Earlier this month, guidelines for the Swachh Bharat Mission (Gramin) were released by the Ministry of Drinking Water and Sanitation.  Key features of the Swachh Bharat Mission (Gramin), as outlined in the guidelines, are detailed below.  In addition, a brief overview of sanitation levels in the country is provided, along with major schemes of the central government to improve rural sanitation. The Swachh Bharat Mission, launched in October 2014, consists of two sub-missions – the Swachh Bharat Mission (Gramin) (SBM-G), which will be implemented in rural areas, and the Swachh Bharat Mission (Urban), which will be implemented in urban areas.  SBM-G seeks to eliminate open defecation in rural areas by 2019 through improving access to sanitation.  It also seeks to generate awareness to motivate communities to adopt sustainable sanitation practices, and encourage the use of appropriate technologies for sanitation. I. Context Data from the last three Census’, in Table 1, shows that while there has been some improvement in the number of households with toilets; this number remains low in the country, especially in rural areas. Table 1:  Percentage of households with toilets (national)

Year Rural Urban Total
1991 9% 64% 24%
2001 22% 74% 36%
2011 31% 81% 47%

In addition, there is significant variation across states in terms of availability of household toilets in rural areas, as shown in Table 2.  Table 2 also shows the change in percentage of rural households with toilets from 2001 to 2011.  It is evident that the pace of this change has varied across states over the decade. Table 2: Percentage of rural households with toilets

State

2001

2011

% Change

Andhra Pradesh

18

32

14

Arunachal Pradesh

47

53

5

Assam

60

60

0

Bihar

14

18

4

Chhattisgarh

5

15

9

Goa

48

71

23

Gujarat

22

33

11

Haryana

29

56

27

Himachal Pradesh

28

67

39

Jammu and Kashmir

42

39

-3

Jharkhand

7

8

1

Karnataka

17

28

11

Kerala

81

93

12

Madhya Pradesh

9

13

4

Maharashtra

18

38

20

Manipur

78

86

9

Meghalaya

40

54

14

Mizoram

80

85

5

Nagaland

65

69

5

Odisha

8

14

6

Punjab

41

70

30

Rajasthan

15

20

5

Sikkim

59

84

25

Tamil Nadu

14

23

9

Tripura

78

82

4

Uttar Pradesh

19

22

3

Uttarakhand

32

54

23

West Bengal

27

47

20

All India

22

31

9

II. Major schemes of the central government to improve rural sanitation The central government has been implementing schemes to improve access to sanitation in rural areas from the Ist Five Year Plan (1951-56) onwards.  Major schemes of the central government dealing with rural sanitation are outlined below.

Central Rural Sanitation Programme (1986): The Central Rural Sanitation Programme was one of the first schemes of the central government which focussed solely on rural sanitation.  The programme sought to construct household toilets, construct sanitary complexes for women, establish sanitary marts, and ensure solid and liquid waste management.
Total Sanitation Campaign (1999): The Total Sanitation Campaign was launched in 1999 with a greater focus on Information, Education and Communication (IEC) activities in order to make the creation of sanitation facilities demand driven rather than supply driven. Key components of the Total Sanitation Campaign included: (i) financial assistance to rural families below the poverty line for the construction of household toilets, (ii) construction of community sanitary complexes, (iii) construction of toilets in government schools and aganwadis, (iv) funds for IEC activities, (v) assistance to rural sanitary marts, and (vi) solid and liquid waste management.
Nirmal Bharat Abhiyan (2012): In 2012, the Total Sanitation Campaign was replaced by the Nirmal Bharat Abhiyan (NBA), which also focused on the previous elements.  According to the Ministry of Drinking Water and Sanitation, the key shifts in NBA were: (i) a greater focus on coverage for the whole community instead of a focus on individual houses, (ii) the inclusion of certain households which were above the poverty line, and (iii) more funds for IEC activities, with 15% of funds at the district level earmarked for IEC.
Swachh Bharat Mission (Gramin) (2014): Earlier this year, in October, NBA was replaced by Swachh Bharat Mission (Gramin) (SBM-G) which is a sub-mission under Swachh Bharat Mission.  SBM-G also includes the key components of the earlier sanitation schemes such as the funding for the construction of individual household toilets, construction of community sanitary complexes, waste management, and IEC. Key features of SBM-G, and major departures from earlier sanitation schemes, are outlined in the next section.

