Phase 4 National Strategy

Sanitation
worker safety and livelihoods in India:

A blueprint for action
Phase 4: National Strategy
29 January, 2018
Table of contents
Our Approach
The Sanitation Worker Ecosystem
Key Insights
National Strategy For Sanitation Worker Safety & Livelihoods
Next Steps
2
We are currently in the final phase of the project
Phase 2 Phase 3 Phase 4
Phase 1
Identifying best Developing solutions Developing strategy
Understanding the problem
practices list blueprint
5 weeks 3 weeks 2 weeks 2 weeks
• Comprehensively understand • Learn from existing • Develop 6-‐7 high potential • Develop an overall strategy
the issue from a w orker initiatives from both a solutions blueprint to address the
Objectives
perspective as w ell as supply-‐ worker and supply-‐side problem

side or institutional perspective
perspective • Develop design principles
for success as w ell as key
constraints
• Stakeholder and institutional • Desk research to identify • Brainstorming to develop a • Develop a national strategy at
mapping innovations in institutions, long-‐list of solutions different levels of government
hardware, software,
Key activities
• Desk and expert research • Collaborative w orking • Discussions/ feedback sessions

financing and regulation session to rate solutions and with B MGF, govt., NGO
• HCD research, incl.
interviews, immersive • Expert interviews identify shortlist stakeholders
journey mapping, user • Field research for case • Develop final blueprint, w ith
storytelling studies, if needed high-‐level recos for 1-‐2 cities
• Develop partnership directory
• Research report outlining the • Best practices report • Solutions report covering • Final national strategy and city
problem in 2 parts: covering: longlist and shortlist of blueprint
Outputs
o Worker lens o Case studies (Global and solutions • Partnership directory covering
o Supply-‐side / institutional Indian examples) key partners
lens o Design principles for
success We are here
3
In previous phases, we conducted in-‐depth field research and interacted with
various stakeholders to understand the ecosystem and identify key issues
Desk research Stakeholder interviews Field research
Review o f government Interactions with • Interactions with 53 workers across

Overview
policies & initiatives, media government o fficials at different types of sanitation work
and academic reports the n ational and ULB • Multiple methods u sed: observation,
levels, contractors, interviews, group discussions
NGOs, experts
• Understanding the • Scale of unsafe • Profile/ background; how they

sanitation system and sanitation work entered the job
Points o f inquiry
plans for expansion • Key underlying • Challenges faced on-‐the-‐job and in
• Current and proposed drivers of the issue exiting the profession
initiatives w.r.t. sanitation • Interventions done • Key financial, health, and social
work by govt/ others to challenges
• Existing understanding of alleviate the • Aspirations and goals
sanitation workers situation – and their
impact/ efficacy
4
Thereafter, we carried out a range of analysis, brainstorms, and workshops to
generate ideas and identify high potential solutions to address the issues
Workshop
Name Organization
Name Organization
11 Anurag Chaturvedi Dasra
1 M Krishna Kam-‐Avida
12 Rohit Singh Gramvani
2 Pavithra L J Tide Technocrats
13 Ankur Garg BBC Media Action
List o f Participants
3 Avinash Kumar WaterAid

14 Dhruv Basar CEPT
4 Sasanka Velidandla CDD
15 Rashmi Dash EY
5 Geeta Singhal BORDA
16 Bhawna Prakash EY
6 A Kalimuthu WASH Institute
17 Kanha EY
7 Akhila Shivdas CFAR
18 Vinitha IIHS
8 Ashif Shaikh Jan Sahas
19 Rajmohan ASCI
9 Sanghmitra Acharya IIDS
20 Anju Dwivedi CPR
10 Meghna Malhotra UMC
21 Tripti Singh CPR
5
We rigorously evaluated solutions to identify the most promising ones
We evaluated the 26 opportunity areas b ased o n their relative

