Contaminated water, poor sanitation, and hygiene significantly impact health, contributing to 90% of the 2 million annual global diarrheal deaths, primarily affecting children (UN, 2016). Access to safe water, sanitation, and hygiene (WASH) is crucial for reducing disease burdens (Fewtrell et al., 2005; WHO, 2017). The Sustainable Development Goals (SDGs), particularly targets 6.1 and 6.2, emphasise universal access to WASH services as vital for public health.
In 2015, India accounted for 90% of South Asians and half the global population practicing open defecation. To address this, the Government of India launched flagship programs such as the Swachh Bharat Mission (SBM) and Jal Jeevan Mission (JJM), leading to significant progress. Open defecation dropped from 29% in 2015 to 15% in 2020 (World Bank, 2022). Access to safe drinking water also increased significantly during this period (GoI, 2022).
This paper ‘Tracking water, sanitation, and hygiene (WASH) indicators in tribal districts of India: a secondary data analysis through 2015–2020’ focuses on WASH coverage among India’s tribal population, which constitutes 10.1% of the country’s population (Census, 2011). Tribes, referred to as Scheduled Tribes in the Indian Constitution, are distributed across the country but primarily concentrated in the eastern, central, and northeastern regions. Tribal communities often face challenges in development and health indicators, including WASH (GoI, 2014). This study analyses changes in WASH coverage between 2015 and 2021 in 90 tribal-dominated districts, scoring and ranking their performance.
This research is the first systematic assessment of WASH progress in India's tribal districts. It pioneers a ranking system for these districts based on their performance. The study identifies districts and WASH indicators requiring prioritisation, providing a framework to track progress at the district level.
Methodology
The study uses data from two rounds of the National Family Health Survey (NFHS), NFHS-4 (2015–16) and NFHS-5 (2019–21), conducted by the Ministry of Health and Family Welfare. These large-scale surveys provide nationally representative data on population, health, and nutrition indicators.
The analysis focuses on household-level WASH data, including sources of drinking water, water treatment practices, sanitation facilities, and hand hygiene. NFHS-4 collected data from 601,509 households, while NFHS-5 surveyed 636,699 households. Specifically, data from 66,412 households in tribal-dominated districts in NFHS-4 and 66,425 in NFHS-5 were analysed using SPSS.
A z-test was employed to measure changes in WASH indicators over time. Additionally, a composite index was developed to rank districts based on four key indicators: access to improved water sources, water treatment practices, improved toilet facilities, and availability of water and cleansing materials. Scaled values for these indicators were computed, ranging from 0 to 1, to generate district-wise composite scores.
Findings
The survey, conducted across 66,400 tribal-dominated households, highlighted significant shifts in WASH indicators between 2015 and 2021. Most households were male-headed, with a median age of 46–47 years. Nearly two-thirds of the heads of households were illiterate, with a majority of the literate population having completed primary or secondary education. Housing quality saw modest improvement, with a 6% increase in pucca houses, though 60% of households still lived in semi-pucca homes. Nuclear families dominated, comprising 66% of all households. Economically, about half of the surveyed households fell into the poorest categories of the wealth index.
Access to improved drinking water sources increased significantly, rising from 76% in 2015 to 82% in 2021. Improved sources such as piped water, tube wells, and community RO plants played a major role, with piped water connections to dwellings, yards, or plots increasing from 23% to 31%. Simultaneously, reliance on unimproved sources decreased from 22% to 16%. Water treatment practices also became more common, with 68% of households treating their drinking water in 2021 compared to 57% in 2015. Boiling, straining through cloth, and filtering water remained the most preferred methods, showcasing heightened awareness of water safety across both improved and unimproved sources.
Sanitation facilities witnessed remarkable improvement, with coverage of improved sanitation rising from 44% in 2015 to 70% in 2021. Flush or pour-flush toilets connected to septic tanks or pit latrines saw a significant increase. Unimproved sanitation facilities, which accounted for 13% in 2015, declined to just 6% in 2021. Open defecation, a critical challenge in tribal areas, saw a dramatic reduction of 50%, dropping from 38% in 2015 to 19% in 2021. This reflects the success of targeted sanitation initiatives in these districts.
Hand hygiene indicators also showed notable progress. Households with water available at designated handwashing locations rose to 87% in 2021. The availability of soap or detergent alongside water increased significantly, with 65% of households reporting access to both, compared to 50% in 2015. These improvements indicate a growing awareness of hygiene practices and their role in health and well-being.
