Open Defecation: India, Indonesia, Pakistan, Ethiopia, and Nigeria Top List

According to the world health Organization, around 1 million people in low- and middle-income countries die every year as a result of inadequate water, sanitation, and hygiene. This figure represents about 58% of total diarrhea deaths. Available data also reveals that an estimated 1 billion (892 million) people worldwide still routinely practice open defecation in street gutters, behind bushes or into open bodies of water.

In addition, around 10% of the world’s population is believed to consume food irrigated by wastewater and countries where open defecation is widely practiced have been shown to have the highest number of deaths of children under the age of 5 years as well as the highest levels of malnutrition, poverty, and widest disparities of wealth.  Open defecation remains a critical global health challenge, affecting almost 1 billion people around the world according to the World Bank.

open defecation

Countries with Widespread Open Defection

Although the proverbial saying that “Cleanliness is next to Godliness” traces its origin to ancient Indian times, the current Indian health and sanitation condition needs much to be desired. According to WHO,  India is the open defecation capital of the world with  626 million people practicing open defecation,  this figure is  twice the number of the next 18 countries combined and accounts for  over 90 per cent of the 692 million people practicing open defecation in South Asia. On the global scene,  India accounts for 59 per cent of the 1.1 billion people in the world who practice open defecation. In contrast, China accounts for more than 95% of the progress made on sanitation in Eastern Asia;

WHO statistics on Open Defecation

Global Statistics on Open Defecation

1. India (626 million)

2. Indonesia (63 million)

3.  Pakistan (40 million)

4. Ethiopia (38 million)

5.  Nigeria (34 million)

6. Sudan (19 million)

7. Nepal (15 million)

8.  China (14 million)

9. Niger (12 million)

10 Burkina Faso (9.7 million)

11. Mozambique (9.5 million)

12. Cambodia (8.6 million).

Source: WHO


Open Defecation: India, Indonesia, Pakistan, Ethiopia, and Nigeria Top List

Disadvantages of Open Toilets and Open Defecation

There are several dangers of open defecation, and the harmful effects of open toilets only serves to complicate the global sanitation dilemma. The harmful effects of open defecation include;


  1. It leads to the spread of diseases and epidemics such as cholera.


  1. It compromises the quality of drinking water sources especially in the rural areas.


  1. The highest levels of malnutrition, poverty, and widest disparities of wealth are found in areas with widespread open defecation.


  1. It increases the rate of childhood mortality.


  1. It contaminates Irrigation water used for agricultural purposes.

Open Defecation: India, Indonesia, Pakistan, Ethiopia, and Nigeria Top List

Law against Public Defecation

Most countries that have made significant progress in combating the menace of open defecation and improved sanitation achieved such feat by a combination of several factors including legislation’s such as the open defecation laws and regulation which prescribes penalties and fine against person(s) engaging in practices that compromises public health and safety. This laws also serves as a deterrent to others who are unwilling to discontinue their habits of open defecation even if they are provided with toilets. Read: Sewer Backup Health risks

The UN General Assembly declared November 19 World Toilet Day back in 2013 and it exists to inform, engage and inspire people to achieve the goal of ensuring the availability and sustainable management of water and sanitation for all. Eliminating the practice of open defecation is going to be crucial in achieving that goal and though progress has been made over the past decade, there is still a lot of work to do. Many countries have made strides in ensuring people have at least a minimum level of sanitation that ensures excreta is separated from human contact.


Public Health Ng
Public Health Nigeria an Interdisciplinary public health movement focused on health education, advancing fair public health policies, promoting fitness, healthy diets, responsible behavior, community health and general well-being.

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