III. Guidelines for Swachh Bharat Mission (Gramin) The guidelines for SBM-G, released earlier this month, outline the strategy to be adopted for its implementation, funding, and monitoring. Objectives: Key objectives of SBM-G include: (i) improving the quality of life in rural areas through promoting cleanliness and eliminating open defecation by 2019, (ii) motivating communities and panchayati raj institutions to adopt sustainable sanitation practices, (iii) encouraging appropriate technologies for sustainable sanitation, and (iv) developing community managed solid and liquid waste management systems. Institutional framework: While NBA had a four tier implementation mechanism at the state, district, village, and block level, an additional tier has been added for SBM-G, at the national level.  Thus, the implementation mechanisms at the five levels will consist of: (i) National Swachh Bharat Mission (Gramin), (ii) State Swachh Bharat Mission (Gramin), (iii) District Swachh Bharat Mission (Gramin), (iv) Block Programme Management Unit, and (v) Gram Panchayat/Village and Water Sanitation Committee.  At the Gram Panchayat level, Swachhta Doots may be hired to assist with activities such as identification of beneficiaries, IEC, and maintenance of records. Planning: As was done under NBA, each state must prepare an Annual State Implementation Plan.  Gram Panchayats must prepare implementation plans, which will be consolidated into Block Implementation Plans.  These Block Implementation Plans will further be consolidated into District Implementation Plans.  Finally, District Implementation Plans will be consolidated in a State Implementation Plan by the State Swachh Bharat Mission (Gramin). A Plan Approval Committee in Ministry of Drinking Water and Sanitation will review the State Implementation Plans.  The final State Implementation Plan will be prepared by states based on the allocation of funds, and then approved by National Scheme Sanctioning Committee of the Ministry. Funding: Funding for SBM-G will be through budgetary allocations of the central and state governments, the Swachh Bharat Kosh, and multilateral agencies.  The Swachh Bharat Kosh has been established to collect funds from non-governmental sources.  Table 3, below, details the fund sharing pattern for SBM-G between the central and state government, as provided for in the SBM-G guidelines. Table 3: Funding for SBM-G across components

Component Centre State Beneficiary Amount as a % of SBM-G outlay
IEC, start-up activities, etc 75% 25% - 8%
Revolving fund 80% 20% - Up to 5%
Construction of household toilets 75%(Rs 9000)90% for J&K, NE states, special category states 25%(Rs 3000)10% for J&K, NE states, special category states -- Amount required for full coverage
Community sanitary complexes 60% 30% 10% Amount required for full coverage
Solid/Liquid Waste Management 75% 25% - Amount required within limits permitted
Administrative charges 75% 25% - Up to 2% of the project cost

One of the changes from NBA, in terms of funding, is that funds for IEC will be up to 8% of the total outlay under SBM-G, as opposed to up to 15% (calculated at the district level) under NBA.  Secondly, the amount provided for the construction of household toilets has increased from Rs 10,000 to Rs 12,000.  Thirdly, while earlier funding for household toilets was partly through NBA and partly though the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), the provision for MGNREGS funding has been done away with under SBM-G.  This implies that the central government’s share will be met entirely through SBM-G. Implementation: The key components of the implementation of SBM-G will include: (i) start up activities including preparation of state plans, (ii) IEC activities, (iii) capacity building of functionaries, (iv) construction of household toilets, (v) construction of community sanitary complexes, (vi) a revolving fund at the district level to assist Self Help Groups and others in providing cheap finance to their members (vii) funds for rural sanitary marts, where materials for the construction of toilets, etc., may be purchased, and (viii) funds for solid and liquid waste management. Under SBM-G, construction of toilets in government schools and aganwadis will be done by the Ministry of Human Resource Development and Ministry of Women and Child Development, respectively.  Previously, the Ministry of Drinking Water and Sanitation was responsible for this. Monitoring: Swachh Bharat Missions (Gramin) at the national, state, and district levels will each have monitoring units.  Annual monitoring will be done at the national level by third party independent agencies.  In addition, concurrent monitoring will be done, ideally at the community level, through the use of Information and Communications Technology. More information on SBM-G is available in the SBM-G guidelines, here.  

With the spread of COVID-19, along with the central government, state governments have also announced several policy decisions to contain and prevent the spread of the virus.  In this blog post, we summarise some of the key measures taken by the government of West Bengal in this regard as of April 18, 2020. 

As of April 18, 2020, there have been 287 confirmed cases of COVID-19 in West Bengal. Of these, 55 have been discharged and 10 have died.  To manage patients, there are 66 COVID hospitals, eight testing laboratories, and 582 institutional quarantine centres in the state. 

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Early response: Leading up to lockdown

Between January and February, the state government's efforts were aimed at raising awareness among citizens on COVID-19.  These include advisories on observing precautionary measures, and informing citizens on travel restrictions, home isolation, and screening protocols for foreign returnees.

On March 2, the state government responded to the growing number of suspected cases by issuing guidelines for preparedness by government medical colleges and hospitals.   These covered admission, isolation and management of suspected COVID-19 cases.  These instructions were extended to private medical colleges and hospitals on March 7.  A week later, the government issued protocols for monitoring travellers at various state checkposts by joint teams of state police and paramedical staff, and for reference of symptomatic patients to isolation facilities in the district.  All cases had to be reported on a daily basis to district surveillance teams.  The government also announced the closure of all educational institutions in the state (government and private) till March 31.  

