Prevalence and burden of no-toilet households in India: an analysis of 261,746 households in 36 states/Union Territories in 2022-2023.

India's Swachh Bharat Abhiyan was a nation-wide program aimed at providing households with toilets to eliminate open defecation. Between 2016 and 2021, millions of households gained access to a toilet. However, as of 2021, over 238 million people still did not have a toilet, and there was considerable variation in this outcome between India's states and Union Territories. We update the estimates on the number of no-toilet households in India using India's Household Consumption Expenditure Survey from 2022 to 2023. We find that 12.5% of India's households, most of which are in rural communities, still have no toilet. This amounts to over 162 million people still living without a toilet. Over 70% of those without a toilet live in just six states, and the lowest socioeconomic status households are the least likely to have a toilet. This emphasizes the need for policy makers to target states and socioeconomic groups that are lagging. Furthermore, policy makers should understand that a household's toilet status can fluctuate because of adverse climate events, such as flooding. This evidence highlights the need for accurate and up-to-date data on no-toilet households throughout India.