…and p rioritized o pportunity areas
impact and feasibility…
PRIORITISATION CRITERIA
1 High
Number of workers impacted
Impact 2
Intensity of impact
Medium
Impact
1
Ease of political buy-‐in
2
Economic feasibility
Feasibility
3
Technical feasibility Low Medium High
4 Feasibility
Likelihood of user acceptance
6
Table of contents
Our Approach
Key Insights
Next Steps
7
Table of contents
Our Approach
Types of work & scale of problem Cleaning processes
Worker challenges & personas Worker ecosystem
Key Insights
Next Steps
8
We discovered that there are actually nine types of sanitation workers across
the value chain
CONTAINMENT /
INTERFACE TRANSPORT TREATMENT DISPOSAL
EMPTYING
Individual toilets
9 1
connected to
sewers Piped sewer n etworks Reuse in
Sewage agriculture
Individual toilets Decanting as manure
Treatment
with septic tanks Stations
Plant
4
2 5
Insanitary Septic tanks
latrines
Open land o r
6
Community toilets water
Pits bodies/
8
dumping
Open sites
Drains
defecation
6
Public Toilets
(~65K toilets)
7
School Toilets
(~1.5M schools)
Railway Tracks 3
Icons indicate unsafe manual intervention
(~2,000 stations)
Note Interface use: insanitary latrines include without slab, night soil serviced by human/animal; open defecation figures include night soil disposed into open drain;
9
latrines with slabs/improved pits and flush latrines connected to other systems excluded from percentage break-‐up
Source: Data on interfaces is from Census 2011 estimates, Dalberg analysis
Description of the various types of sanitation work (1/2)
Type o f work Description Location
Sewer cleaning • Unblocking and cleaning sewer and wastewater

1
drains • Urban areas
• Complaint-‐based, seasonal (rainy season) and
occasionally for preventive maintenance
2 Faecal sludge • Emptying, collection and transport of human waste • Primarily urban,
handling from septic tanks mostly unplanned
• On-‐demand; de-‐sludging frequency varies greatly localities
ranging from 6 months – 10-‐15 years
3 Railway • Cleaning faecal matter from railway tracks and • Rail network and
cleaning platforms; several times a day railway stations
• Cleaning faecal matter from railway toilets and platform
toilets
4 Latrine cleaning • Emptying of dry/single-‐pit latrines primarily in rural • Primarily rural
areas; daily collection and transport/emptying of fecal
matter
10
Note: Riskiness is defined by looking at the immediate risk on the job (e.g. risk of fatalities) and risk of prolonged illnesses
Description of the various types of sanitation work (2/2)
Type o f work Description Location
5 Treatment • Maintaining and operating sewage and faecal sludge • Urban, across the ~527
Plant work treatment plants on a daily basis STPs/FSTPs in India
6 Community/Public • Maintaining public/community toilets (often insanitary) • Rural and urban CTC2 s,
Toilet keeping on a daily basis mostly in slums; public
convenience shelters
7 School toilet cleaning • Operating and maintaining school toilets on a daily • Schools-‐rural and urban
basis
8 Sweeping/Drain • Cleaning open drains and road sweeping, often • Urban-‐ drains alongside
cleaning encountering fecal matter due to open defecation and roads
insanitary latrines connected to drains
9 Domestic Work • Cleaning toilets in middle-‐high income • Urban areas

households/institutions, encountering insanitary
conditions at times
11
Note: Riskiness is defined by looking at the immediate risk on the job (e.g. risk of fatalities) and risk of prolonged illnesses
We estimate that there are ~5 mn full-‐time equivalents of sanitation workers
nationally; ~ 2.5 mn face high occupational hazards and risks
CATEGORY 1
Latrine cleaners
Recognition in existing legal/policy frameworks
~770k
Railways cleaners
~95k
Official govt. figures:
High
Sewer cleaners
~182k1 households ~153k
/media awareness
(SECC, 2011) Fecal sludge handlers

~22k We h ave focused
CATEGORY 2 on Category 1 and
CATEGORY 3
2 in this
Treatment plant workers engagement
~6k
Drain cleaners
Low
Domestic workers ~417k

