . . . . . . . 26
Figure 3.5:
Progress in Improved Sanitation in Madhya Pradesh (rural and urban), 1990-2015 . . . . 27
Annexure - 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Annexure - 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
WATER & SANITATION

Figure 3.6:
Progress in Improved Sanitation in rural areas of Madhya Pradesh, 1990-2015 . . . . . . 28
Figure 3.7:
Proportion of households by use of latrine facility in Madhya Pradesh, 2011 . . . . . . . 28
Figure 3.8:
Proportion of households practicing open defecation in Madhya Pradesh, 2011 . . . . . 29
Figure 3.9:
BPL
Below Poverty Line
CBO
Community Based Organization
Proportion of households using improved sanitation facility in the
CHERG
Child Health Epidemiology Reference Group
districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
CRSP
Central Rural Sanitation Programme
CSD
Commission on Sustainable Development
DLHS
District Level Household Survey
EAG
Empowered Action Group
GSDP
Gross State Domestic Product
HDI
Human Development Index
IEC
Information, Education, Communication
IGME
Inter-agency Group for Child Mortality Estimation
JMP
Joint Monitoring Programme MDG
MDG
Millennium Development Goal
MICS
Multiple Indicator Cluster Survey
MDWS
Ministry of Drinking Water and Sanitation
NBA
Nirmal Bharat Abhiyan
NDWM
National Drinking Water Mission
NFHS
National Family Health Survey
NRDWP
National Rural Drinking Water Programme
NRWQMSP
National Rural Water Quality Monitoring and Surveillance Programme
NSS
National Service Scheme
in Madhya Pradesh, 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
NWP
National Water Policy
Linear relationship between percentage of households practicing open
OD
Open Defecation
defecation and percentage of households with availability of drinking water
ODF
Open Defecation Free
ORGI
Office of the Registrar General
PRI
Panchayati Raj Institution
RGDWM
Rajiv Gandhi Drinking Water Mission
SC
Scheduled Caste
ST
Scheduled Tribe
TSC
Total Sanitation Committee
U5MR
Under-Five Mortality Rate
UN
United Nations
UNICEF
United Nations Childrens Fund
UT
Union Territories
WASH
Water, Sanitation and Hygiene
WATSAN
Water and Sanitation
WHO
World Health Organization
WSP
Water and Sanitation Programme (World Bank)
WSSD
World Summit on Sustainable Development
Figure 3.10: Proportion of households practicing Open Defecation in the

districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Figure 3.11: Proportion of households practicing open defecation in the
sub-districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Figure 3.12: Proportion of households using improved sanitation facilities in urban vs.
rural in the districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Figure 3.13: Proportion of households practicing open defecation (urban vs. rural) in
the districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 3.14: Proportion of households using improved sanitation facilities by social
groups in the districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Figure 3.15: Improved sanitation facilities and open defecation by wealth
quintile in Madhya Pradesh, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Figure 3.16: Disparities in improved sanitation facilities by location and social groups
Figure 4.1:
away from premises, at district level in MP, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Figure 4.2:
acronyMs
Relationship between the proportion of households practicing defecation

and accessing drinking water away from the household premises in the districts of
madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Figure A2.1: Districts with households using unimproved sources of drinking water . . . . . . . . . . 48
Figure A2.2: Districts with households using unimproved sanitation facility . . . . . . . . . . . . . . . . 48
the context
The Millennium Development Goal (MDG) 7 aims to
track in meeting the sanitation targets.
halve the proportion of population without access to
EXECUTIVE
SUMMARY
safe drinking water and improved sanitation. Water and
Applying an equity lens puts a different context on
sanitation services are vital for child survival1. While the
this overall progress. This report examines the overall
latest WHO-UNICEF JMP water and sanitation update
status of water and sanitation in Madhya Pradesh via
confirms that the world has met the MDG water target,
the Census 2011 data and its disaggregation in districts,
the world is significantly off-track and unlikely to meet its
sub-districts rural-urban geographies, social groups and
MDG sanitation target by 2015 (WHO and UNICEF, 2013).
economic status of the population.
India has achieved the water targets, but is notably off-
drinking water
Drinking Water Progress in India and Madhya Pradesh
India has met the MDG drinking water target. In 2012,
without access to improved drinking water sources.
one-tenth of the households in India were still using
Madhya Pradesh and 13 other states are home to 90
drinking water from unimproved sources. Madhya
per cent of households in India without access to safe
Pradesh represents 10 per cent of all households in India
drinking water (Census, 2011).
Drinking Water Coverage in Madhya Pradesh

79.1per cent of households in Madhya Pradesh have
state between 2001 and 2011. Availability of drinking
access to improved drinking water. However, only
water within household premises remains low. While
23.4 per cent of households benefit from piped water
only one-fourth of the households in Madhya Pradesh
supplies and 54.6 per cent rely on drinking water from
have access to drinking water within their premises,
handpumps, tubewells or borewells (Census, 2011). To
the situation is particularly critical in 11 districts where
increase the improved drinking water coverage in the
more than 40 per cent of households access drinking
state, attention has to be paid on 14 districts where
water from sources away from their premises. In fact,
more than 30 per cent households access drinking water
the proportion of households fetching drinking water
from unimproved sources. It is important to underline
away from their premises has increased by 6 percentage
that tap water coverage in fact decreased across the
points between 2001 and 2011.
Equity of Drinking Water Coverage in Madhya Pradesh

Large disparities are found between urban and rural
especially large in 13 districts where rural drinking water
areas and among different social groups. While the
coverage is 25 percentage points lower than in urban
improved drinking water coverage of urban households
areas (Census, 2011). With regard to location of drinking
is 93.4 per cent only 74.1 per cent rural households have
water, households in rural areas have 4 times less access
access to it (Census, 2011). The urban-rural disparity is
to drinking water within the premise as compared to
ii
See for instance Prss-stn et al. (2004), Prss-stn et al. (2006), WHO (2007), Bhuta et al (2008), 3IE (2009), CHERG (2010).
iii
WATER & SANITATION

urban areas. Overall, improved drinking water coverage
coverage for other social groups. Furthermore, a wide
among Scheduled Tribe (ST) households is 16.2
rich-poor gap also exists in Madhya Pradesh. While 36 per
percentage points lower compared to Scheduled Caste
cent of the poorest quintile households use unimproved
(SC) households. Disparities among ethnic groups are
drinking water, only 3 per cent of the richest quintile
mainly seen in 9 districts where the coverage among
households use such water sources. Finally, collecting
ST population is 15 percentage points lower than the
water is seen as a responsibility principally of women.
Water Quality in Madhya Pradesh
Equity of Sanitation Coverage in Madhya Pradesh

Significant disparities between urban-rural and social
in 11 districts defecate in the open. Compared to other
groups are found in terms of access to improved
social groups, in almost all districts, the Scheduled Castes
sanitation facilities in Madhya Pradesh. Urban areas
and Scheduled Tribes are most deprived from improved
have 6 times higher coverage of improved sanitation
sanitation facilities. Inequalities among wealth quintiles
compared to rural areas where only 12.2 per cent
are steep with the gap between the poorest and the
households have access to improved sanitation. In 31
richest in terms of improved sanitation is 80 percentage
districts, the urban coverage of improved sanitation is
points. While still 2 per cent of the richest population
Despite the fact that Madhya Pradesh has made
thousand drinking water sources reported to have been
over 6 times higher than the rural coverage. Census 2011
quintile practice open defecation, it is 96 per cent in
encouraging progress in terms of improved water
tested during 2005 and 2013 (MDWS, 2013), drinking
also reveals that over 40 per cent of the urban population
case of the poorest population quintile (NFHS-3, 2007).
sources (Census 2001, 2011), in achieving some key
water safety remains a serious challenge in the state
results of the National Rural Water Quality Monitoring
of Madhya Pradesh as highlighted by several surveys
concLusion
and Surveillance Programme (NRWQMSP), with over 500
(MDAWS, 2007; WSP, 2011).
The international community strives to provide universal
Census 2011, one of the other important observations
safe drinking water and improved sanitation for all. India
comparing the Census 2001 and Census 2011 data, is the
sanitation
is very much part of the international initiatives and is a
net addition of households practicing open defecation
Sanitation Progress in India and Madhya Pradesh
signatory to the global water and sanitation endeavours,
in Madhya Pradesh, with 2.4 million households in
most notably the Millennium Development Goal target
fact startedpractising open defecation in the state, as
7c, to halve, by 2015, the proportion of people without
the increase in number of households outpaced the
sustainable access to safe drinking water and basic
increase in sanitation coverage.
India is very unlikely to achieve its MDG sanitation target
remains, however, too slow. What is more, by adjusting
by 2015. In 2012, only 43 per cent of households in India
the decadal increase in the number of households,
used improved sanitation facilities. It is projected that
it is alarming to note a net increase in number of
the country will achieve its sanitation target by 2054
households practicing open defecation: above 2.4
(WHO and UNICEF, 2013). While only 17 states have
million households in Madhya Pradesh, actually started
already met their targets, Madhya Pradesh will take
practicing Open Defecation between 2001 and 2011,
another 90 years after the 2015 MDG mark, not meeting
due to population increase, outpacing the sanitation
its sanitation target before 2105 if current trends persist.
improvements. More than 8 per cent of Indias open
Despite Madhya Pradesh making steady progress in
defecators live in Madhya Pradesh while around 70 per
improving its sanitation coverage, with 1.7 million new
cent of the states population practices open defecation.
household toilets used between Census 2001 and
Census 2011 shows that Madhya Pradesh, along with
Census 2011, doubling it from 6.5 per cent in 2001 to
13 other states, accounts for 95 per cent of households
12.2 per cent in 2011 (Census 2001, 2011), this progress
using unimproved sanitation in India.
sanitation.
In conclusion, while progress has been tremendous in
One the one hand, the performance of India in the
India, meeting its MDG water target and with over 275
water sector is notable as the Country has achieved its
million people who gained access to improved sanitation
MDG target well before 2015, and similarly the state of
between 1990 and 2011, 620 million still defecated in
Madhya Pradesh also achieved its state specific water
the open in 2011 (WHO and UNICEF, 2013). Furthermore,
target. On the other hand, progress in the sanitation
Indias proportion of Open Defecators in the world has
sector, at both national and state levels, needs to be
risen from 51 per cent in 1990, 55 per cent in 2000 to 59
accelerated substantially. As per current rate of progress,
per cent in 2011 (WHO and UNICEF, 2013). With around
India would achieve its MDG sanitation target only by
50 million people still defecating in the open in 2011,
2054, while Madhya Pradesh would only met hers by
the state of Madhya Pradesh faces a huge challenge, but
2105, 90 years after the 2015 MDG deadline.
also a fantastic opportunity to significantly improve the
Sanitation Coverage in Madhya Pradesh
iv
lives of millions of children and women by improving
Of the 72.3 per cent households using unimproved
households in all the other districts use unimproved
Despite Madhya Pradesh having seen 1.7 million new
the WASH facilities and services in communities across
sanitation in Madhya Pradesh, the vast majority
sanitation facilities and practise mostly open defecation
household toilets used between Census 2001 and
the state.
-accounting for around 50 million people- defecate in
(Census, 2011). Further, 75 per cent of the households in
the open. Except 4 districts, more than 50 per cent of
240 sub-districts practice open defecation.
1.1. Background
1
INTRODUCTION TO
WATER & SANITATION
An estimated 212,000 children under the age of five
total population of open defecators and 22 per cent of
die each year in India due to diarrhoea (Liu et al,
worlds total under-five deaths. Madhya Pradesh is a case
2012). This amounts to580 children dying every single
in point among all states in India as Census 2011 starkly
day due to a preventable and treatable disease, with
reveals that over 72 per cent of Madhya Pradesh has no
88 per cent of these deaths directly attributable to
access of improved sanitation and the state accounts
unsafe drinking water, inadequate sanitation and poor
for 27 per cent of the increased open defecators in the
hygiene conditions (WHO, 2004). Water, Sanitation and
country, while featuring amongst the highest infant
Hygiene (WASH) have serious implications on health,
mortality rates at 59 deaths per thousand live births.
malnutrition, human dignity, poverty and economic

