Many aspects of urban change in recent decades have been so rapid in India that they have overwhelmed government capacity to manage it. In most urban centres, local governments have been unable to keep up with the pace of economic and physical expansion and there are large deficits in provision of infrastructure and services (mostly in informal settlements) that have relevance for health and wellbeing of urban population.

Unfortunately, India has the unpleasant distinction of contributing to nearly half of global open defecation in urban areas. Critically linked to lack of proper sanitation is the gender dimension, wherein school dropout among girl child has been found to be related to lack of toilet facilities within schools; and crime against women attributed to open defecation. Despite all the funding and programmes there are more than a billion people without access to safe drinking water and sanitation, which impacts people’s health and well-being.

India has performed poorly on WASH (water, sanitation and hygiene) related issues, which is not only costing it dearly (nearly $54 billion a year) but lack of access to sanitation facilities is also creating gender disparity, with women being more severely affected. With gaps in the performance of current WASH schemes, an urgent need for action to improve the life of large group of population is felt. Capacity-building and involvement of stakeholders such as medical doctors, health workers, educators, women and social scientists is needed to facilitate behavioural change and help evolve WASH programmes to improve ground realities.

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