~2M CT/PT cleaners
~202k
School toilet cleaners
~840k
Size of bubble
High Indicates number
Low
Exposure to h uman faecal matter of workers
There is a n eed to identify and estimate the n umber o f workers involved in u nsafe
sanitation work via an independent and verifiable third-‐p arty assessment
12
Source: Dalberg analysis
~1.1 mn (~45% of total) sanitation workers are in urban areas, with drain and
community and public toilet cleaners accounting for ~600K
Number o f sanitation workers (2017)

% of individuals
Rural Urban
Number of urban
All workers ~1.4 mn ~1 .1 mn sanitation workers is
lesser than rural
% of workers 60% 40% workers, but urban
workers carry out the
more risky jobs such as
~81k sewer cleaning and
Latrine cleaners ~90% ~10%
septic tank cleaning
Sewer cleaners NA 100% ~153k
Septic tank cleaners ~20% ~80% ~18k
Railway workers NA 100% ~95k
CTC/PT cleaners ~10% ~90% ~178k We h ave

focused o n
School toilet cleaners ~80% ~20% ~167k urban
sanitation
Treatment p lant workers NA 100% ~5k workers
Drain cleaners NA 100% ~417k
13
Source: Icons from the noun project; Dalberg analysis
Gender lens: ~50% of urban sanitation workers are women, working primarily
as school toilet and drain cleaners
Number o f sanitation workers (2017)

% of individuals
Women sanitation
Women Men
workers are found in
All workers ~560K ~560K jobs that bear low
fatality risk or are
% of workers ~50% ~50% less hazardous, but
often their husbands
are involved in more
risky jobs such as
Latrine cleaners ~77k ~95% ~5% sewer cleaning
Sewer cleaners NA NA 100%
Septic tank cleaners NA NA 100% Women prefer

working as school
Railway workers ~77k 10-‐20% 80-‐90%
toilet cleaners due
~45k 70-‐75% to an “emotional
CTC/PT cleaners 25-‐30%
attachment” with
School toilet cleaners ~150k >90% <10% children and
assured monthly
NA NA 100% income
Treatment p lant workers
50-‐60% 40-‐50%
Drain cleaners ~209K
14
Source: Icons from the noun project; Dalberg analysis
Going forward, the number of urban sanitation workers with significant
exposure to faecal matter is expected to reduce to 1 mn
Number o f u rban sanitation workers1 (2022)
Drain cleaners coming in contact w ith faecal