development as a whole; the progress in the WASH
The connection between open defecation and lack
sector needs, therefore, to be carefully scrutinized.
of hygiene on the one hand, and child mortality and

morbidity on account of diarrhoea and other WASH-
The target of the United Nations Millennium
related diseases on the other, are well- established.
Development Goal (MDG) target 7 to halve the
Outcomes of various meta-analyses show that the
proportion of population without sustainable access to
practice of handwashing with soap alone can reduce
safe drinking water as compared to its 1990 baseline,
the incidence of diarrhoea in children under 5 years by
has been achieved in advance of the 2015 MDG mark
44 per cent (CHERG, 2010; 3IE, 2009; Cochrane, 2008;
globally as well as in India and also in Madhya Pradesh. It
Fewtrell, 2005; Curtis and Cairncross, 2003), and that
is commendable that between 1990 and 2010 over two
sanitation reduces diarrhoea risk by about 36 per cent
billion people across the world gained access to improved
(CHERG 2010).
drinking water sources such as piped water supply,

borewellsand protected wells. In 2011, the population
While many countries, including India, have achieved the
in Madhya Pradesh using unimproved drinking water
MDG drinking water target, the main challenge persists
sources was, however, still estimated to be 21.9 per cent
for its sanitation target and other goals such as child
for all household (Census, 2011). Furthermore, drinking
morbidity and mortality that heavily rely on improved
water quality as well as sustainability of water sources
water and sanitation. Child survival strategies must direct
also remains a challenge in India as well as in Madhya
efforts towards the leading causes of child mortality such
Pradesh.
as diarrhoea and other faecally transmitted infections.

Evidence shows that well-established interventions
however,
such as improved WASH services are needed in order to
disappointing. As per current trends, it is very unlikely
accelerate progress to save lives efficiently (Prss-stn
that the MDG target for sanitation will be met (UNICEF
et al. 2004; Prss-stn et al. 2006; WHO 2007; Bhutta
and WHO, 2013), that is, to halve the proportion of
etal. 2008; 3IE 2009; CHERG 2010). Health targets can
population without sustainable access to improved
indeed best be attained when there is a convergence
sanitation by 2015 as compared to 1990. India
between sectors such as health and nutrition, along
accounts now for around 60 per cent of the worlds
with water, sanitation and hygiene (WASH).
The
progress
of
sanitation
remains,
WATER & SANITATION

1.2. internationaL coMMitMents on water and
sanitation
Several conventions and agreements at the international
water and sanitation. An overview of some of these
as well as at the regional level have been formed to
conventions, treaties, agreements or other important
directly or indirectly address issues related to water
milestones focusing directly on water and sanitation is
and sanitation. The main motive of these conventions
presented in chronological order.
is to attain sustainable development with a focus on
Convenion / Treaty / Meeing

1977 UN WaterConference, Mar
del Plata, Argenina
Descripion
1980s declared the Internaional Drinking Water and Sanitaion Decade
1980s
Declared the Internaional Drinking Water and Sanitaion Decade
1986 CRSP, India
Central Rural Sanitaion Programme (CRSP) launched in India
Development
Protecion of the Quality & Supply of Freshwater Resources: Applicaion of Integrated Approaches
to the Development, Management & Use of Water Resources
Also known as: Earth/Rio Summit

1997 World Water Forum,
Marrakesh
1999 Community-Led Total
Reinforcement of earlier commitments. Namely, the Mar del Plata, Dublin Principles and Chapter
18 of the Rio Summit
Sanitaion (CLTS)
Started in Bangladesh through an applicaion of PRA (by the Village Educaion Resource Center
(VERC) with support from Water Aid
1999 CRSP, India
CRSP was renamed the Total Sanitaion Campaign (TSC) and restricted as part of reform iniiaives.
Eight major Internaional development goals that the United Naions member states agreed to
achieve by the year 2015. The MDG 7 aims to halve the populaion without access to improved
Goals (MDGs)
water and sanitaion.
(note that iniially sanitaion was only menioned only in context of improving the lives of slumAlso known as: Millennium Summit dwellers)
2000 Millennium Development
2002World Summit on Sustainable WSSD was organized to discuss ways of implemening sustainable development in the world.
Development (WWSD),
Delegates concluded that integrated water resources management and water eiciency planning
Johannesburg
should be an essenial element in all naional or regional development strategies by 2015 and
added this target to the list of Millennium Development Goals.
2002 Africa San Conference
2002 First Africa San Conference on Sanitaion and Hygiene, Johannesburg, South Africa
2002 World Summit on Sustainable Governments agreed to a speciic target to cut in half the proporion of people without basic
Development in Johannesburg
sanitaion by 2015
2003 SACOSAN, Bangladesh
2003 First South Asia Conference on Sanitaion (SACOSAN), Dhaka, Bangladesh
2004-2005United Naions
Commission on Sustainable
Development (CSD) 13, (Water and
Sanitaion were themaic clusters)
The Commission adopted measures to address water, sanitaion and human setlements in an
integrated manner, taking into account economic, social and environmental aspects, related to
2005Millennium Development
Goals +5
2006 Sanitaion Task Force
2008 The Internaional Year of Sanitaion, declared by the UN General Assembly

Event to review progress, renew and reinforce commitments, and idenify concrete acions and
iniiaives to ensure that all countries achieve the MDGs by 2015.
2008 High Level Event on MDGs,

New York, USA,
Water: Improve drinking water supplies for almost a billion people lacking them, including about
300 million in sub-Saharan Africa.
Sanitaion: Increase spending on water and sanitaion from 0.5% to at least 1.0% of GDP to greatly
increase access as scheduled.
2012 Water and Sanitaion for All
Sanitaion and Water for All is a global partnership between developing countries, donors,
muli-lateral agencies, civil society and other development partners working together to achieve
universal and sustainable access to sanitaion and drinking water, with an immediate focus on
achieving the Millennium Development Goals in the most of-track countries.
2012Nirmal Bharat Abhiyan, India
Indias Total Sanitaion Campaign (TSC) is revamped into the Nirmal Bharat Abhiyan (Clean India
Campaign) with the aim to render the Country Open Defecaion Free by 2022.
2013 Sanitaion for All
Member states in the General Assembly adopted a resoluion of Sanitaion for All oicially
designaing 19 November as World Toilet Day. This will go a long way in raising awareness about
the need for all human beings to have access to sanitaion.
1.3. nationaL coMMitMents on water and sanitation
1992Agenda 21 - United Naions

Conference on Environment and
2008 Internaional Year of

Sanitaion
sectoral policies and cross-cuing issues as ideniied at the eleventh session of the Commission,
as well as naional, sub- regional and regional speciiciies, circumstances and legal frameworks.
Review of eight major Internaional development goals that United Naions member states agreed
to achieve by the year. Review notes that improved sanitaion is essenial to fulill Goal 4 Reduce
child mortality and Goal 5 Improve maternal health. Improvements in public-health services are
key to achieving this, while provision of safe water and beter sanitaion are essenial underlying
premises of improved public health. Goal 7, Ensure environmental sustainability, is equally closely
ied with improvement in water and sanitaion. Access to safe drinking water has improved
worldwide, but billions of people sill lack safe drinking water and basic sanitaion. The target is to
halve, by 2015, the proporion of the people without sustainable access to safe drinking water and
basic sanitaion
2006 Sanitaion 21 Task Force set up by Internaional Water Associaion (IWA)
Since independence, India has been focussing on
demand-responsive approach. This approach involved
addressing the safe water needs of its people. The
10 per cent contribution by the community and 90
Environment Hygiene Committee (1949) recommended
per cent by the government for the infrastructure
provision of safe water supply for the benefit of 90
development related to water. Post-2000 has been
per cent of people within 40 years. Later in 1950, the
seen as consolidation phase. During 2002, the NWP
Constitution of India conferred ownership of all water
was revised with a priority on villages that lack safe
resources to the government. In 1969, the National Rural
water. In the same year, India committed to the MDGs.
Drinking Water (NRWQMSP) programme was launched
Later in 2004, all drinking water programmes were
with technical support from UNICEF which focused on
brought under the umbrella of RGNDWM. In 2007, the
drilling bore wells and establishing piped water supply
pattern of funding set during 1999 was changed to
schemes.
equal contribution between the Centre and the state

government.
The phase 1969 -1989 was a transition from technology

to policy, and in 1987 the first National Water Policy
With regard to sanitation, after 13 years of rather
(NWP) was elaborated. The next phase was termed the
slow rural sanitation progress under the Central Rural
restructuring phase (1989 - 1999). During this phase,
Sanitation Programme (CRSP), the Government of India
the National Drinking Water Mission (NDWM) that was
launched the Total Sanitation Campaign (TSC) in 1999.
formed in 1986 was renamed as Rajiv Gandhi National
The TSC Guidelines were formulated as an ideal policy
Drinking Water Mission (RGNDWM) in 1991. Later in
to eliminate open defecation in rural India. The 2004 TSC
1994, the 73rd Constitutional Amendment assigned
guidelines sought to make the Programme community-
Panchayati Raj Institutions (PRI) the responsibility
led and people-centred, emphasising broadly on
of providing drinking water to communities. Under
information, education, communication (IEC), capacity
Swajaldhara Scheme in 1999, there was a paradigm shift
building and hygiene education by involving PRIs,
in reforms on rural water, from government-oriented,
CBOs and NGOs. The TSC aimed for an Open Defecation
supply-driven approach to the people-oriented,
Free India by 2012, which unfortunately, was far from
WATER & SANITATION

being achieved. In April 2012, TSC was revamped into
In the Government of Indias Five Year Plans, considerable
theNirmal Bharat Abhiyan (NBA), Clean India Campaign,
amounts have been spent on the improvement of water
with a substantially increased budget and setting the
and sanitation (Figure 1.1). However, the analysis shows
open defecation free target to 2022.
that the planned investment decreased during the 10th
and 11th Five Year Plans.

