APPENDIX C

Name: Ms. Blessy B

Year : M Sc N II year

Topic : Hazards of open air defecation

Group : Women

No. of people : 60

Place : Community Hall, Selected area, Guntur

Duration : 30 minutes

Method of teaching : Lecture cum discussion by with the help of LCD

Audio Visual Aids : LCD Projector

Objectives:

General objective: By the end of video assisted structured teaching programme the group will gain in-depth knowledge on hazards of
open air defecation

Specific objectives: The group will be able to

Define open air defecation

Describe the incidence of open air defecation
Discuss the reasons for open air defecation
Explain the hazards of open air defecation
Explain the prevention of open air defecation
Emphasize on integrated initiatives for prevention of open air defecation
Discuss the simple sanitation technology options for prevention of open air defecation
 Teaching
Time Objective Content and Evaluation
learning
activity
2min To Introduction:
introduce Namasthe !
topic I am M Sc (N) student of KSR College of Nursing, now I teach you about hazards
of open air defecation.
In India, we still have 135 million people with no access to basic health care
facilities.
There are about 226 million with no access to safe drinking water.
Out of a billion people approximately 750 million people either defecate in
open or they use bucket privies, manually cleaned by scavengers.
Every lane, by lane, park, roadside, vegetable patch, agricultural fields and
railway track and any other open space is used for defecation or urination in
our country by several million people.
1min To define Definition of open air defecation:
open air Open air defecation is the practice of people defecating outside and not into a Lecture Can you
defecation designated toilet. cum define open
discussion air
3min To describe Incidence of open air defecation: defecation?
the About one billion people, or 15 percent of the global population, practice
incidence of open defecation. Lecture
open air India is the country with the highest number of people practicing open cum What is the
defecation defecation: around 600 million people or nearly half of the population. discussion incidence of
Most of it occurs in rural areas, where the prevalence is estimated at 65 open air
percent of the population. defecation?
3min To discuss Reasons for open air defecation:
the reasons No toilet available Lecture What are the
for open air A toilet is available but is of "low quality", such as: cum reasons for
defecation Toilets are filthy, dark, smell bad, or unattractive (often this is the discussion open air
case for shared or public toilets) defecation?
There is a risk to personal safety (e.g. if the toilets are public or
shared, and criminals are known to gather there to wait for possible
victims)
Toilets are only at some distance; also, it may be dangerous to get
 there at night
Diarrhea may mean there is not enough time to go to a distant shared
toilet
Toilet is dilapidated, and the user may fear a collapse or danger to
children
Toilet enclosure does not provide enough privacy
Reasons for people owning a household toilet but still openly defecating may
include:
The toilet was provided (e.g. by an NGO or government program) and not
wanted by the recipients
The toilet building can be put to other uses such as a storage room
To delay the toilet pit filling up, in the case of a pit latrine
No toilet available at the work place (e.g. during farming activities or at
school)
Open defecation is embedded as a routine or social norm, or there are social
taboos (e.g. father-in-law not using the same toilet as daughter-in-law)
Cultural or habitual preference for going to the toilet

5min To explain Hazards of open air defecation:

the hazards Health hazards: Lecture What are the
of open air It was observed that 600,000 under-five children in India died in 2010 due cum health
defecation to diarrhoea, pneumonia and other diseases directly linked to a combination discussion hazards of
of contaminated water supply, unsafe sanitation conditions, and inadequate open air
hygiene practices. defecation?
Out of the 6,00,000, around 2,12,000 children died due to diarrhoea. Thus
diarrhoea causes 12.6% of the child deaths in India.
It can also lead to malnutrition and stunted growth in children.
It can also leads to water pollution
Other diseases caused by open air defecation are:

When a person defecates in the open, the pathogens present in the faeces travel
from the hand to the mouth in the following manner:
 Safety and gender hazards:

There are also strong gender impacts: lack of safe, private toilets makes
women and girls vulnerable to violence and is an impediment to girls
education. Rapes and sexual molestation take place when women search for
places for open defecation that are secluded and private, often during hours of
darkness.

5min To explain Lecture What are the

Prevention of open air defecation:
the cum preventive
prevention Key drivers to eradicate open defecation include: discussion measure for
of open air open air
defecation Political will defecation?

A focus on behavior change

Sanitation solutions that offer a better value than open defecation

Stronger public sector local service delivery systems

Creation of the right incentive structures

Political will:

Prime Minister Narendra Modis administration is now prioritizing this issue

and elevating cleanliness and sanitation as a national development priority. Such
political will at the highest level is absolutely fundamental.

A focus on behavior change:

In rural India, there are places with signs that say: We will not give our
daughters in marriage to someone from a village that doesnt practice total
sanitation. This is the type of social movement that is required.