matter w ill decrease as presence of open
Push on defecation and insanitary latrines reduces
National schemes
Swachh Adoption of like AMRUT w ill
Bharat w ill bio-‐digestor
1,200,000 significantly increase
reduce toilets w ill sewer coverage ~177k ~7k ~1 Mn
1,000,000 number of reduce
insanitary exposure to ~170k
800,000 latrines faecal m atter ~310k
600,000
400,000 ~214k ~17k
200,000
~60k ~53k
0
Latrine Railway Sewer cleaners Septic tank Drain cleaners School toilet CTC/PT Treatment Total Number
cleaners workers cleaners cleaners cleaners plant workers of Workers
Category 1 Category 2
Increase
/decrease 25% 45% 10% 26% 1%
over 2017 40% 2% 16%
(%)
(1): Number of workers coming in contact with faecal matter; Note: Projections based on business as usual scenario without taking account mechanisation
(except railways which has announced installation of bio-‐toilets) 15
Source: Census 2011, WSP F inancial Requirements of Urban Sanitation in India, Expert interviews, Dalberg analysis
Table of contents
Our Approach
Key Insights
Next Steps
16
We carried out extensive
shadowing to understand the
sources of safety risk for different
types of sanitation work
17
Sewer cleaning: work process
Step 1 Step 2 Step 3 Step 4 Step 5
Machines and workers Attempt to use Machines are Workers perform the Workers clean
arrive at the location of machines (suction, in ineffective, have design unblocking (and other) themselves with water
the blockage. Diagnose this case), but have to constraints. Workers tasks with rudimentary at the same premises.
issue, plan action, guide the hose have to resort to tools like hammers,
check for safety using manually. emptying the chamber sickles, rods and
rudimentary manually. Enter the spades.
mechanisms. septage material with
no PPE.
With news of sewer deaths and govt.’s push towards mechanisation, manual intervention
Trend is likely to decrease but will depend on city-‐specific initiatives 18
Septic tank desludging: work process
Desludging operators Use rods to open the Guide hose inside Workers add water to The lid of the tank is
arrive at the household covers of septic tank. septic tank, usually the pipes and the reconstructed by the
that has called them. These covers often without any PPE. solidified sludge to workers.
break inside the tank Workers occasionally make the suction
and workers have to have to enter the tanks process easier. I f this
pick them up with their when suction doesn’t doesn’t work, they
hands. work and/or sludge is have to enter manually.
solidified.
Likely to increase, given the private operator mode of employment with limited oversight;
Trend as demand increases, the “unsafe” aspect of the job will also increase 19
Railway track cleaning: work process
Gravel P latforms (like Warangal) Concrete Apron P latforms (like Trichy)
Spray limestone on Pick up solid waste from Pick up solid waste from tracks using scooper and put it in a bin;
fecal matter once train tracks by hand and put it in wear gloves and mask. Push excreta into drains using hose pipe
passes. a bin; wear gloves and (fitted along the tracks).
mask (sometimes
incomplete).
If bio-‐digestors are introduced then amount of faecal matter on tracks will reduce, limiting
Trend workers’ exposure to faecal matter 20
Treatment plant: work process
Step 1 Step 2 Step 3
Workers use long tools to pick out They have to enter these chambers manually at They also open valves without
non-‐septage material that blocks least once a week when the tools are insufficient. protective gear to release septage
filtering chambers. material on open grounds, where it
‘bakes’ for days as it is converted to
manure.
Trend As STPs become more prevalent, unsafe work will increase if unchecked 21
Public, Community and School toilet cleaning: work process
Public/Community toilet cleaning School toilet cleaning
Cleaners’ day starts at ~5 am and they clean in 6-‐8 cycles till ~10 pm; cleaning Workers clean before, after and during
schedule prescribed by CT/PT operator. Use mops, brooms, disinfectants supplied school hours (total 3-‐4 times). Some are
by operator; un-‐branded, strong; typically don't use gloves, masks. given masks and gloves, most clean with
hands, mops and brooms. Some toilets,
Workers encounter clogged faecal matter in the bathrooms. Drains often also get particularly for younger kids, often used
clogged due to bidis, plastics, sanitary pads, etc. poorly and have clogged faecal matter.
As contractually operated CT/PTs and access to school toilets grow, unsafe work will
Trend increase 22
Drain cleaning: work process
Workers (typically men) Female workers follow They carry the material Workers empty the They then take these
unclog drains using later, scoop material with the bags to nearby collected material into push carts to
shovels with long onto plastic bags push carts. push cart. designated collection
handles; no other without any equipment spots.
protective gear. This or protective gear.
material often contains
fecal matter.
As open defecation and insanitary latrines reduce, presence of faecal matter in drains will
Trend also reduce, limiting workers’ exposure to faecal matter 23
Table of contents
Our Approach
Key Insights
Next Steps
24
Sanitation workers face severe financial, social and health challenges
• Daily wages of INR 100 – 600 in cities;

monthly salaries o f INR 3k – 10k for
contractual workers (< min. wages)
• Uncertain cash flow due to daily work
• Financial shocks à debt for life
FINANCIAL
• Life expectancy o f ~50

• Mostly b elong to lowest Dire years vs. national average
Dalit sub-‐caste groups life and
of 68 years and ~60 years
(Valmikis, Helas, Lalbegis work
conditions for Dalits
etc.); socially ostracized
• High rates o f p rolonged
• Not given access to
SOCIAL HEALTH illness and mortality
education, health, land,
• Mental h ealth issues
markets, financing, due
• Rampant alcoholism and
to social status
drug abuse
25
(1): Average salaries in garment industries are Rs. 5500/month, based on news reports from Chennai.
Sanitation workers can be viewed as six distinct personas on the basis of their
motivations, opportunities and ability
Reluctant Complacent Caged Trapped Transient First among

inheritor part-timer bird traditionalist hustler equals
Relatively new Workers, both Permanent