Figure 1.1: Planned investment (rs. crores) in water and sanitaion sector and its share (per cent) in total plan
outlay, India
Planned investments in water and sanitation outlay
Percentage share of total plan outlay
Planned Invesments
Percent
450,000
7.00
6.54
395380
400,000
6.00
350,000
5.44
300,000
4.15
250,000
200,000
4.00
3.00
167110
2.62
111689
1.46
1.07
65224
1.23
50,000
-
4.6
3.62
2.75
150,000
100,000
3.85
5.00
60108
40470
2.00
1.00
490
720
1057
4370
10306
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
Plan
Plan
Plan
Plan
Plan
Plan
Plan
Plan
Plan
Plan
Plan*
0.00
Source: Planning Commission of India (2002, 2011)

*Revised projecions
rationaLe oF the rePort
Given the amount of investment as well as the critical
of drinking water coverage, sanitation is of growing
impacts water and sanitation have on health, nutrition
concern. Furthermore, large gaps still persist between
and other key socio-economic indicators, the current
rich and poor, rural and urban, as well as different social
status of the sector needs to be reviewed in the light
groups for both sanitation as well as drinking water
of the latest Census of India 2011 data. While Madhya
coverage. These elements will be further analysed in the
Pradesh has shown an encouraging progress in terms
present document.
WATER & SANITATION
India has met the MDG drinking water target well before
as high as 12 per cent in 2010, and the projection for
2015. However, the proportion of its population without
2015 is that 6 per cent of the countrys population would
access to improved drinking water was estimated to be
still remain without access to improved water sources.
2 WATER
TARGET MET: Proportion of population using unimproved drinking

water source has been halved in 2012, in comparison to 1990.
ON TRACK: Proportion of population that are likely to meet the
MDG drinking water target by 2015.
NOT ON TRACK: Proportion of population that is not likely to meet
the MDG drinking water target by 2015.
Furthermore, 27 states and Union Territories had
drinking water sources (Figure 2.1).
met their MDG drinking water target in 2012. While

Jharkhand is on track to achieve its target by 2015, seven
Figure 2.4 shows the trend (least square estimate) in
states, mainly from the north-eastern region and Kerala,
improved drinking water in the EAG states. In case of
are not on track to achieve the target by 2015.
Madhya Pradesh, 11 per cent of its population will still

lack access to improved drinking water in 2015 after
It is important to underline that although Madhya
achieving the drinking water MDG target. The estimates
Pradesh, along with Rajasthan and Maharashtra, have
at national level for different time periods (except 2011)
achieved their respective drinking water MDG target,
in the figure have been generated through least square
these three states account for around 30 per cent of
method. The data sources used for estimation are
Indias households which remain without improved
indicated below the figure.
In order to provide quality informaion to align with the internaional requirements, Census 2011 has disaggregated
some of the drinking water sources as compared to Census 2001.
Census 2011
Improved
Unimproved
Census 2001
Tap water from treated and untreated

sources
Tapwater
Covered well
Not available
Handpump
Handpump
Tubewell/ Borehole
Tubewell/ Borehole
Uncovered well
Well
River/Canal
River/Canal
Spring
Spring
Tank/ Pond/ Lake
Tank/ Pond/ Lake
Other sources
Other sources
WATER & SANITATION

Figure 2.1: Share of households with no access to improved drinking water sources, 2011
Gujarat
3%
Bihar
3%
Kerala
12%
Other states
10%
Tamil Nadu
4%
Maharashtra
11%
Uttar
Pradesh
4%
West Bengal
4%
Madhya Pradesh
represents 10% of all
households in India
without access to
improved drinking water
sources.
Madhya Pradesh
10%
Karnataka
5%
Assam
6%
Rajasthan
8%
Andhra Pradesh
6%
Source: Census (2011)
44
31
11
77
37
46
11
Unimproved source
57
11
39
13
33
25
87
89
69
6
94
100
89
mapping of improved drinking water coverage shows a
use of other unimproved drinking water sources such
similar pattern among the districts (Figure 2.5).Micro-level
as springs, rivers, canals, tanks, ponds, lakes, etc. though
data reveal the most vulnerable sub-districts that require
minimal, still remains to be fully eliminated. Finally, it is
immediate attention: over 70 per cent of households
important to underline that tap water coverage in fact
in three sub- districts, namely Jaisinghnagar (77%),
decreased from 25 per cent to 23 per cent across the
Kusmi (76%) and Deosar (70%) do not have improved
state between 2001 and 2011.
drinking water coverage. Furthermore, between 30 and
While seven districts in Madhya Pradesh have access to
have access to improved drinking water sources. These
improved drinking water coverage in a range of more
districts are Buxawaha (38%), Ghughari(41%), Kharagpur
than 90 per cent, 30 per cent of households in 14 districts
(42%), Chitrangi (43%), Baldeogarh (44%), Pushparajgarh
still do not have coverage of improved drinking water
(46%), Karera (46%), Paraswada (47%), Barhi (47%), Jabera
sources. These districts are mainly in Sagar, Jabalpur and
(48%), Rajnagar (48%), Palera (49%), Garoth (49%) and
Shahdoldivisions. Singrauli is the worst-affected district
Shamgarh (49%).
Figure 2.3: Trends in drinking water sources for the diferent divisions of Madhya Pradesh, 2001-2011
89
93
a decrease of unimproved ones. Across all divisions, the
where over 50 per cent households use unimproved
Figure 2.2: Trends in improved and unimproved sources of drinking water in eAG states, 1990-2015
Improved source
drinking water sources (Figure 2.4). The sub-district
50 per cent of households in 14 sub-districts do not
Jharkhand
7%
Orissa
7%
an increase in the use of improved water sources and
75
Tapwater
2 2
19 16
51 57
67
63
1
9
1
28
77
47
49
61
56
1
34
1
17
Handpump/Tubewell/Borewell
12
12
48
51
62
3
26
47
1
21
54
1
25
48
1
18
Well
4
53
28
Other sources
3
50
34
7
51
3
37
57
62
53
35
33
43
23
16 13
2001 2011 2001
1990
Bihar
2015
1990
2015 1990
Chhattisgarh
2015 1990
Jharkhand
2015 1990
Madhya Pradesh
Orissa
2015
1990
2015
Rajasthan
1990
2015
Uttar Pradesh
1990
2015
Bhopal
Uttarakhand
24
26
2011 2001
Gwalior
2011 2001
Indore
2011 2001
Jabalpur
2011 2001
Narmadapuram
12
2011 2001
Rewa
55
31
25
2
20
48
24
10
2011 2001
Chambal
46
32
24
20
46
3
29
29
36 34
23
2
21
43
54
28 25
1
21
11
2011 2001
Sagar
23
13 12
2011 2001
Sahadol
2011 2001 2011
Ujjain
Madhya
Pradesh
Source: Census (2001, 2011.)
Source: Census (1991, 2001, 2011); DLHS-2 (2006), DLHS-3 (2010); MICS 2000; NFHS-2 (2000), NFHS-3 (2007) ; NSS (1998, 2002)
2.1. DrInkInG WATer TrenDS AnD DIFFerenTIALS In

MADHyA PrADeSH
10
Figure 2.3 shows the trends in the use of different sources
tubewell/borehole; these include Indore, Chambal,
of drinking water in the 10 administrative divisions of
Bhopal, Ujjain, Gwalior, Jabalpur and Narmadapuram.
Madhya Pradesh. Two groupings of divisions for drinking
The second is a set of divisions in which over 30 per cent
water sources emerge in Madhya Pradesh. The first is
of households still rely on unimproved drinking water
the set of divisions mainly relying on improved drinking
sources, typically unprotected wells. These divisions
water sources such as tap water and handpump/
are Rewa, Sagar and Shahdol. Overall, there has been
11
WATER & SANITATION
Figure 2.4: Proportion of households using improved drinking water sources in the districts of Madhya
Pradesh, 2011
Figure 2.5: Proporion of households using improved drinking water sources in the sub-districts of Madhya
Pradesh, 2011
Morena
91
In 14 districts, one in every

three households does not
have access to improved water
source.
Bhind
89
Gwalior
94
Datia
85
79 Per cent
Sheopur
92
Shivpuri
71
Neemuch
73
Mandsaur
65
Ratlam
84
Jhabua
83
Dhar
82
Alirajpur
86
Barwani
83
Per cent
<70%
70-80%
80-90%
Above 90%
Rajgarh
65
Shajapur
76
Ujjain
89
Indore
96
West Nimar
86
Ashoknagar
81
Guna
80
Dewas
85
East Nimar
80
Burhanpur
89
Vidisha
87
Bhopal
93
Sehore
81
Harda
81
Raisen
89
Tikamgarh
60
Chhatarpur
62
Panna
67
Sagar
70
Narsinghpur
96
Hoshangabad
86
Betul
80
Damoh
65
Chhindwara
76
Satna
84
Katni
85
Jabalpur
94
Seoni
71
Mandla
65
Rewa
81
Sidhi
71
Shahdol
60
Umaria
61
Dindori
62
Singrauli
44
Anuppur
62
Per cent
Balaghat
66
<70%
70-80%
80-90%
Above 90%
12
13
WATER & SANITATION

2.2. LOCATIOn OF DrInkInG WATer SOurCeS
Figure 2.7: Proporion of households having access to drinking water away from their premises in the districts
of Madhya Pradesh, 2011
Figure 2.6 gives an indication of the distance between
of households fetching drinking water away from
households and drinking water sources in Madhya
their premises has increased by six percentage points
Pradesh. Though the state has met its MDG drinking
between 2001 and 2011.
provide drinking water in closer vicinity to households:
Further analysis (Figure 2.7) shows that more than 40
indeed, only one quarter of households have access to
per cent of households in 11 districts access water from
drinking water within their premises. In fact, the situation
distant sources.
Sheopur
34
Neemuch
29
Figure 2.6: Proporion of households by locaion of drinking water source in Madhya Pradesh
70
Ratlam
35
2011
Barwani
28
40
30
30.5
24.6
20
Indore
18
Dhar
38
Alirajpur
30
51.2
45.6
Per cent
Ujjain
29
Jhabua
43
50
Guna
32
Mandsaur
33
60
Datia
27
Shivpuri
38
has worsened over the last 10 years: the proportion
2001
Gwalior
17
30.5 Per cent
water target, significant efforts are still required to
In 34 districts, more than 30

per cent of population access
drinking water at a distance
of over 100 metres from their
premises.
Bhind
26
Morena
21
West Nimar
25
Per cent
Upto 25%
26-30%
31-40%
> 40%
Rajgarh
46
Shajapur
40
Dewas
27
East Nimar
29
Ashoknagar
32
Vidisha
23
Bhopal
17
Sehore
22
Harda
24
Raisen
32
Tikamgarh
44 Chhatarpur
37
Panna
38
Sagar
31
Chhindwara
31
Katni
28
Jabalpur
22
Narsinghpur
24
Hoshangabad
17
Betul
30
Damoh
44
Satna
30
Seoni
35
Mandla
48
Umaria
29
Dindori
52
Rewa
36
Sidhi
38
Singrauli
37
Shahdol
26
Anuppur
32
Balaghat
30
Burhanpur
19
24.3
23.9
2.3. APPLyInG THe equITy LenS: DISPArITy beTWeen

urbAn-rurAL AnD SOCIAL GrOuPS
10
0
Within the premises
Near the premises
Away
These regional averages mask disparities in the coverage
(47%), Shahdol (32%), Anuppur (31%), Tikamgarh (29%),
of drinking water. In order to identify such disparities,
Mandsaur (29%), Sagar (28%), Neemuch (28%), Dindori
drinking water coverage is further disaggregated
(28%), Chhatarpur (28%), Mandla (27%), Sidhi (26%) and
between rural and urban areas, socio- economic status
Rajgarh (25%).
Source: Census (2001, 2011)
WITHIN THE PREMISES: Source located within the premises where

the household live.
NEAR THE PREMISES: Source located within a range of 100 metres
from the premises in urban areas and within a range of 500
metres in rural areas.
AWAY: Source located beyond 100 metres from the premises in
urban areas and beyond 500 metres in rural areas.
14
and social groups.

