Kumar Pradeep, Hasan Nihal, Rajak Rahul
Independent Researcher, Lucknow, Uttar Pradesh, India.
Population & Development, Institute of Development Studies Kolkata, 27/D, DD Block, Sector 1, Bidhannagar, Kolkata, West Bengal, India.
Sci Rep. 2024 Dec 30;14(1):31659. doi: 10.1038/s41598-024-80949-3.
Despite the significant improvement in sanitation coverage , utilization of improved sanitation still does not reach the optimal level across all socioeconomic groups in India. Therefore, achieving improved sanitation facilities and reducing all forms of inequality United Nations Sustainable Development Goal [SDG 6.2] by 2030 is a big challenge to the most populous country in the world. Given this backdrop, this study examines the socioeconomic status-related inequality in the utilization of improved sanitation facilities among Indian Households. The study utilized fifth round of National Family Health Survey (NFHS); a national representative cross-sectional survey of India conducted in 2019-2021. Logistic regression was applied to estimate the effect of various predictors on utilization of improved sanitation facilities. We also used decomposition analyse to identify the factors responsible for utilization of improved sanitation. The results indicate that 69% of Indian households utilized improved sanitation facilities. The study highlights that young and unmarried household heads, lower education, poor household wealth status, living in rural areas, and marginalized social groups had lower access to improved sanitation facilities. The multivariate regression analysis suggested that households belonging to richer [AOR: 14.0; 95%, CI: 13.6-14.3] and richest [AOR: 46.7; 95%, CI: 45.0-48.5] wealth quintiles have 14 and 47-times higher odds of having sanitation facility than households which belong to poorest quintile respectively. The decomposition analysis suggested that 11 to 18% of inequality was explained by the geographical region and social group of household heads. The concentration curve of utilization of improved sanitation was more concentrated in Central and Eastern part of Indian households (Concentration Index: 0.51 and 0.47), which has reduced to 0.17 and 0.22 during NFHS-4 to NFHS-5. We also found that 68 districts out of 707 districts in India had less than 50% utilization of improved sanitation facilities. The study concludes that households with a better socioeconomic status were more able to access improved sanitation. Thus, inclusive strategies are needed to reduce socioeconomic inequality at the micro level and strengthen ongoing policies.
尽管卫生设施覆盖率有了显著提高，但在印度，所有社会经济群体对改良卫生设施的使用率仍未达到最佳水平。因此，到2030年实现改良卫生设施并减少所有形式的不平等（联合国可持续发展目标[SDG 6.2]），对这个世界人口最多的国家来说是一项巨大挑战。在此背景下，本研究考察了印度家庭在使用改良卫生设施方面与社会经济地位相关的不平等情况。该研究利用了第五轮全国家庭健康调查（NFHS）；这是2019 - 2021年在印度进行的一项具有全国代表性的横断面调查。应用逻辑回归来估计各种预测因素对改良卫生设施使用情况的影响。我们还使用分解分析来确定使用改良卫生设施的相关因素。结果表明，69%的印度家庭使用了改良卫生设施。该研究强调，年轻且未婚的户主、低教育水平、家庭财富状况差、居住在农村地区以及边缘化社会群体使用改良卫生设施的机会较少。多变量回归分析表明，属于较富裕[调整后比值比（AOR）：14.0；95%置信区间（CI）：13.6 - 14.3]和最富裕[AOR：46.7；95% CI：45.0 - 48.5]财富五分位数的家庭拥有卫生设施的几率分别是属于最贫困五分位数家庭的14倍和47倍。分解分析表明，11%至18%的不平等可由家庭户主的地理区域和社会群体来解释。改良卫生设施使用情况的集中曲线在印度家庭的中部和东部更为集中（集中指数：0.51和0.47），在NFHS - 4到NFHS - 5期间已降至0.17和0.22。我们还发现，印度707个区中有68个区改良卫生设施的使用率低于50%。该研究得出结论，社会经济地位较好的家庭更有能力使用改良卫生设施。因此，需要采取包容性战略来减少微观层面的社会经济不平等，并加强现行政策。