Workers (men) Sewer workers Workers who
workers, both women and sewer workers
who have just and drain are looking for
women and men, who face and drain
entered this job cleaners, jobs that
young men, who less hazardous cleaners who
and are keen to typically male, provide the best
are forced into environments have been
move on to jobs who have been economic pay-‐
the profession and are doing this job
beyond working for out and
due to the death comfortable in for y ears, and
sanitation but several decades currently a job
of the primary the current job, earn
foresee no and expect to in sanitation
income earner and have no significantly
opportunities continue doing provides them
who used to be in desire to move more than
for doing that so that
this profession out other workers
These p ersonas d iffer in terms o f b ackgrounds, motivations, aspirations, and p ersonalities,
and will therefore require customized s olutions and p athways
26
Note: Details on these personas is in the annex
Table of contents
Our Approach
Key Insights
Next Steps
27
Sanitation workers engage with various stakeholders in the sanitation
ecosystem; the subsequent slides describes different parts of this ecosystem
• Policy design • Ratification of policies
• Rehabilitation of manual Central • Implementation of
State
scavengers rehabilitation schemes
• Organisation and Govt. Govt.
empowerment
of workers Civil
• Awareness campaigns Society
• Capacity-‐building and Capacity
Organizations building
systems support
Urban Local Supply of
gear and Manufacturers
Bodies
equipment
Unions Organisational
support Permanent
employment
Supply of
Work contracts gear and
And licensing equipment
Sanitation
• Caste-‐based Social Workers Employment Private
networks and Family and capital • Operate septic tank v ehicles
Operators, • Manage community toilets
self-‐association Community Contractors • Multi-‐y ear service contracts
• Labor supply contracts
Attention Direct Single job

employment contracts
Government entities
• Public sensitization,
Households Customers/employers
behavior change • Hire workers directly or via
• Advocacy and Media contractors for emptying and Supporting entities
awareness pits and septic tanks, or Institutions
unblocking household Innovators/suppliers
pipes
28
[Policy] Manual scavenging first prohibited in 1993, scope expanded in 2013;
rehabilitation scheme for manual scavengers introduced in 2007
MS Act (1993)1 Scheme for Rehabilitation MS Act (2013)2 Swachh Bharat New Municipal
of Manual Scavengers (SRMS) Mission (SBM) SWM Rules
• Prohibited • Focused on rehabilitation of • Widens definition of • Increasing access
employment of manual scavengers and manual scavengers to to sanitation; aims • States to
manual scavengers dependents via skills training, include others coming to end OD by 2019 organize w aste
• Banned loans, etc. in contact w ith fecal • Will likely increase collectors and
construction of dry • Post 2013 Act, focuses on matter no. of w orkers for improve safety
latrines and self-‐employment and one-‐ • Attempts to fix certain types of standards
replacement of time cash assistance accountability work ( e.g., school
existing ones toilet cleaning)
1993 2003 2007 2011 2013 2014 2016 2017
Writ F iled by SKA National Advisory National Urban Supreme Court Order Bio-‐toilets in
and others Council Resolution Livelihoods Mission • Manual sewer cleaning Trains
should be m ade illegal • Rail B udget
• Requires government • Urged Central even in emergency
• Provides for includes funds
bodies to strictly Government to sustainable situations; ULBs should
for bio-‐toilets
implement the 1993 Act enact new law to draft plans for
employment and in all coaches
• Prompted the S C to identify and income-‐generating mechanization
by 2019, to
monitor legislative rehabilitate m anual • Directs states to
opportunities to reduce fecal
progress; forced states scavengers, and conduct identification
urban B PL youth matter on
to ratify 1993 Act punish offenders surveys, and
tracks
rehabilitate all MS’
(1): Employment of Manual S cavengers & Construction of Dry Latrines (Prohibition) Act; (2): Prohibition of Employment as M anual S cavengers and their Rehabilitation Act
29
Source: Original copies of the 1993 and 2013 Acts, Ministry of S ocial Justice and Empowerment documentation on S RMS, NSKFDC Annual Reports 2013-‐2016
[Policy] Safety norms have been prescribed at the national level for the
riskiest types of work
Sewer Cleaners Septic Tank Treatment Plant Railway Cleaners Road Sweepers/
Cleaners Workers Drain Cleaners
• The Manual Scavenging Act 2013 specifies: • Annual General • Solid Waste
o Conditions u nder which manual Conditions o f Contract Management Guidelines
intervention is allowed (e.g., damaged drawn up by the MoR1 2016 by the MoE&F2
manholes, emergency, machine’s inability to mandate the use of require ULBs to ensure
carry out task) mechanized cleaning that SWM workers are
o Safety gear: 44 types specified (e.g., air equipment provided with safety
purifier gas masks, nylon safety belts) gear (jacket, gloves,
o Cleaning equipment: 14 types specified • Contractors mandated boots, etc.) by
(e.g., suction machine, jetting machine) to p rovide gear and contractors, and that
ensure usage workers are using them
• Operative guidelines b y states for FSM, incl.
specifications of septic tanks, licensing of • Workers entitled to
desludging operators, safety gear for workers periodical medical
check-‐u ps and
• For contractual operations (e.g. STPs), the terms treatment
include p rovision o f safety gear and tools
• No n ational guidelines for community and p ublic toilet cleaning (devised at ULB level)
• No mention o f cleaning p rocesses for school toilets in the Swachh Vidyalaya scheme
30
(1): M inistry of Railways, (2): M inistry of Environment and F orestry
[Governance] Various ministries are responsible for sanitation within their
respective systems, and they operate in silos
Urban sanitation system Schools Railways
National
Ministry o f Housing
Ministry o f HRD Ministry o f Railways
and Urban Affairs
Organization structure
State Government State Education Divisional Railway

