Ending Open Defecation: Twelve National Sanitation Programs

India started its national effort in 1986 with this program, which paid for individual latrines for households below the poverty line. Its own construction-led approach moved rural sanitation coverage only about 9 percent, the weak result that later programs set out to fix.

Launched in 1999, this campaign worked through local government institutions to create demand for latrines instead of simply subsidizing construction. An independent evaluation found it modestly raised household latrine ownership with little measurable effect on children's health.

Vietnam established this national target program in 2000, led by the Ministry of Agriculture and Rural Development, and ran it through successive phases across all of its provinces. It pairs rural water supply with sanitation under one program, with the World Bank describing its goal as increasing sustained access to both.

From 2003 to 2006 local government leaders guided their constituents toward 100 percent household latrine coverage. The campaign drew on the community-led approach first tried in a Rajshahi village, and improved sanitation coverage rose from about 33 percent in 2003 to 61 percent by 2016.

Indonesia's Ministry of Health made community-based total sanitation national policy by decree in 2008. The strategy follows the community-led principle of creating demand for sanitation to stop open defecation, and it has produced over 9,000 verified open-defecation-free villages.

Endorsed in 2011, when national sanitation coverage stood at 46 percent, the master plan adopted a no-subsidy principle and a target of ending open defecation by 2017. The target slipped, but Nepal went on to declare itself open-defecation-free in 2019.

Kenya started this campaign in May 2011 with community-led total sanitation as its core strategy and a roadmap targeting 2013. That target was missed nationwide, and the government extended the same approach under a framework covering 2016 to 2020.

Tanzania built on its 1970s Mtu ni Afya campaign with a new national program, whose public brand from 2017 was Nyumba ni Choo, meaning a house is a toilet. Open defecation fell from 7.2 percent of the population in 2017 to 1.3 percent in 2022.

India restructured its predecessor campaign into this mission in October 2014, with the aim of ending open defecation and improving solid waste management. The government declared rural India open-defecation-free in 2019, while household surveys found a meaningful share of new toilets unused.

Cambodia organized its effort into two successive five-year action plans under a long-term strategic plan to 2025. During the first plan, rural sanitation coverage rose from 40.9 percent to 71.2 percent by 2017, and the second set a target of 90 percent by 2023.

Announced in 2015, this campaign began as a fix for public toilets at tourist sites and widened to rural areas and public spaces. More than 68,000 public toilets were built nationwide from 2015 to 2017.

The Philippine Department of Health uses the community-led total sanitation approach and certifies barangays as having achieved zero open defecation. As of 2019 one third of the country's 42,046 barangays had been certified, and policies issued that year set a target of 2022 for all barangays.