Though Prime Minister Narendra Modi through his Swachh Bharat Abhiyan (Clean India campaign) has promised to build 100 million toilets across the country, experts say the money will not be well spent unless it's accompanied by a massive awareness campaign involving the government, non-profit groups and citizens.
According to Nikhil Dey, who has worked extensively in rural areas of India: "So far the toilets have been given to people who did not even have basic amenities like water or pucca (permanent) houses".
"In a place like rural Rajasthan, where women have to walk at least three kilometres to fetch water, they would not want toilets in their houses as it would be their responsibility to keep them clean," the noted activist told IANS.
For Bindeshwar Pathak of Sulabh International, a pioneer in the field of sanitation, the government's strategy so far has been flawed as it addressed the issue from bottom to top instead of top to bottom.
"Till now most of the schemes have focussed on providing toilets to the poor or the below poverty line (BPL) people. It is difficult for the poor, who do not have land to build the houses. Instead the rich should have been targeted first," Pathak told IANS.
Agreeing with this school of thought, Urban Development Secretary Shankar Agrawal told IANS: "What went wrong in the earlier schemes was that we did not ensure that the toilets had necessary things for smooth operation like water."
"So, most of the toilets started being used for storage purposes. The quality of construction was also poor. Apart from this, the beneficiaries were also never consulted," Agarwal added.
Agrawal, who is in-charge of the Clean India campaign in urban India, says the government has never launched any such campaigns in urban areas earlier. "This time, we have decided to give Rs. 4,000 incentive to people for building individual toilets. All forms have to be submitted online," he told IANS.
He said that while 50 percent of the money would be given to beneficiaries after the scrutiny of forms, the rest would be given after the toilets are built and photographs sent to he ministry.
Pathak said that while building toilets under schemes like the Nirmal Bharat campaign, the government had ignored the quality of construction and the technology used.
"Most of the villages had one-pit toilets built which were of no use after some years as the pits made were too small," he said.
"Even the villages which were awarded for building the maximum number of toilets have not maintained the momentum now".
According to Agrawal, this time the government is ensuring that a "standard design" is followed everywhere. "We will have a look at all the good contractors, the list of whom will be finalized by the urban local bodies."
The situation in India is so bad that open defecation is more common than in poorer countries such as Bangladesh, Kenya, the Democratic Republic of Congo, Malawi, Burundi and Rwanda.
According to data released by the National Sample Survey Office (NSSO) from a survey conducted in 2012, only 32 percent of rural households have their own toilets and less than half of Indian households have a toilet at home.
There were more households with a mobile phone than with a toilet, the survey revealed. In fact, the last census data reveals that the percentage of households with access to television and telephones in rural India exceeds that of households with access to toilet facilities.
According to the World Bank, India's sanitation deficit leads to losses worth roughly six percent of its gross domestic product by raising the disease burden. Unicef says poor sanitation impairs health, leading to high rates of malnutrition and productivity losses.
Children are more affected than adults as the rampant spread of diseases inhibits their ability to absorb nutrients, thereby stunting their growth.