Open Defecation, Sanitation, and Associated Health Issues in India: A Comprehensive Analysis with a Focus on Assam (2000–2022)

Abstract

Open defecation (OD) remains a pressing public health issue in India, linked to diseases such as diarrhea, stunting, and soil-transmitted helminth (STH) infections. This paper examines OD prevalence, sanitation coverage, and associated health outcomes across India, with a particular focus on Assam. Leveraging sources like the National Family Health Surveys (NFHS), Swachh Bharat Mission (SBM) reports, and peer-reviewed research, the analysis highlights a national decline in OD from 73% in 2000 to 19.4% by 2019–2021, yet reveals persistent regional disparities. In Assam, OD stood at 52.3% in 2015–2016, driven by unique challenges like flooding and cultural resistance, contributing to elevated diarrhea (12.5%) and stunting (36.4%) rates. The paper recommends resilient infrastructure, behavior change campaigns, and community-driven solutions to address these disparities and enhance public health outcomes.