The disaggregation of improved drinking water coverage
Rural and urban areas of Madhya Pradesh do not have
by ethnic groups in Figure 2.9 shows that the coverage
equal access to improved drinking water sources (Figure
of improved drinking water is lower on average among
2.8). While rural areas have lower access to improved
SC and ST as compared to other group. The largest
drinking water sources in all the districts of Madhya
discrepancies exist in districts from the north-eastern
Pradesh, the urban-rural gap is particularly wide (25%
and southern region of Madhya Pradesh. Districts where
and above) in 12 districts, mostly located in east and
improved drinking water coverage is lower than 15
partly in north-eastern and north-western regions. These
percentage points among ST compared to other social
districts with high rural-urban difference are Singrauli
groups are Singrauli, Sidhi, Dindori, Anuppur, Mandla,
15
WATER & SANITATION
Damoh, Chhindwara, Burhanpur and West Nimar. The
to other groups in Shivpuri, Ashoknagar, Datia and
improved water coverage among ST is better compared
Rajgarh districts.
Figure 2.9: Proporion of households with improved drinking water coverage by social groups in the districts of
Madhya Pradesh, 2011
93 91
Figure 2.8: urban-rural dispariies of households with improved drinking water coverage in the districts of
74
93
90 96
90 99
68
92 90
82 72
Rural population in 13 districts

have 25 percentage points
less coverage of improved
water compared to their urban
counterparts.
83 92
90
Scheduled Tribes population in

9 districts have 15 percentage
points less coverage of
improved water compared to
other social group.
94 94
89 99
87 97
89 88
86 87
71 83
71 65
83 78
80 86
65 62
66
94
56
76 92
59
84 97
72
86
93
94 96
62
87 94
83 91
90
69
62 81
77 93
82
54
95 98
62
97
76
95
95
82
86
95 88
91 85
71
91
68
92
64 77
89
61
89
54
87 90
74 70
93 81
35
82 98
81 97
84 99
Per cent
Rural
Urban
83 90
83 66
89 76
82 73
92
Per cent
SC
ST
83
89 83
69 51
69 57
91 78
50 33
96 86
66 54
91 84
86 74
60
65 56
97 90
85 84
91 79
85
88 76
72 64
91 91
92 74
90 97
78 94
80 93
84 97
84 77
57
77
16
84 96
86 97
81 97
84
88
82 99
85 96
57
87 83
65 66
80 92
65 80
61
79 97
79 93
88 82
68 66
61 66
85
86 83
64 58
79
82 67
57
71 57
78 67
78 64
72
Source: Census 2011
Drinking water access within household premises is
Morena (7.8%), Shajapur (7.9%), Alirajpur (8.0%), Guna
still mainly benefitting urban areas, with more than
(9.0%), Ujjain (9.1%), Katni(9.4%)) more than 90 per cent
half of urban households having access to drinking
of rural households do not have drinking water source
water within the premises compared to only one-
within their premises. However, the challenge remains
tenth in the case of rural households (Figure 2.10). All
for many urban households too. Over 50 per cent of the
the districts show a marked difference between rural
urban households in 13 districts (Tikamgarh (34.5%),
and urban areas having access to drinking water within
Damoh (37.1%), Sidhi (37.2%), Chhatarpur(40%), Shivpuri
the premises. In 18 districts (Tikamgarh (4.1%), Dindori
(42.1%), Panna (43.2%), Rajgarh (43.9%), Dewas (45.6%),
(4.1%), Rajgarh (4.5%), Jhabua (4.7%), Shivpuri (5.7%),
Barwani (45.9%), Dindori(46.4%), Ashoknagar (47.6%),
Sheopur (6.0%), Chhatarpur (6.3%), Bhind (6.6%), Ratlam
Shajapur (48.4%), Balaghat (49.6%)) do not have access
(6.8%), Damoh (6.9%), Mandla (7.1%), Panna (7.3%),
to drinking water within their premises.
17
WATER & SANITATION

Figure 2.10: Proporion of households with access to drinking water within their premise for urban and rural
areas in the districts of Madhya Pradesh, 2011
Figure 2.11: Improved drinking water source by wealth quinile, Madhya Pradesh, 2006
Piped sources
100
66
51
8
13
55
71
63
9 in every 10 rural households

of 18 districts do not have
drinking water within the
premises.
13
58
11
36
Other improved sources

30
25
28.7
80
42
57.3
62
59
58
48
40
43
59
61
51
48 4
15
54
20
60
25
16
15
Per cent
Rural
Urban
26
46
53
32
54
51
51
40
38.3
58
20
17.7
18
56
28
8
0
15
14
13
68.3
61.7
55
13
57
22
60
37
60
14
13
59
68
14
55 24
9
56
19
16
14
46
50
51
46
60
37
11
56
59
51
18
12
15
60
44
18
50
16
61
51
12
Percent
34
57
10
51.7
19
Unimproved sources
Poorest
50
18
53
2.3
Second
Middle
Fourth
Source: NFHS-3 (2007)
Figure 2.12: Time spent to get water by the household members, Madhya Pradesh, 2006
e than 30 minutes
r
o
M
4.1 0.3 0.6
2.4. InequITy by WeALTH AnD GenDer

5.1
16
richest wealth quintile.
12
group, higher the use of unimproved drinking water

Figure 2.12 shows the time spent to get to a water
decreasing pattern of improved drinking water by
source by different household members, and that it is
Female child under 15 yr
decreasing wealth quintiles: only 64 per cent of
mostly the adult women (81.7%) followed by adult man
Male child under 15 yr
households in the poorest quintile use improved
(12.3%) and female child under 15 years (4.5%) that carry
Other
drinking water while the use is 97 per cent in case of the
the burden of fetching water.
0.4 0.5
an 30 minu
s th
te
s
e
Adult woman
sources in Madhya Pradesh. Figure 2.11 shows a
Lower the socio-economic status of the population
Richest
Adult man
82
79
Source: NFHS-3 (2007)
2.5. WATer quALITy
18
The Ministry of Drinking Water and Sanitation (MDWS)
tested for water quality, sources in 42 districts were
has been regularly monitoring and surveying water
found to be contaminated. Out of these, Shahdol
quality throughout the state. Out of all the 50 districts
appears is the worst - affected district followed by
19
WATER & SANITATION

Seoni and Chhindwara. Water sources in Datia, Morena
water sources (94%) contaminated with E. coli (WSP
drinking water within their premises, the situation is
households. Applying an equity lens emphasizes the
and Katnidistricts are mainly contaminated by faecal
2011). Also, the Multi District Assessment of Drinking
particularly critical in 11 districts where more than
high inequality existing between the poor and rich
coliform which is one of the major causes of waterborne
Water Safety (MDAWS 2007) carried between 2006-
40 per cent of households access drinking water
in the use of drinking water from improved drinking
diseases such as dysentery and typhoid, and others such
2007, across 47 Districts of Madhya Pradesh jointly by
from sources away from their premises. In fact,
water sources. Furthermore, at the household level,
as gastroenteritis and hepatitis-A.
UNICEF and PHED had found 23 per cent of the 6400
the proportion of households fetching drinking
women bear the main responsibility of fetching
water samples microbiologically contaminated (human
water away from their premises has increased by 6
drinking water.
MDWS has been spending substantial funds on rural
interference, thermotolerant coliforms) and 37 per cent
percentage points between 2001 and 2011.
water quality since the initiation of National Rural
of 640 samples microbiologically contaminated (animal
Water Quality Monitoring and Surveillance Programme
interference, faecal streptococci).
4. The Ministry of Drinking Water and Sanitation

3. Disparities between rural and urban areas in terms
reports that water quality needs particular attention
of availability and particularly in terms of the
in the rural areas of 46 districts with drinking
Drinking water quality remains, thus, a key challenge for
accessibility of improved drinking water within
water showing chemical and/or bacteriological
the state, ensuring that chlorination residual is found in
premises are large (rural 13% and urban 55%)
contaminations.
However, despite the fact that Madhya Pradesh has
the drinking water supplied to households. Decreasing
in Madhya Pradesh. Disparities between social
made encouraging progress in terms of improved water
the distance between the drinking water supply point
groups across the state are also notable: improved
As a summary, the disparities existing between rural
sources (Census 2001, 2011), in achieving some key
and the consumer, by increasing the number of functional
drinking water coverage among SC households
and urban areas as well as different social groups
results of the National Rural Water Quality Monitoring
pipe water supply schemes in the state, providing safe
is 16.2 percentage points lower compared to SC
within the state are presented in Figure 2.13 below.
and Surveillance Programme, with over 500 thousand
treated drinking water through tap connections to
drinking water sources reported to have been tested
individual households would substantially improve the
during 2005 and 2013 (MDWS, 2013), drinking water
situation. Also, the National Drinking Water Advocacy
safety remains a serious challenge in the state of
and Communication Strategy (DWACS) of MDWS and
Madhya Pradesh as highlighted by several surveys.
UNICEF soon to be released offers a major opportunity
Indeed, a recent survey carried out by the Water
to address the water quality issue, by taking action to
and Sanitation Programme of the World Bank, found
significantly reduce the contamination during transport
almost all (97%) household drinking water samples
and storage of drinking water.
(NRWQMSP). Madhya Pradesh has shown encouraging

progress.
95
Urban
93.4
90
India
87.1
Urban SC
92.2
Urban ST
88.3
85
Per cent
contaminated with E. coli, and almost all community
Figure 2.13: Dispariies in improved drinking water faciliies by locaion and social groups in Madhya Pradesh, 2011
2.6. SuMMAry OF FInDInGS: DrInkInG WATer In

