You manage what you measure : using mobile phones to strengthen outcome monitoring in rural sanitation

Although India is now included in the front ranks of rapidly growing emerging economies, it is also paradoxically home to the majority of people defecating in the open in the world (joint monitoring program 2010). It is estimated that one in every 10 deaths in India is linked to poor sanitation and hygiene (Water and Sanitation Program (WSP) 2011). Diarrhea, a preventable disease, is the largest killer and accounts for every 20th death (Ibid). Diarrhea is linked to malnutrition, especially in children, and India has one of the highest rates of child malnutrition in the world, nearly double that of sub-Saharan Africa (Gragnolati et al 2005). To address this sanitation challenge, the Government of India (GoI) has invested heavily in programs to achieve universal sanitation coverage. However, despite two large national rural sanitation campaigns, the goals of an open defecation free India, a Nirmal Bharat, remains elusive. To ensure investments in sanitation lead to commensurate outcomes, the sector needs a reliable and timely monitoring system.