Emerging evidence in Rajasthan, a State with a population of 68.5million shows that scaled-up improved sanitation across India is quite possible in a few years. This paper highlights the recent sanitation campaigns in the districts of Churu and Bikaner in Rajasthan, with rural populations of 2.04million and 2.36 million respectively, which are now both progressing swiftly to being fully open defecation free. This has been achieved by the district level local government adopting a systems approach which has three interrelated elements: (a) creating a strong enabling environment capable of sustaining service delivery at scale, (b) generating demand for sanitation and hygiene by households and communities, and (c) increasing the supply of sanitation products and services This theory of change, which was developed and tested in 13 countries over a period of 6 years, also has two cross-cutting elements which are strong government leadership and evidence-based learning. While similar approaches have been successful elsewhere, evidence from Rajasthan is quite compelling, as the State faces many challenges such as scarce water resources, the large population and geographic spread, low literacy rates, and the prevailing socio-cultural context.
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