State Sanitation
State
(Council o f Municipal Department Board

Departments
Commissioners)
District Education
Local
Urban Local Body Station Health Office

Office
• Coordinating policies and • Centre: Monitoring • MHRD: directing state • MoR: drawing out G eneral
standardizing operations functioning of ULBs; drafting education depts. for Conditions of Contracts for
between ULBs national standards; financial construction and O&M of O&M, tailored by divisional
• Providing tech and infra support to states/ ULBs school toilets boards
Role
support • State: drafting urban policies; • State education • Station H ealth Office:
financial support to ULBs departments: controlling responsible for cleaning of
• ULBs: implementing policies budgets for school cleaning tracks, platforms, buildings
31
[Governance] The Ministry of Social Justice and Empowerment is tasked with
the welfare and rehabilitation of sanitation workers
Welfare and rehabilitation support to sanitation workers
Ministry o f Social
Justice and
Empowerment
• Founded in 1993; non-‐
statutory and non-‐ • Founded in 1997
National
constitutional body
Organization structure and roles
National Safai • Develop and implement

• Address grievances of National Commission schemes for w elfare and
workers, related to safety, pay Karamchari Finance
for Safai Karamcharis rehabilitation of sanitation
and service and Development workers
(NCSK)
• Ensure implementation of the Corporation • Spread awareness on schemes
2013 Act and the S C among ULBs and w orkers
judgment
• Route financial interventions

• Each state m andated to State Commission for (such as loans) to w orkers,
constitute S CSKs State Channelizing
State
• Only 13 states complied and

Safai Karamchari along w ith regional rural banks
Agencies • Disburse one-‐time-‐cash
have functional bodies1 (SCSK)
assistance
• Register w orkers
Local
Of the four focus states for District o ffice • Drive awareness campaigns
BMGF, only Maharashtra • Last-‐mile implementation
has an active SCSK2
32
(1): Based on interviews conducted with NCSK; (2): NCSK Annual Report 2015-‐16 (latest available)
[Employment] There are six models of employment, with the government
playing roles of varying importance in different types of sanitation work
Government Labour Suppliers PPP/Service Private Operators Households

Contracts
Employer
Managed completely by Contractors only for Multi-‐year service Operations run directly by Households employ
the government, w ith no labour supply; employ contracts private operators for workers directly for short-‐
outsourcing SWs via informal profit; informal term needs
contracts agreements w ith SWs
Septic Tank Septic Tank