MADHyA PrADeSH
80
Madhya
Pradesh
79.1
75
Rural SC
78.2
Rural
74.1
20
All the EAG states have made tremendous progress in
in the state, attention has to be paid on 14 districts
providing improved drinking water and have met their
where more than 30 per cent households access
respective MDG water targets. Four main issues require
drinking water from unimproved sources. It is
immediate attention with regard to drinking water,
important to underline that tap water coverage in
namely coverage of improved drinking water sources,
fact decreased across the state between 2001 and
accessibility, disparity and water quality:
2011.
1. Ten per cent of Indias population who use
2. Availability of drinking water within household
unimproved drinking water live in Madhya Pradesh.
premises remains low. While only one-fourth of
To increase the improved drinking water coverage
the households in Madhya Pradesh have access to
70
Rural ST
70.3
65
21
3.1. Progress towards the Mdg sanitation target
3 SANITATION
India has made encouraging progress in terms of
(Narayanan et al, 2011).India is very unlikely to meet its
increasing its sanitation coverage, with around 275
MDG sanitation target by 2015. While only 20 per cent of
million people gaining access to improved sanitation
Indias population had access to improved sanitation in
between 1990 and 2011 (WHO and UNICEF, 2013).
1990, it has increased by 23 percentage points by 2012.
However, despite these tremendous gains, sanitation
It is estimated that only 47 per cent of the countrys
still remains a major challenge for the country, with 620
population will have access to improved sanitation
million people still defecating in the open in 2011 (WHO
in 2015, the MDG target year. Furthermore, given the
and UNICEF, 2013). What is more, Indias proportion of
current trends, it is estimated that India will achieve
Open Defecators in the world has risen from 51 per
the MDG sanitation target only by 2054. The estimates
cent in 1990, 55 per cent in 2000 to 59 per cent in 2011
for MDG baseline, intermediate time points and target
(WHO and UNICEF, 2013). The distribution of OD by
period have been estimated by employing the linear
wealth quintile is also sharply skewed: the wealthiest
regression estimation method. Please refer to Annexure
40 per cent of Indians are 10 times more likely to use
5 for more details.
improved sanitation than the poorest 40 per cent
TARGET MET: Proportion of population using unimproved sanitation facilities has been halved in 2012, in comparison to 1990.
ON TRACK: Proportion of population that are likely to meet the
MDG sanitation target by 2015.
NOT ON TRACK: Proportion of population that is not likely to meet
the MDG sanitation target by 2015.
using Census 2011, household level informaion on type of latrine facility was used to deine improved and unimproved
sanitaion, as detailed below.
Improved
Having latrine facility within the premises

- Flush/pour lush latrine connected to sepic tank
- Flush/pour lush latrine connected to piped sewer system
- Flush/pour lush latrine connected to other system
- Pit latrine with slab/venilated improved pit
Unimproved
Having latrine facility within the premises

- Pit latrine without slab/open pit
- Service latrine - Night soil removed by human
- Service latrine - Night soil serviced by animal
- Night soil disposed into open drain
not having latrine facility within the premises

- Alternaive source: Open
- Alternaive source: Public latrine
23
WATER & SANITATION

of these states are likely to achieve their targets by 2025.
target in 2012. These states are mainly from the north
Furthermore, 7 additional states are expected to achieve
and north-eastern regions as well as Goa and Kerala. In
their sanitation targets by 2050. The worst prospect is
addition, Dadra and Nagar Haveli and Meghalaya are
for 4 states likely to achieve their sanitation targets over

50 years after the 2015 MDG target year, with Madhya
not have achieved the MDG sanitation target by 2015, 4
Pradesh likely to meet its target only by 2105 (Figure 3.1).
Figure 3.1: State wise achievement of the MDG sanitaion target
35.1
20
2160
10
0
2105
1990
Source: Census (2001, 2011); DLHS-2 (2006), DLHS-3 (2010); MICS (2000); NFHS-2 (2000), NFHS-3 (2007); NSS (1996, 1998, 2009)
Census 2011 shows that the coverage of household
when comparing Census 2001 and Census 2011 data;
toilets increased by 11 per cent compared to Census
implying that the increase in number of households
2001 in India and approximately a 6 points increase
outpaced the increase in number of new toilets built
in Madhya Pradesh, where 1.7 million new household
between 2001 and 2011.
toilets have been used between Census 2001 and

Census 2011. However, despite these encouraging
At the state level, the major contributors to open
findings, progress is too slow. Indeed, by adjusting the
defecation are mainly the EAG states in the country.
decadal increase in the number of household, it appears
Madhya Pradesh, one of the EAG states, is observed
that an additional 2.4 million households in Madhya
the fourth highest contributor with its 71.2 per cent
Pradesh, in fact started practicing open defecation,
households practicing open defecation (Figure 3.2).
40
30
50
2077
2074
2067
2046
2046
2033
2032
2028
2028
2027
2024
2023
2016
2013
2013
2013
2011
2011
2010
2010
2008
2007
2007
2007
2007
2007
2006
2005
2004
100
Jammu & Kashmir
2003
48.8
Chhattisgarh
2003
50
51.7
Jharkhand
2003
53.1
Assam
2003
70
Orissa
Year
150
Rajasthan
2040
80
60
Madhya Pradesh
Before 2015
200
90
75.4
65
Tamil Nadu
3 states
in 10 years
3 states
States already achieved MDG target
78
71.2
64.4
Bihar
17 states
5 states
in 25
years
78
76.9
250
Uttar Pradesh
2140
5 states
in 62 years
Percentage of households practicing open defecation

100
India
State expactaions of
achieving MDG targets ater
2015
2190
2090
2 states
after 90 years
Total number of households

300
Percentage of households
likely to achieve their targets by 2015. While 16 states will
Figure 3.2: number of households and percentage pracicing open defecaion in India, 2011
Million Households
Only 17 states/UTs have already met the MDG sanitation
Source: Census (2001, 2011)
Overall, 14 states in India account for 95 per cent of
WHO and UNICEFs Joint Monitoring Programme (JMP)
households with unimproved sanitation. Uttar Pradesh
shows that around 60 per cent of the people practising
alone contributes 16 per cent followed by Bihar with 11
open defecation around the globe live in India (WHO
per cent. Madhya Pradesh, along with Maharashtra and
and UNICEF, 2013). Figure 3.3 shows that overall 12
Andhra Pradesh, ranks at the third position, contributing
states in India account for 90 per cent of households
8 per cent of households with unimproved sanitation in
defecating in the open. Uttar Pradesh alone contributes
India.
to 17 per cent followed by Bihar with 12 per cent.

More than 8 per cent of Indias open defecators live in
The MDG sanitation progress update prepared by the
Madhya Pradesh where around 70 per cent of the states

population practices open defecation.
Figure 3.3: Share of open defecaion in the states of India, 2011

Other states
6%
Chhattisgarh
3%
Jharkhand
4%
Gujarat
4%
Karnataka
5%
Uttar
Pradesh
17%
Bihar
12%
Orissa
6%
West Bengal
6%
Madhya Pradesh accounts for 8% of Indias

open defecators.
Madhya
Pradesh
8%
Maharashtra
7%
Rajasthan
Tamil Nadu
7%
7%
Andhra
Pradesh
8%
24
25
WATER & SANITATION

Uttarakhand is the only EAG state that has achieved
between 1990 and 2015. However, around three-
the MDG sanitation target. Estimates show that the
fourths of its households are likely to still lack improved
Figure 3.5: Progress in Improved Sanitaion in Madhya Pradesh (rural and urban), 1990-2015
% HH with access
100
90
its sanitation needs. All other EAG states have poor

sanitation coverage. In the case of Bihar, a neutral trend is
The projection methodology may be referred in
seen. In the case of Madhya Pradesh, improved sanitation
Annexure-5.
MDG
100
Estimated Values
( Extrapolated / Interpolated)
sanitation facilities in 2015 (Figure 3.4).
state has made a dramatic improvement in addressing
Trendline
90
1990:19 1991:19 1995:20 2000:21 2005:23 2008:24 2015:26
80
80
70
70
60
60
50
50
40
40
30
30
Improved sanitation (%)

82
82
95
89
74
78
82
73
Unimproved sanitation (%)

87
81
79
67
88
67
91
28
80
53
20
10
72
47
18
26
18
22
18
13
11
19
33
21
20
10
0
1995
2000
2005
2010
2015
Year
20
12
19
26 20
24
0
1990
33
27
19
23
21
MDG target
Figure 3.4: Trend in improved sanitaion in eAG states, 1990-2015
Per cent coverage
facilities would have increased by 10 percentage points
Sources : NSS49 (1993); NSS52 (1996); NFHS-2 (1999); MICS (2000); Census (2001); DLHS-2 (2003); NFHS-3 (2006); DLHS (2008); NSS65 (2009);
5
1990
2015 1990
Bihar
2015 1990
Chhattisgarh
2015 1990
Jharkhand
2015
Madhya
Pradesh
1990
2015
Orissa
1990
2015
Rajasthan
1990
2015
Uttar
Pradesh
1990
2015 1990
Uttarakhand
2015
India
Source: Census 2001, 2011; DLHS-2 (2006), DLHS-3 (2010); MICS 2000; NFHS-2 (2000), NFHS-3 (2007); NSS (1998, 1996, 2009)
Again, using the JMP methodology, the trend line in
only reach 15 per cent of improved sanitation coverage
Figure 3.6 can be plotted. In rural areas of Madhya
by 2015, 35 points below the MDG target of 50 per cent
Pradesh, the sanitation coverage is even further lagging:
for rural areas.
if current trends continue, the rural areas in the state will

(JMP)
state will only reach 27 per cent of improved sanitation
methodology used worldwide and developed by
coverage by 2015, 32 points below the MDG target of 59
UNICEF and WHO, the trend line in Figure 3.5 can be
per cent for both rural and urban combined.
Using
the
Joint
Monitoring
Programme
plotted. Has can be seen, if current trends continue the
26
27
WATER & SANITATION
Figure 3.8: Proporion of households pracicing open defecaion in Madhya Pradesh, 2011
Figure 3.6: Progress in Improved Sanitaion in rural areas of Madhya Pradesh, 1990-2015
% HH with access
100
Trendline
MDG
Estimated Values
( Extrapolated / Interpolated)
90
100
100
86.4
90
90
1990:1 1991:1 1995:3 2000:6 2005:9 2008:11 2015:15
70
70
60
60
50
50
40
40
30
30
20
20
70
70
Per cent
60
MDG target
Per cent coverage
80
80
80
50
40
30
22.5
20
10
15 10
10
0
1
1
1990
3
1995
11
Urban
2000
2005
2010
2015
Total
Rural
Madhya Pradesh is well below the national average
piped sewer system or septic tank. Of the households
3.2. sanitation trends and diFFerentiaLs in Madhya

Pradesh
when it comes to improved sanitation. Only 27.7 per
falling under the unimproved sanitation category, 70
While the lack of improved sanitation facilities and
cent of households in the state use improved sanitation
per cent of them practice open defecation, with the
the practice of open defecation is overall high (70%)
facilities (Figure 3.7). One-fourth of the households in
majority located in rural areas of the state (Figure 3.8).
in the state, there exists a significant variation of 63.9
While 70 per cent of households in Madhya Pradesh
percentage points between the urban and rural areas.
defecate in the open, a wide percentage range is found
Above 75 per cent of households in 33 districts lack
among districts (Figure 3.10). Except four districts, more
access to improved sanitation facilities and practice
than 50 per cent of households in all other districts
open defecation. Only four districts have improved
practice open defecation. 19 districts are particularly
sanitation coverage higher than 50 per cent, which is
worse off, with more than 80 per cent households
still low. These districts are Indore (78%), Bhopal (71%),
practicing open defecation.
Sources : NSS49 (1993); NSS52 (1996); NFHS-2 (1999); MICS (2000); Census (2001); DLHS-2 (2003); NFHS-3 (2006); DLHS (2008); NSS65 (2009);
the state have flush/pour flush latrine connected to