However, regional disparities persisted. In 28 districts, the coverage of improved water sources remained below 80%, while others ranged between 80% and 99%. Sanitation coverage varied widely, from as low as 27% in some districts to full coverage in others, with 29 districts having less than 60% access to improved sanitation.
The survey ranked tribal districts based on their WASH performance in 2021. Top-performing districts were predominantly from the northeastern region, with East Jaintia Hills, Anjaw, and West Kameng ranking highest. Conversely, Mayurbhanj, Koraput, and Pashchimi Singhbhum in the central and eastern regions were among the lowest-ranking districts. Surprisingly, northeastern districts like Papum Pare and Aizawl also appeared among the bottom performers, suggesting localised challenges within otherwise high-performing regions. Wealth disparities were evident, as households in the poorest categories were more prevalent in the bottom-performing districts.
Between 2015 and 2021, most districts showed improvement in their WASH performance scores, with only 13 districts, half of which were in Mizoram, failing to improve. These findings underscore the progress made in tribal areas, particularly in sanitation and hygiene, but also highlight the need for targeted, region-specific interventions to address persistent inequalities. Data-driven strategies and continued investment in WASH infrastructure and education will be key to sustaining and scaling these gains.
Discussion: Progress and challenges in achieving WASH goals in tribal India
India, as the second most populous country, plays a vital role in achieving the SDGs. Significant strides have been made toward SDG 6.1 and 6.2, focusing on WASH, through initiatives such as the SBM and JJM. Launched in 2014, SBM aims to create an open defecation-free India by promoting behavior change, constructing toilets, and establishing robust monitoring systems. By 2022, the initiative had provided access to toilets for 100 million rural households, benefitting over 500 million people. Reports suggest that 95% of households now have and use toilets. The ongoing SBM Phase II (2020–2025) focuses on sustaining gains by addressing new eligible households and improving waste management systems.
Similarly, the JJM, launched in 2019, has provided potable tap water connections to 54% of rural households by March 2022. It seeks to ensure adequate, safe water for all rural households and institutions. These initiatives have had a considerable impact in tribal regions, reflecting in marked improvements in key WASH indicators between 2015 and 2021.
Improvements in tribal areas
The most significant progress was a 50% reduction in open defecation in tribal regions, from 38% in 2015 to 19% in 2021, nearly double the national rural decline over the same period. Improved toilet facilities rose from 44% to 70%, indicating widespread acceptance and use. While access to improved water sources increased, 70% of tribal households still lacked piped water at home, disproportionately affecting women and children, who often bear the burden of fetching water.
Behavioral changes were also notable. The proportion of tribal households with both water and soap at handwashing places rose from 50% in 2015 to 64% in 2021, matching national rural improvements. Water treatment practices also increased, reflecting greater awareness of water safety regardless of the source.
Regional disparities and challenges
Despite overall progress, district-level analysis revealed stark disparities. Many tribal districts ranked among both the best and worst performers, highlighting uneven implementation and socio-economic differences. For example, districts like Kinnaur and Nicobars performed well despite poverty, suggesting effective program delivery. In contrast, Papum Pare and Leh underperformed despite better economic indicators.
Notably, 86% of tribal districts showed improved WASH scores compared to 2015. However, 13 districts slipped in performance, emphasizing the need for more granular analysis and targeted interventions. Nearly 54% of households in these districts fall into the poorest wealth categories, underscoring the socio-economic barriers to WASH access.
Limitations and recommendations
A key limitation is the lack of a dedicated, nationally representative WASH survey for tribal populations. Comparisons with rural populations may not accurately reflect tribal-specific challenges. Additionally, definitions of WASH indicators in national surveys differ from international standards, potentially overestimating progress. For example, shared sanitation facilities and intermittent water supply do not meet globally accepted benchmarks for “safely managed” services.
To address these gaps, there is a need for standardized WASH indicators and a comprehensive tribal-specific survey. Such efforts would enable inclusive, equitable monitoring and support necessary interventions to further improve WASH outcomes in tribal areas.
Conclusion
Ensuring universal and equitable access to safe sanitation and affordable drinking water, especially in tribal areas, remains a significant challenge. India has made remarkable progress over the past five years, but sustaining and building on these achievements is essential to meet the SDG target of 100% WASH coverage. Continued focus is required on targeted, data-driven interventions, along with standardized monitoring frameworks to scale these achievements.
Ranking tribal-dominated districts based on WASH indicators is a valuable tool to identify priority areas for action. Targeted interventions should be implemented in these districts through the SBA platform, in coordination with Health, Tribal Affairs, and Water and Sanitation departments, to drive progress toward achieving SDG WASH targets by 2030.