Sewer Work Drain Cleaning Railway Cleaning*
Type o f work
Desludging** Desludging
Govt. School Toilet
Sewer Work Treatment Plant Work* Latrine Cleaning
Cleaning
Govt. managed Community/Public
CT/PT Cleaning Toilet Cleaning
• Construct, manage and • Supervise labour • Provide land • Develop guidelines for • Develop specification
Government
maintain the facilities • Provide equipment, • Contract out operation and m onitor
gear, benefits management and • License desludging adherence ( for septic
• Monitor cleanliness maintenance operators tanks)
Stakeholder roles
and operations • Monitor performance, • Monitor operations

adherence to terms
• N/A • Payment channel to • Execute contracts • Generate business • Fulfil household
workers • Provide gear, cleaning • Hire w orkers demand
Non-‐Govt.
• Source replacement agents • Buy gear and

workers w hen required • Construct and equipment for w orkers
maintain facilities
according to S LAs (in
PPP model)
33
*: Contractor changes every 2-‐3 years, while workers remain the same (as per findings from Trichy and Warangal), **: some limited government-‐owned trucks for PTs (in Trichy)
[Employment] Worker remuneration and benefits are primarily a function of
the nature of employer, and is less related to the type of sanitation work
Type o f work Risk to Health Monthly Income (INR) Benefits Working d ays
(Low – High) p.m.2
Contractual Government PF, ESI 1 , etc.
Sewer cleaners 5 – 7.5k 10 – 30k 30
Septic tank
4 – 8k N/A 30
cleaners
Railway track
4 – 10k* N/A 26
cleaners
CT/PT cleaners 5 – 7k 10 – 30k 30
Treatment
8 – 10k* N/A 26
plant workers
School toilet
2.5 – 5k* 2.5 – 5k* 24
cleaners
Drain cleaners 7 – 8k* 10 – 30k 26
Low correlation b etween riskiness and salaries, o r o ther factors like age and experience o f
worker; income systematically h igher for p ermanent government employees
*: S et by state labour departments, they are often lower than state minimum wages (average ~INR 12k); (1): Employee S tate I nsurance; (2): Adjusting for sick 34
days/leaves available; S ource: Estimates of incomes based on interviews in Delhi, Trichy and Warangal; Dalberg analysis
[Manufacturers] Mechanisation is limited to sewer and septic tank cleaning;
generic safety gear is used for all types of sanitation work
CLEANING EQUIPMENT SAFETY GEAR

•1 Machines exist for s ewer and s eptic tank cleaning; •1 Sub-‐o ptimal gear p rovided to workers
limited uptake o f mechanisation for d rain cleaning • A typical kit includes gloves, mask, and a
reflector jacket – whereas an ideal kit should
•2 4-‐5 types o f machines are b eing u sed and are variants also include helmet, boots, oxygen masks (for
of j etting and suction o perations certain types of work), etc.
• These machines come with their limitations and
do not address all use cases •2 Same b asic gear b eing u sed for all types o f sanitation
work
•3 Some localisation has h appened; h owever, n o game-‐ • Lack of nuanced understanding of gear required
changing innovation in this space. E.g., for each type of work
• Three wheeler-‐mounted machines for narrow • 4-‐5 large scale players in the market with
lanes undifferentiated offerings
• Mini-‐jetting machines introduced in Hyderabad
•3 ULB spend o n gear is low
•4 While there are several manufacturers, assemblers • ULBs seem to be spending <1% worker salaries
and d istributors o f these machines, there are s ome b ig on safety gear
players with R&D capability and large p roduction
units; HAL h as b een recently engaged in innovation
Equipment and safety gear for sanitation h as seen little innovation o ver the years,
and current o ptions are s ub-‐o ptimal from a safety p erspective
35
Source: Field research, interviews; Dalberg analysis
[Unions] Workers have some degree of unionisation, with govt. ones having
the strongest ties; demands mostly focus on compensation
Type o f u nion s upport
1 2
Safai Karamchari Political/Caste based