Figure 3.7: Proporion of households by use of latrine facility in Madhya Pradesh, 2011
Improved sanitation
27.7%
Unimproved sanitation
72.3%
80
70
70
Gwalior (59%) and Jabalpur (53%).
Per cent
60
50
40
30
19.0
20
1.6
1.3
0.1
0.3
0.7
Pit latrine with slab/ventilated

improved pit
Flush/pour flush latrine

connected to other system
Service latrine - night soil

serviced by animal
Night soil disposed into open

drain
Pit latrine without slab/open

pit
5.8
10
1.2
0
Open defecation
Public latrine

connected to piped sewer
system

connected to septic tank
28
29
WATER & SANITATION

Figure 3.9: Proporion of households using improved sanitaion facility in the districts of Madhya Pradesh, 2011
Morena
20
Gwalior
59
27.7 Per cent
In 46 districts, the
improved sanitation
coverage is less than 50
per cent.
Bhind
22
Datia
22
Sheopur
12
Figure 3.10: Proporion of households pracicing Open Defecaion in the districts of Madhya Pradesh, 2011
Morena
79
Guna Ashoknagar
15
19
Mandsaur
24
Ratlam
32
Jhabua
11
Dhar
29
Alirajpur
10
Barwani
18
Per cent
<15%
15% - 25%
26% - 50%
>50%
Ujjain
42
Indore
76
West Nimar
22
Rajgarh
15
Shajapur
23
Dewas
36
East Nimar
25
Burhanpur
34
Vidisha
24
Bhopal
71
Sehore
31
Sheopur
87
Shivpuri
85
Harda
46
Tikamgarh
10 Chhatarpur
15
Panna
10
Sagar
24
Damoh
14
Betul
24
Satna
27
Katni
19
Jabalpur
53
Raisen
29
Hoshangabad
47
In 46 districts, more than

50 per cent of population
defecate in the open
Gwalior
38
Datia
77
70 Per cent
Shivpuri
14
Neemuch
26
Bhind
76
Narsinghpur
34
Chhindwara
25
Seoni
19
Mandla
12
Balaghat
17
Neemuch
70
Mandsaur
74
Rewa
22
Sidhi
7
Singrauli
11
Ashoknagar
84
Vidisha
75
Rajgarh
84
Shahdol
Umaria 17
13
Dindori
5
Guna
80
Ratlam
65
Jhabua
88
Anuppur
17
Dhar
69
Alirajpur
89
Barwani
80
Per cent
<50%
50% - 75%
>75%
Ujjain
54
Indore
19
West Nimar
76
Shajapur
76
Dewas
62
East Nimar
72
Bhopal
25
Sehore
68
Harda
52
Tikamgarh
Chhatarpur
89
84
Panna
89
Sagar
73
Damoh
85
Betul
75
Katni
80
Jabalpur
42
Raisen
69
Hoshangabad
51
Satna
70
Narsinghpur
64
Chhindwara
73
Seoni
78
Umaria
86
Dindori
93
Rewa
75
Sidhi
92
Singrauli
88
Shahdol
82
Anuppur
82
Mandla
86
Balaghat
81
Burhanpur
59

30
31
WATER & SANITATION
Figure 3.11 shows that the situation of open defecation
practice open defecation. Furthermore, in 72 sub-
at the sub-district level has a similar pattern to the one
districts the proportion of households practicing open
Figure 3.12: Proporion of households using improved sanitaion faciliies in urban vs. rural in the districts of
illustrated for the districts. Out of 342 sub-districts, more
defecation is over 90 per cent.
73
65
than 50 per cent of households in 323 sub-districts
73
16
50
12
62
11
Figure 3.11: Proporion of households pracicing open defecaion in the sub-districts of Madhya Pradesh, 2011
High inequality exists

between rural and urban
areas in the coverage of
improved sanitation.
86
65
5
45
In 240 sub-districts,
more than 75 per cent
of population are open
defecators.
63
55
59
13
68
57
53
71
59
81
82
13
66 7
82
13
77
75
41
76
18
78
5
64
9
73
68
15
12
65
12
6
57
54
63
73
37
70
52
2
63
24
70
26
79
32
21
53
8
78
18
21
49
65
70
78
88
55
10
21
17
5
20
4
64
11
16
59
13
75
58
12
11
61
10
67
Per cent
Rural
Urban
17
Per cent
<50%
50% - 75%
>75%
3.3. aPPLying the equity Lens: disParity Between

urBan-rurAL AnD SOCIAL GrOuPS
(54.2%), Sidhi (50.2%), Singrauli (45.7%), Panna (45.3%),
population and 22 per cent of the urban population in
Umaria (44.2%), Dindori (43.8%), Ashoknagar (42.7%),
Madhya Pradesh defecate in the open. A large gap exists
Anuppur (42.4%), Damoh (41.8%), Chhatarpur (41%),
between rural and urban areas, particularly in Ratlam,
Sheopur (40.4%)) more than 40 per cent of urban
Jhabua, Gwalior, Ujjain and Alirajpur districts where the
households still defecate in the open.
proportion of the rural population defecating in the

open is 70 percentage points higher than for the urban
Notable disparities also exist among the different social
population.
groups in Madhya Pradesh with regard to access and use
While only 27.7 per cent of households in Madhya
In 19 districts, urban coverage is 6 to 10 times higher
Pradesh use improved sanitation, urban coverage
than rural coverage. The largest gaps are in 12 districts
is 6 times higher than rural coverage. Furthermore,
where urban coverage is over10 times higher than rural
It is also important to underline that while open
the state only 7.5 per cent of ST households and 19 per
large rural-urban differences in access to improved
coverage (Figure 3.12).
defecation is considered primarily a rural phenomenon,
cent of SC households use improved sanitation facilities.
it is in fact also massively practiced by urban households,
While disparities exist in the majority of districts, they are
with 22 per cent of them lacking basic sanitation facilities
particularly wide in western and south-western districts
across Madhya Pradesh. In 11 districts (Tikamgarh
as well as in the districts of central Madhya Pradesh.
sanitation prevail in all the districts of Madhya Pradesh.
32
Figure 3.13 shows that 86 per cent of the rural
of sanitation facilities. Figure 3.14 shows that, overall, in
33
WATER & SANITATION
Figure 3.13: Proporion of households pracicing open defecaion (urban vs. rural) in the districts of Madhya
Pradesh, 2011
Figure 3.14: Proporion of households using improved sanitaion faciliies by social groups in the districts of
93
90
25
86
82
94
23
10
40
14 15
88
36
94
24
8
6
10 12
3
8
96
54
26
92
23
86
13
11
94
81
78
78
58
80
66
61
87
16
82
24
20
95
97
19
35
42
31
34
3
5
21
19 20
4
31
15 10
9
19
13
3
17
6
22
26
26
5
14
10
16
13
4
22
32
13
12
6
20
10
6
35
5
18
36
3
13 6
15
43
19
40
88
49 54
9 10
25
9
14 11
11 7
60
81
Per cent
Rural
Urban
12
44
93
34
24
30
28
44
96
85
88
87
92
94
5
8
10 15
46
95
15
26
17
24
33
72
20
22
28
38
73
27
21
89
77
91
42
30
78
29
94
89
27
82
18
38
50
88
38
86
95
95
45
86
20
81
41
43
39
12
94
93
92
Scheduled Caste and

Scheduled Tribe are
signiicantly less likely to use
improved sanitation compared
to other social groups.
46
19
32
86
31
12
More than 40 per cent of

the urban population in
11 districts defecate in the
open.
32
7
22
21
14
Per cent
SC
ST
35
WATER & SANITATION

3.4. inequaLity By weaLth
Figure 3.15 shows a large inequality between the
open defecation. While more than80 per cent of the
poorest and the richest wealth quintiles in terms of the
households from the richest quintile use improved
use of improved sanitation facilities. Despite the focused
facilities, it is surprising to note that even among the
attention the TSC gave to BPL families, hardly one per
states richest households, one out of five still doesnt
cent of households from the poorest quintile uses
use improved sanitation facilities and that two per cent
improved sanitation, while 96 per cent of them practice
of that richest quintile would still defecate in the open.
Figure 3.15: Improved sanitaion faciliies and open defecaion by wealth quinile in Madhya Pradesh, 2006
Improved sanitation
100
95.5
Other unimproved sanitation
84.9
66.5
Open defecation
26.4
2.3
17.2
toilets. Over half of the population in 46 districts of MP
have unequal access to improved sanitation
defecates in open areas.
compared to the other ethnic groups. While 37 per

cent of population belonging to other ethnic groups
2. Large disparities in terms of the use of improved
use improved sanitation, the coverage is one- fifth
sanitation exist between urban and rural areas,
in the case of the ST and half in the case of the SC
among social groups and between wealth quintile.
population. With regard to the household standard
While nearly three quarters of the urban population
of living, only one per cent of poorest population
use improved sanitation, the coverage is 6 times
quintile uses improved sanitation while it is 81
lower in rural areas where only 12.2 per cent use such
per cent in case of the richest population quintile.
improved sanitation facilities. Furthermore, over
Figure 3.16 below, gives a visual representation
40 per cent of the urban population in 11 districts
of the wide disparities existing between rural and
defecate in the open. Similarly, the SC/ST population
urban areas as well as among social groups of the

state.
80
80.5
Per cent
31.3
Figure 3.16: Dispariies in improved sanitaion faciliies by locaion and social groups in Madhya Pradesh, 2011
60
80
Urban
40
70
42.3
72.8
17.7
60
20
9.0
15.8
Urban SC
52.6
6.1
Second
50
Middle
Fourth
Richest
Source: NFHS - 3 (2007)
3.5. suMMary oF Findings: sanitation in

