Linking Service Delivery Processes and Outcomes in Rural Sanitation : Findings from 56 Districts in India

The year 2012 marked the close of the Government of India's (GoI's) Total Sanitation Campaign (TSC). The program was started in 1999 to achieve universal rural sanitation coverage. Although rural sanitation coverage has increased during TSC, progress still falls short of the program goal of universal coverage. The objectives of this assessment are to: provide GoI with an overview of the range of service delivery processes adopted by different districts across states and their relative performance in terms of outcomes; identify which service delivery processes are linked to better (or worse) performance; and identify where the key bottlenecks are to achieving or sustaining outcomes. In the first round of this assessment undertaken in 2010, six service delivery processes were identified as being critical for achieving sustainable rural sanitation outcomes at scale. In this second round, the number of processes assessed was increased to nine and grouped into three thematic components corresponding to the three stages in which the districts implement the program: catalyzing, implementing, and sustaining. Once this is in place, program implementation needs to focus on aligning operations to facilitate achievement of outcomes. Finally, the outcomes achieved must be sustained to achieve downstream impacts such as improvements in health and quality of life.