On March 16, the government notified the West Bengal Epidemic Disease COVID-19 Regulations, 2020.  These regulations specify screening and treatment protocol for COVID-19 patients, and empower the district administration to take containment measures to curb the spread of COVID-19.   

The next day, the state reported its first confirmed case of COVID-19.  The government proceeded to issue orders: (i) for segregating isolation wards for suspected and confirmed COVID-19 cases, (ii) specifying treatment protocols for confirmed cases, (iii) establishing medical boards in all COVID-19 hospitals with representation from different medical disciplines, and (iv) establishing fever clinics for suspected patients.  Anganwadi centres and creches were also closed, with provisions to ensure supply of two kilograms of rice and potatoes to each beneficiary.  

On March 21, the government ordered the closure of certain establishments to restrict non-essential social gatherings till March 31, 2020.  This included closure of restaurants, clubs, amusement parks, and museums.  Further, all trains entering the state and inter-state buses were banned till March 31, 2020.

Subsequently, the government announced a lockdown.  In addition to steps for physical containment, the government also undertook various health and welfare measures.  These are detailed below.

Measures taken post-lockdown

On March 22, a lockdown was announced in 23 areas of the state until March 27.  Restrictions during the lockdown included: (i) prohibition on public gatherings of over seven people, (ii) suspension of public transport, and (iii) closure of shops, commercial establishments, offices and factories.  Establishments providing essential goods and services such as health services, print media, banks, groceries, and e-commerce delivery of food and groceries, were excluded from the restrictions.  Over the next few weeks, steps were taken to expand these exemptions, and to regulate the movement of goods and services.

  • List of essential goods and services:  On March 24, the lockdown was extended till March 31 in the entire state, and the exemptions were expanded to include industries producing coal, power, steel, or fertilisers.   After the centre notified a 21-day lockdown, the list of exemptions in the state was gradually expanded to include agricultural operations, fish production, tea garden operations, and operations in krishak bazars for marketing agricultural produce.  At the same time, restrictions were placed on hoarding of masks and hand sanitisers.  

  • Last week, after the central government extended the lockdown till May 3,  orders were passed for resumption of government offices from April 20 onwards at a strength of 25% of workforce.  Similar permission was also granted for restricted operations in jute mills, and IT/IT enabled services.  

  • Regulating movement of goods and services:  A pass system was introduced on March 25 to regulate the movement of persons supplying essential goods and services.  Transportation of non-essential cargo was prohibited till March 31, 2020.  However, as a one-time measure, permission was granted on March 26 to such vehicles to reach their destination.  Two days later, the government ordered for the seamless movement of commodities in all district borders and interstate areas. 

Health Measures

On March 26, a Committee of Experts was constituted to advise on strategies for isolation, quarantine, testing, health infrastructure, and disease prevention.  The Committee has been issuing protocols on clinical management of COVID-19 cases.  The government also established various monitoring committees on setting up isolation hospitals, managing critical care, and to audit the cause of deaths related to COVID-19 patients.  

To respond to the increasing number of patients, the government acquired private healthcare facilities in April.  Further, to expand its testing capacity, the government recommended sample pooling for COVID-19 testing yesterday.

In addition to these measures, the government also issued several guidelines, advisories and orders on containment of the virus, patient handling and protecting healthcare workers.  Some of these are detailed below: 

  • For healthcare facilities:  Advisory for setting up of isolation facilities, orders for establishment of fever clinics to segregate patients with severe symptoms, separation zones for suspected cases to protect healthcare personnel, and use of hydroxychloroquine for asymptomatic healthcare workers.

  • For government:  Guidelines for cluster containment and treatment strategies to contain COVID-19 in hi-risk spots, directions for awareness generation among rural population for containment, and arranging for counselling sessions for quarantined patients.

Welfare/Austerity Measures

  • Creation of relief fund:  The “West Bengal State Emergency Relief Fund” was created on March 23 to mobilise additional resources to cope with the emergency.  On April 2, austerity measures were announced by the government.   These include prohibition on announcement of new schemes, unless required in urgent public interest.

  • Distribution of food:  Free entitlement of wheat and rice was announced on March 26 to beneficiaries under some food subsidy schemes (including the Antyodaya Anna Yojana) until September, 2020.

  • Measures for workers:   Directions were notified in March for provisions on shelter, food, quarantine, wage payment, and continued tenancy for workers.   

  • Free insurance cover was announced on April 1 for treatment of certain categories of persons, including heathcare workers, and police.

For more information on the spread of COVID-19 and the central and state government response to the pandemic, please see here.