We live in a world where the private sector is able to understand consumer

profiles of those living in the most remote locations. In almost every village
in the world, you can find a cell phone or a bottle of Coca-Cola. By
harnessing the expertise of the private sector in understanding what
consumers want, need, the way they think, believe and act, we can mobilize
state-of-the-art behavior change communications to accelerate the
eradication of open defecation.

Sanitation solutions that offer a better value than open defecation:

Defecating in the only option for some, but for others it is the preferred
method. Using a local river or stream, or even the bush, may feel better than
using a hole in the ground that smells or has flies and lacks light

Marketing 101 tells us that we have to offer solutions with benefits that
outweigh the benefits of open defecation.

Strong public sector local service delivery system:

Local district and village capacity is of utmost importance. This means that
 local leaders and frontline workers have to have the capacity, technical knowledge
and incentives to engage communities with behavior change interventions and
facilitate interaction with private sector providers.

Creation of right incentive structures:

It is important to use both financial and nonfinancial incentives. Local

service delivery mechanisms need financial resources to deliver, but this can
also be buoyed by nonfinancial incentives as well.

Each country context is different and there is no one-size-fits-all solution.

However, if we build on the experience from countries in the last decade
and harness the power of the public and private sectors, we have no doubt in
my mind that the world can end open defecation by 2030

3min To Integrated initiatives for prevention of open air defecation:

emphasize Lecture What are the
A key aspect is awareness raising, behaviour change campaigns, increasing
on cum integrated
integrated political will as well as demand for sanitation. Community-Led Total discussion initiatives
initiatives Sanitation (CLTS) campaigns have placed a particular focus on ending open for
for defecation by "triggering" the communities themselves into action. prevention
prevention of open air
of open air Various Indian government-led initiatives are ongoing to reduce open defecation?
defecation defecation in that country. It began as the "Total Sanitation Campaign",
which was relaunched as Nirmal Bharat Abhiyan in 2012 and integrated into
the wider Swachh Bharat Abhiyan (Clean India Mission) in 2014.

The Nirmal Bharat Abhiyan:

The Total Sanitation Campaign (TSC) of India is called Nirmal Bharat

Abhiyan (NBA).
 The objective is to accelerate the sanitation coverage in the rural areas. The
goal of NBA is to achieve 100% access to sanitation for all rural households
by 2022.

The maximum incentive per toilet available to a BPL household has been
increased from Rs. 4600 to Rs. 10000.

The Centres share is Rs. 3200 while the States have to give Rs. 1400. The
remaining Rs 900 has to be provided by the families.

Swachh Bharat Abhiyan:

On 2 October 2014, Prime Minister Narendra Modi launched the Swachh

Bharat Mission, which aims to eradicate open defecation by 2019, the 150th
birth anniversary of Mahatma Gandhi, by constructing 12 crore toilets in
rural India, at a projected cost of 1.96 lakh crore

Simple sanitation technology options for prevention of open air defecation:

3min To describe Lecture What are the
the simple Toilet bags: cum simple
sanitation discussion sanitation
technology A more advanced solution of the plastic toilet bag has been provided by the technology
options for Swedish company Peepoople who are producing the "Peepoo bag", a "personal, options for
prevention prevention
single-use, self-sanitizing, fully biodegradable toilet that prevents feces from
of open air of open air
defecation contaminating the immediate area as well as the surrounding ecosystem". This bag defecation?
is now being used in humanitarian responses, schools and urban slums in
developing countries

Bucket toilets and urine diversion:

Bucket toilets are a simple portable toilet option. They can be upgraded in
various ways, one of them being urine diversion which can make them similar to
urine-diverting dry toilets. Urine diversion can significantly reduce odors from dry
 toilets. Examples of using this type of toilet to reduce open defecation are the
"MoSan toilet (used in Kenya) or the urine-diverting dry toilet promoted by SOIL
in Haiti.

Summary:
2min To
summarize I have discussed with you various aspects of hazards of open air defecation and how
the topic
to prevent problems of open air defecation in-detail.

References:

1. Dr. Bindeshwar Pathak, Endeavours in Environmental Sanitation,

www.sulabhinternational.org,4 April 2004.
2. K. Park, Parks Text Book of Preventive and Social Medicine, M/s
Banarsidas Bhanot Publishers, Jabalpure, India, 18th Edition, Page No.
 505,564.
3. Sunidha Nadhamuni, Household Water and Sanitation PTI, India Water
Portal News, 27 July 2009.
4. Dietvorst, Tag Archives: Open Defecation, IRIN 3rd December 2009.
WEBSITES:
http:// www. wikipedia.com
http://www.google.com
http://www.rsm.as.uk/academ/obg102.php
http://www.pubmed.com