Madhya Pradesh
Universally available improved sanitation seems to be a
Census 2011 data, on the one hand it is encouraging
distant dream for Madhya Pradesh as well as the other
to note a doubling of the sanitation coverage with 1.7
EAG states except Uttarakhand. Two main issues emerge
million new household toilets used between 2001
in Madhya Pradesh with regard to sanitation, namely that
and 2011; on the other hand, progress is too slow with
the majority of the population defecates in the open and
the state likely to reach its MDG target only by 2105,
that large inequities and disparities exist:
i.e. 90 years after the 2015 milestone. Rural improved

sanitation is only 12.2 per cent, as per Census 2011.
36
1. Less than 28 per cent of population in Madhya
Furthermore, it appears that an additional 2.4 million
Pradesh use improved sanitation facilities. The state
households in Madhya Pradesh in fact started
accounts for 8 per cent of countrys population that
practicing open defecation when comparing Census
uses unimproved sanitation and practices open
2001 and Census 2011 data, as increase in number
defecation. When comparing the Census 2001 and
of households outpaced the increase in number of
Per cent
3.2
1.3
Poorest
India
44.0
Urban ST
46.6
40
30
Madhya
Pradesh
27.7
20
Rural
10
12.2
Rural SC
7.7
Rural ST
4.3
0
37
The present chapter examines the correlations existing
a regression analysis between the availability of drinking
between the non-availability of drinking water within
water away from the premise of the households as
the households and the sanitation practice of these
an independent variable and the practice of open
households, using the Census 2011 district level data for
defecation by the households as a dependent variable.
Madhya Pradesh. Relationships have been examined by
WATER & SANITATION
In the first case, Figure 4.1 below, shows the scattered
correlation between the vicinity of drinking water and
plot and the fitted regression line with a coefficient
open defecation. The analysis leads to the inference that
of determination (R = 50%) and the Pearsons linear
households are more likely to practice open defecation
correlation coefficient (r = 0.7). The high positive
if their source of drinking water is away from their
correlation between the two variables indicates a
premise, i.e. over 100 meters away from the household
linear positive relationship between those two water
in urban areas and more than 500 meters away in rural
and sanitation variables, showing a strong positive
areas.
Figure 4.1: Linear relaionship between percentage of households pracicing open defecaion and percentage
of households with availability of drinking water away from premises, at district level in MP, 2011
y = 1.3945x + 29.692
100.0
R = 0.5006, R=0.71
90.0
Trend line
80.0
70.0
Open Defecation
4
CORRELATION
BETWEEN
4.1. correLation Between Location oF drinking water

and oPen deFecation
60.0
50.0
40.0
30.0
20.0
10.0
10.0
20.0
30.0
40.0
Drinking water away from premises
50.0
60.0
A supplementary analysis based on quartile distribution
open defecation coincides with the districts featuring
between the same two variables is shown in Figure
the maximum percentage of households (Q4) with
4.2 below. An observation of the map reveals that the
drinking water sources away from their premises. A
highest concentration (Q4) of households practicing
similar pattern is also observed for the lower quartiles.
39
WATER & SANITATION
Figure 4.2: relaionship between the proporion of households pracicing defecaion and accessing drinking
water away from the household premises in the districts of Madhya Pradesh, 2011
Drinking water away from premises of households (quartile distribution)
Open defication practice by households (quartile distribution)

Q1 (Below median)
Q1 (Below median)
Q2 (Median)
Q2 (Median)
Q3 (Above median)
Q4 (More than 75%)
Q3 (Above median)
D
Q4 (More than 75%)

D
D
D
D
D
D
D
D
D
40
The statistical analysis at district level between the water
have a positive influence on the adoption of improved
and sanitation service levels shows a strong positive
sanitation practices though to absolutely prove this
correlation. As expected, the availability of improved
premise, many variables would have to be controlled for
drinking water facilities at household level seems to
in future analyses.
41
5 CONCLUSION
Despite having achieved the MDG water target, around
between regions and districts, between rural and
10% of Madhya Pradeshs population (that is around 7
urban areas (with 64 per cent points difference in
million people) still lacked access to improved drinking
terms of open defecation), different social groups (with
water source in 2011. There is an urgent need to work
Schedules Tribes having three times lower access to
further in the state for eliminating the wide disparities
improved sanitation facilities than the state average)
existing between regions and districts, rural and urban
and among wealth quintiles, with the richest have 80
(42 percentage point difference) and socio-economic
times more access to improved sanitation than the
status of the households, with 33 per cent points
poorest. Even within the richest quintile of Madhya
difference between the poorest and the richest in terms
Pradeshs population group, nearly 20 per cent still use
of use of improved drinking water sources. Specially
unimproved sanitation facilities and around 2 per cent
focus has to be given to the increasing the access to
practice open defecation.
improved drinking water sources for Scheduled Tribe
The statistical analysis at district level between the water
population groups, who on average have 8 per cent less
and sanitation service levels shows a strong positive
access to improved drinking water sources as compared
correlation. As expected, the availability of improved
to the state average.
drinking water facilities at household level seems to
It is important to underline that tap water coverage in
have a positive influence on the adoption of improved
fact decreased by 2 per cent across the state between
sanitation practices. This calls for stronger convergence
2001 and 2011. It also has to be underlined that while
between the water and sanitation sectors.
the MDG target for water has been achieved, this target
There is a need in the state for more efficient efforts to
only considers water coverage, but doesnt take water
provide improved drinking water universally despite the
quality into consideration. Water quality in Madhya
fact that the MDG water target has been achieved. The
Pradesh requires more attention, since high levels of
sanitation sector demands more strategic planning and
chemical and micro-biological contaminations are
decision making to improve the programmatic efforts
found the latter having clear links with open defecation.
to accelerate the performance and achieve the target

in the state.
Indeed, the largest and most urgent challenge to be

tackled in the water and sanitation sector is the wide
spread practice of open defecation prevailing in the state
of Madhya Pradesh. It is evident from the performance of
the country that India wont achieve its MDG sanitation
target in 2015, and neither will Madhya Pradesh; in fact,
statistical analysis forecasts the achievement in MP only
This report presented the encouraging progress

in terms of improved drinking water coverage and
underlined the clear need to accelerate progress in
terms of the elimination of open defecation, given
its impacts on health, nutrition, education and other
key socio-economic indicators, as well as its critical
importance for upholding the rights, development and
by 2105 if current trends remain unchanged. In 2011, 70
dignity of children and women. Water, Sanitation and
per cent of households in Madhya Pradesh practiced
Hygiene (WASH) services, potentially saving the lives of
open defecation, accounting to around 50 million
thousands of children across the country as well as in
people.
Madhya Pradesh, every year.
The sanitation sector also reveals high disparities
With MDWSs vision of an Open Defecation Free India
43
WATER & SANITATION

by 2022, a radical review of the current approaches are
quality control, awareness raising, engaging of key
needed and will demand vision, realism, commitment,
stakeholders, building of alliances and partnerships,
continuity, courageous leadership and action at all
and on the ground, through social and behaviour
levels. The National Drinking Water Advocacy and
change communication to eliminate Open Defecation,
Communication Strategy (DWACS) and the National
based on intensive Inter-personal communication and
Sanitation and Hygiene Advocacy and Communication
operationalizing of sanitation frontline workers. All have
Strategy (SHACS) offer tremendous opportunities
key roles working together, to improve the wellbeing of
to accelerate progress in both sectors. This can only
all communities, with special focus on children, women,
be achieved through a combination of actions:
socially excluded and vulnerable families and offering
strengthened concurrent Monitoring and Evaluation,
them a clean and healthy India.
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Dewey, Elsa Giugliani, Batool A Haider, Betty Kirkwood, Saul S Morris,
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Household
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KristofBostoen, Val Curtis, Isaac CH Fung, and Wolf-Peter Schmidt
(2010) Water, sanitation and hygiene for the prevention of diarrhoea,
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Curtis, V. and Cairncross, S. (2003), Effect of washing hands with soap

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DLHS-1 (1999), District Level Household Survey-1, Rapid Household

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Lawn E Joy, Rudan Igor, Campbell Harry, Cibulskis Richard, Li Mengying,
Mathers Colin, Black E Robert (for the Child Health Epidemiology
Reference Group of WHO and UNICEF) (2012), Global, regional, and
national causes of child mortality: an updated systematic analysis for
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NFHS-3 (2007), National Family Health Survey -3, International Institute

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Narayanan, R, H Van Norden, APatkar and L Gosling (2011), Equity and

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54th round. Ministry of Statistics and Programme Implementation
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Housing and Population Census of India 2001, New Delhi.
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Housing and Population Census of India (preliminary figures) 2011,
New Delhi.
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& Sanitation 2002. New Delhi, India.
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during Eleventh Five Year Plan. New Delhi, India.
Prss-stn A, Kay D, Fewtrell L, Bartram J (2004), Unsafe water,

sanitation and hygiene, in Ezzati M, Lopez AD, Rodgers A, Murray
CJL (eds) Comparative Quantification of Health Risks, World Health
Organization, Geneva.
Prss-stn, A. and C. Corvaln (2006), Preventing Disease through

Healthy Environments: Towards an Estimate of the Environmental
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and Benefits of Water and Sanitation Improvements at the global
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WHO (2007), Fewtrell L, Prss-stn A, Bos R, Gore F, Bartram J. Water,

sanitation and hygiene: quantifying the health impact at national and
local levels in countries with incomplete water supply and sanitation
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Burden of Disease Series No. 15).
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National Rural Water Quality Surveillance Programme.
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Sanitation and Drinking Water: 2013 Update.

WSP (2011), Scaling Up Rural Sanitation: Findings from the Impact

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3IE International Initiative for Impact Evaluation (2009) Synthetic

Review 001, Hugh Waddington, BirteSnilstveit, Howard White and
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R4D//PDF/Articles/SR_Sanitation.pdf, accessed 5 March 2013.

45
WATER & SANITATION
Annexure-1
Distribuion of the extreme ive districts pracicing Open Defecaion
Scenario -1 (percentage of households)
Descriptive Statistics
Open defecation practicing districts with

percentage of households
Minimum: 18.9% (Indore)
Lowest
Maximum: 93.3% (Dindori)
Gwalior
38.2
Range: 74.4 percentage points
Medium
Highest
ANNEXURES
Tikamgarh
89.4
Panna
89.3
Bhopal
25.2
Indore
18.9
Sidhi
91.8
Jabalpur
41.7
Dindori
93.3
Hoshangabad
50.7
Alirajpur
89
Scenario -2 (number of households)

Minimum: 57880 households (Harda)
Open defecation practicing districts with

percentage of households
Morena
Maximum: 407687 households (Rewa)
Bhind
Lowest
Gwalior
Medium
Datia
Sheopur
Average (per district): 209530 households
Highest
Range: 349807 households
Shivpuri
Tikamgarh
Neemuch
Guna
Chhatarpur
Ashoknagar
Panna
Mandsaur
Vidisha
Rajgarh
Ratlam
Shajapur
Bhopal
Ujjain
Sagar
372775
Damoh
Raisen
Dhar
West Nimar
Singrauli
Shahdol
Anuppur
Dindori
Mandla
Seoni
Harda
East Nimar
Sidhi
Jabalpur
Hoshangabad
Alirajpur
Barwani
Katni
Narsinghpur
Dewas
Indore
Satna
333711
Umaria
Sehore
Jhabua
Rewa
407687
Betul
Chhindwara
321309
Balaghat
319772
Burhanpur
46
47
WATER & SANITATION
Annexure-2
Annexure-3
Districts using unimproved Drinking Water Sources and Sanitaion

Faciliies
Data on Households using Improved Drinking Water Sources, 2011

State/Division/ District
Figure A2.1: Districts with households using unimproved sources of drinking water
Households using unimproved drinking water source
India: 12.8% (national average)

