India laid to the 24. Mars a national blockade hoping to stop the spread of the coronavirus pandemic. According to the latest available data, in early April 2020, there were more than 1500 cases of Covid-19, a disease associated with the new coronavirus.
These figures lead to surprisingly low prevalence rates compared to the rest of the world due to the late arrival of the virus. However, a significant deterioration of the scenario cannot be ruled out, while experts warn that India is under serious threat, in particular because of the fragility of its health system.
Personal hygiene and especially handwashing methods are being scrutinized because millions of the poorest Indians do not have access to basic facilities. We are social demographers and have studied handwashing practices in India especially for this article.
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Studies in India have shown how good hand hygiene reduces the risk of diarrhoea, pneumonia or atrophy – important factors in high infant and child mortality.
Unfortunately, the focus on handwashing is not included in the major Bharat Swach mission or in the Pure India programme launched in 2014. The spread of the coronavirus has highlighted this problem, as hand hygiene is one of the easiest ways to prevent both the infection and the spread of the virus. Hand hygiene in India
The reliability of handwash surveys and the way statistics are collected are discussed. According to a national survey conducted in 2011-2012, 63 percent of households reported that they normally wash their hands with poststool soap, a low indicator for a country where toilet paper is rarely used.
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However, recent studies in India have shown that the most reliable statistics on hygiene practices are obtained from an environmental audit, where staff in the field check the presence of a soap and water source in the house where people wash their hands.
For example, the latest National Population Survey of India, coordinated by the International Institute of Population Science in 2015-16, collected information from which the data for this study were derived. It was found that 39.8 percent of households had no soap or water, which is often explained by the lack of soap in the study. Large geographical differences
In India, the proportion of households without soap and water is less than 71.4 percent of the population of Bangladesh or 52.9 percent of the population of Nepal without such facilities. During the same period, however, Indian households were worse off than those in Pakistan (31.4%) or Myanmar (16.4%).
If we break down the data, we see that 20 percent of households in urban areas, where access to mains water is more common, do not have hand-washing facilities, compared to 51 percent in rural areas. Regional disparities are even greater, ranging from less than 10% in Delhi to more than 60% in the state of Odisha. As you can see on the map below, better hand hygiene can be found in northwest India, the Caribbean coast and many northeastern states.
On the other hand, the areas where hand washing is least common are clustered around Odisha, Chhattisgar and Jharkhand.
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The map also shows another area of poor hand hygiene in the more developed state of Tamil Nadu in southern India. Although the spatial characteristics of hygiene are very pronounced, the map of lower soap and water consumption does not fully correspond to the less developed regions of India. socio-economic disparities
Our study also looked at the social and economic characteristics of households. We found that only 4% of the richest households had no money to wash their hands, compared to 80% of the poorest households. The lowest level of hand hygiene was observed in houses without a toilet (64%) or in families with illiterates (68%).
The consequences of these inequalities can be significant in terms of internal transfers and impacts on vulnerable groups.
Employees, housekeepers, cooks, drivers, daily allowances, people working in small businesses in cities and communities lose their livelihoods. Without an economic plan to support them, they return home and cause the largest sudden migration to India since the Section in 1947. In India, reverse migration is taking place.
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Soon they will be able to bring KOVID-19 to their home districts and villages and continue to spread the virus throughout the country. The situation is particularly worrying in households made up exclusively of people over 65 years of age, less than half of whom have access to soap and water.
The benefits of hand-washing in India go far beyond coronaviruses, as it reduces the spread of all types of pathogens. In 2017, researchers have estimated the net annual cost of hand-washing in India at 23 billion dollars. The United States of America highlighted the significant progress made in India in reducing diarrhoea and acute respiratory tract infections through behavioural changes. Local initiatives have already started to encourage people to wash their hands often. Experts also point out that the lack of access to water – especially safe drinking water – in India could be another problem for the poorest communities to protect themselves from the coronavirus, even though hand-washing should be more frequent. In this context, hand-washing campaigns during the crisis will be crucial for public health in India, as will improving access to basic services for all.
Christoph Z. Gilmoto, Senior Researcher in Demography, Institute for Development Studies (IRD), and Thomas Licart, PhD in Demography, University of Strasbourg.
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