ABSTRACT Visual depiction of the direct and indirect health impacts associated with the changes from Swachh Bharat Mission (SBM) which include reduction in childhood stunting and wasting, decreased under-5 mortality, decreases in vaccine-preventable disease and diarrhoeal disease, decreases in environmental contamination of communicable microbes, and improvements in child cognition scores. To address widespread issues of contaminated drinking water and lack of defecation, Bharat's National Government enacted a large-scale initiative known as Swachh Bharat Mission (SBM). The objective of this systematic review is to evaluate SBM's impacts on health and communicable disease control. This review has followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, with searches conducted in seven different databases. Studies analysed impacts/trends relating to health or communicable disease control in any region of Bharat were eligible for inclusion. Study quality was assessed using the Kmet checklist. About 25 articles were included in this review. It was shown that either improved sanitation/access to clean drinking water or increased access to toilets has been associated with a low incidence of communicable disease. Improvements in sanitation facilities/toilet coverage and stool disposal were also associated with decreased under-five mortality rates, child wasting, and child stunting. Improvements in cognitive effects were also seen, particularly in girls. SBM has been found to be associated with important, measurable impacts on health across Bharat. These have included notable declines in the impacts of communicable diseases, as well as other public health problems such as infant mortality. Further efforts to improve sanitation will likely have significant health benefits at a population level.
Varshney et al. (Wed,) studied this question.