Madhya Pradesh: 20.9% (state average)
District max: 56.3%
District min: 4.2%
Inter district range: 52.1 %
Morena
8.9
Gwalior
6.2
Sheopur
8.3
Bhopal
7.2
Ujjain
11.1
Raisen
11.4
Indore
4.3
Bhind
10.6
Narsinghpur
4.2
Better than
national average
(districts-11)
Between national
and state average
(districts-19)
Worse than state

average
(districts-20)
Jabalpur
5.8
Burhanpur
11.2
Figure A2.2: Districts with households using unimproved sanitaion facility

India: 55.8% (national average)
Madhya Pradesh: 72.3% (state average)
District max: 94.6%
District min: 23.6%
Inter district range: 71.0 %
Households using unimproved sanitation facility
Gwalior
41.0
Bhopal
29.2
Indore
23.6
Harda
54.2
48
Hoshangabad
53.2
Better than
national average
(districts-6)
Jabalpur
46.7
Between national
and state average
(districts-8)
Worse than state

average
(districts-36)
Percentage share of
households having
Improved source of
drinking water facility
Percentage share of Scheduled Percentage share of Scheduled

Castes households having
Tribes households having
Improved source of drinking
water facility
water facility
INDIA
87.1
89.6
73.4
MADHYA PRADESH
79.1
81.7
71.7
Sheopur
91.7
92.3
90.3
Morena
91.1
92.6
90.7
Bhind
89.4
88.5
88.3
Gwalior
93.8
93.7
93.7
Daia
84.7
85.6
86.7
Shivpuri
71.2
71.0
82.8
Guna
79.7
83.2
78.0
Ashoknagar
81.4
80.2
85.6
Tikamgarh
60.2
64.5
62.5
Chhatarpur
61.9
64.2
57.5
Panna
66.7
68.1
66.4
Sagar
69.6
72.5
64.1
Damoh
64.7
69.4
51.5
Satna
84.5
88.2
82.1
Rewa
81.3
86.5
83.2
Sidhi
71.3
82.6
60.1
Singrauli
43.6
49.6
33.5
Umaria
61.4
68.8
57.1
Dindori
62.3
70.7
56.9
Shahdol
60.0
64.6
55.8
Anuppur
61.5
66.0
53.6
Neemuch
73.3
71.3
65.0
Mandsaur
64.9
60.8
66.1
Ratlam
83.8
84.0
76.6
Ujjain
88.9
87.0
89.5
Shajapur
76.1
74.4
70.0
Dewas
85.2
88.0
76.0
Dhar
82.4
92.1
74.2
Indore
95.7
94.8
88.3
Khargone (West Nimar)
86.3
88.7
76.3
Barwani
83.4
90.7
78.9
Jhabua
83.0
92.9
81.3
Alirajpur
85.8
90.7
85.0
Khandwa (East Nimar)
79.7
82.4
72.9
Burhanpur
88.8
91.6
72.1
Rajgarh
65.1
64.9
65.8
Vidisha
86.8
87.3
82.6
Bhopal
92.8
91.2
91.1
Sehore
80.8
82.9
66.4
49
Percentage share of
households having
Improved source of
drinking water facility
WATER & SANITATION
Table contd.
Annexure-4

water facility
water facility
Raisen
88.6
90.6
78.1
Betul
80.1
85.8
73.9
Harda
81.4
85.2
84.2
Hoshangabad
86.0
90.8
83.9
Katni
84.9
89.1
83.4
Jabalpur
94.2
95.9
86.2
Narsimhapur
95.8
97.4
89.9
Mandla
64.7
79.3
57.0
Chhindwara
75.7
81.8
67.1
Seoni
71.0
78.5
66.8
Balaghat
66.0
77.6
63.8
Data on Households using Improved Sanitaion Faciliies, 2011

INDIA
MADHYA PRADESH
Sheopur
Morena
Bhind
Gwalior
Daia
Shivpuri
Guna
Ashoknagar
Tikamgarh
Chhatarpur
Panna
Sagar
Damoh
Satna
Rewa
Sidhi
Singrauli
Umaria
Dindori
Shahdol
Anuppur
Neemuch
Mandsaur
Ratlam
Ujjain
Shajapur
Dewas
Dhar
Indore
Khargone (West Nimar)
Barwani
Jhabua
Alirajpur
Khandwa (East Nimar)
Burhanpur
Rajgarh
Vidisha
Bhopal
Sehore
Raisen
Betul
Harda
Hoshangabad
Katni
Jabalpur
Narsimhapur
Mandla
Chhindwara
Seoni
Balaghat
Percentage share of
households having
Improved sanitaion facility Improved sanitaion facility
Improved sanitaion facility
44.0
27.7
11.5
20.3
22.1
59.0
21.6
14.2
19.2
14.9
9.9
14.9
9.6
24.1
14.0
27.3
21.6
7.0
11.1
12.8
5.4
16.6
17.2
25.9
23.6
31.8
42.1
22.6
36.2
28.8
76.4
21.8
17.8
11.3
10.1
25.0
33.5
15.0
24.1
70.8
31.1
29.3
23.5
45.8
46.8
18.7
53.3
33.9
12.4
24.6
18.6
0.0
31.3
19.0
6.4
13.9
12.1
45.8
10.5
7.7
11.7
6.2
5.0
5.3
3.8
13.0
6.3
18.6
14.2
3.2
7.6
12.5
6.8
13.2
14.3
18.0
10.1
18.9
21.0
8.6
19.4
25.3
59.6
12.8
18.3
34.5
9.3
19.1
20.8
8.1
10.9
49.4
15.0
14.9
26.2
32.4
34.5
11.5
40.3
19.8
21.5
25.7
17.2
21.8
19.5
7.5
2.9
15.1
30.6
24.4
11.8
2.5
3.9
2
2.7
3.8
2.2
5.5
2.8
20.1
11.5
1.7
2.7
4.3
2.3
5.2
4.4
7.5
14.7
6.8
30.7
10.4
8.7
7.8
42.8
5.1
5.8
3.4
4.8
7.6
3.3
7.7
7.3
54.1
9.8
6.2
5.9
9.8
16.5
4.4
21.7
10.2
3.4
6.1
6.5
7.6
50
51
WATER & SANITATION

Annexure-5
Methodology and Limitaion of Data
Estimation Technique
Data Limitation
Multiple secondary data sources containing data
The non-availability of data sources containing data
on improved drinking water source and improved
on the desired indicators uniformly for different time
sanitation facility were put for meta-analysis to develop
periods and with consistent research, sampling design
the estimates for MDG baseline (1990), MDG target
and concept for the indicators was a great challenge.
(2015) and for the intermediate time periods 1995, 2000,
However, to generate the required estimates to study
2005, 2010 and vice versa.
the trends during MDG period (1990-2015), the multiple

data sources including Population Census of India
The Statistics approach of linear regression analysis

was employed to generate the estimates under
(1991, 2001 & 2011), MICS, DLHS (1, 2 & 3), NFHS (1, 2 &
consideration. The approach follows the steps, as below
3), NSS (49th, 52nd and 54th rounds) etc. containing the
by fitting the following straight line.
data following different research designs and sampling

techniques at unequal time periods were used. Trend
Y = B0+B1*X+ei (i=1,2,3,.............n)
line estimated using Linear Regression Analysis a
Where B0: intercepton Y-axis
degree of deviation in combination of data sources and
B1: slope of the line
methodology may produce the different estimates.
ei: random error

The fitted regression line is:
y = b0 + b1*x, indicating y is the value for the
argument x.
Where
b0 = y - b1*x and
b1 = (x - EX)(y - EY)/( x - EX 2)
EX = mean value of X
EY = mean value of Y
52
United Nations Children's Fund (UNICEF)

UN House, Plot No:-41-42,
Polytechnic Colony,
Shyamla Hills, Bhopal 462013,
Madhya Pradesh, India
Email: bhopal@unicef.org

Kamal Kumar Gaur - MP (UNICEF) - Water & Sanitation Report

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Water

UNICEF Field Office for

DevInfo Support Group

Kamal Kumar Gaur,

A SITUATION ANALYSIS OF MADHYA PRADESH

WATER & SANITATION

Directorate of Census Operations and UNICEF. Its main purpose is to provide

areas in which accelerated progress in urgently required, especially in terms of

Dr. Aruna Sharma

eradicating open defecation throughout the state. The Millennium Development

Additional Chief Secretary,

Pradesh, Panchayat & Rural

determining future policy directions.

Defecation is worst form of sanitation practice, exacerbating the child morbidity

and mortality rates across the state.

must be accelerated, especially in terms of the elimination of Open Defecation

-and indeed unacceptable- as we know that it can be significantly reduced

through adequate Water, Sanitation and Hygiene (WASH) services, potentially

focus on children, women, socially excluded and vulnerable families. In this

context, the women-centred Madhya Pradesh State- level Sanitation Campaign

Pradesh, every year.

MARYADA (meaning Dignity in Hindi), strongly anchored in the principles of

Sanitation and Hygiene Advocacy and Communication Strategy (SHACS) offer

be sustained and indeed accelerate to bring about collective behavior change

change for the elimination of Open Defecation at community level. I thus

encourage all stakeholders to support the states efforts of achieving universal

access to improved WASH facilities and services.

UNICEF has been a long-standing partner of the Government of Madhya Pradesh

in providing valuable technical and financial support in implementing the

remarkably low in state.

Office of Census Madhya Pradesh.

the Water and Sanitation sector in the State.

A SITUATION ANALYSIS OF MADHYA PRADESH

WATER & SANITATION

Directorate of Census Operations, Madhya Pradesh is working closely with

Mr. Sachin Sinha, IAS

A SITUATION ANALYSIS OF MADHYA PRADESH

WATER & SANITATION

Planned investment (Rs. crores) in water and sanitation sector and

Share of households with no access to improved drinking water sources, 2011. . . . . . 10

Trends in improved and unimproved sources of drinking water in

EAG states, 1990-2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

National Commitments on Water and Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Trends in drinking water sources for the different divisions of

Proportion of households using improved drinking water sources in the districts of

Location of Drinking Water Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Proportion of households using improved drinking water sources in the sub-districts of

Inequity by Wealth and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Proportion of households by location of drinking water source in Madhya Pradesh . . 14

Summary of Findings: Drinking Water in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Urban-Rural disparities of households with improved drinking water coverage in the

Sanitation Trends and Diferentials in Madhya Pradesh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

in the districts of Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Inequality by Wealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Proportion of households with improved drinking water coverage by social groups

4. Correlation between Water & Sanitation . . . . . . . . . . . . . . . . . . . . 38

groups in Madhya Pradesh, 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

State wise achievement of the MDG sanitation target . . . . . . . . . . . . . . . . . . . . . . 24

Number of households and percentage practicing open defecation in India, 2011 . . . 25

Share of open defecation in the states of India, 2011 . . . . . . . . . . . . . . . . . . . . . . . 25

Trend in improved sanitation in EAG states, 1990-2015 . . . . . . . . . . . . . . . . . . . . . 26

Progress in Improved Sanitation in Madhya Pradesh (rural and urban), 1990-2015 . . . . 27

A SITUATION ANALYSIS OF MADHYA PRADESH