Unions unions
• Municipality workers o n govt. p ayroll • Consisting of all workers, linked by political
Membership (sewer workers, drain cleaners, etc.) support/caste
• Railway workers may have similar unions in • Not specific to sanitation workers
respective junctions • Includes contractual workers
• Delhi Safai Karamchari Union • Madiga Reservation Porata Samithi

Examples • Delhi Jal Board Karamchari Union (~3,5001 ) (Warangal-‐Madiga Community)
• Government School Scavenger Union, • Centre of Indian Trade Unions (CITU)-‐
Warangal (>3,0002 ) affiliated to Communist Party of India (~3 M)
Demands/ • Increase in income, disbursement of salaries • Increase in income, regularization of job
support on time, jobs for dependents, health • Broader asks such as categorization of SCs
benefits
Workers d emands mostly around increase in income, regularization o f j obs and
timely payment; s afety gear and p rocesses s eem to b e low p riority
(1): S ewer Deaths: Don't Engage Untrained Workers, DJB Union Urges Arvind Kejriwal, 2017; (2): Government's move to sack scavengers fires stir; 36
Source: Field research, Dalberg analysis
[CSOs] There are few CSOs focused on SWs, operate mostly at small scale and
typically adopt a rights-‐based approach to the problem
There are few CSOs focused on the issue of unsafe sanitation work
• CSOs have a broader mission-‐focused on lower-‐caste communities, bonded labour, etc. and lack
an explicit focus on sanitation workers
Most are working at the local level at small scale
• Most CSOs are working on a small scale at city, ward or block level
• CSOs not really engaging with stakeholders to enable systemic, large-‐scale change
CSOs adopting a rights-‐based approach

• Awareness creation amongst workers w.r.t. their rights; convincing them to leave profession
• Rehabilitation through vocational training and livelihood programs
Most efforts have had limited impact

• Most interventions have impacted <500 workers
• There is little information on sustainability of these initiatives
37
[Media] Increasing media attention, mostly on the riskiest jobs, has helped
create public awareness and spur government action
Major players Coverage Impact
• NDTV: “Special feature” • Focus p rimarily on sewer • NDTV: 1.56 mn viewers 1
on SWs; Manual and railway workers, • Topic is yet to b e integrated into
Scavenging as a focus potentially due to the mainstream n ews reporting
TV higher riskiness and
theme within sanitation
institutionalised nature of
those jobs
Several p ublications, incl. • Broader coverage than TV, • After the reportage o f d eaths in Delhi, the
Indian Express, Outlook, incl. septic tank cleaners, L.G. announced full mechanisation of
Print (incl. The Hindu, Wire, Scroll STP workers, SWM workers sewer cleaning with violators being
online) • Coverage p rimarily reactive deemed “guilty of culpable homicide”
or incident-‐d riven • NCSK relies heavily o n n ews reports to
track workers, in the absence of a
systematic identification system
Documentaries: Kakkoos • Comprehensive coverage of • Kakkoos: ~500K YouTube views

(2017), Mugamoodi sanitation work across the • Manhole: ~13K YouTube views
(2017), Manhole (2016), spectrum
Film
Fecal Attraction (2011) • Lack a national focus
• Media p ortrays s anitation workers with a b road b rush; n ot n uanced

• Social media coverage o n the topic is infrequent and d riven b y n ews
38
(1): TV v iewership on 16 M ay: Who won the battle?; Source: Dalberg analysis
Table of contents
Our Approach
Key Insights
Next Steps
39
Through in-‐depth research and stakeholder interactions, we uncovered 29
issues that impact worker safety and livelihoods
Dimension What we h ave looked at
1 • Entry into p rofession: Worker mental models

Behavioural • On-‐the-‐j ob: Worker perceptions and behaviours
(7 issues) • Pathways for p rogression: Worker motivations and aspirations
2 • Caste lens: Role of caste in perpetuating unsafe conditions for workers
• Gender lens: Women’s choices and constraints
Social
(8 issues)
3 • Toilet and sanitation system interface and corresponding public behaviour

Infra • Sanitation infra for containment and transport: sewers, drains, septic tanks, etc.
(4 issues) • Cleaning equipment: availability, suitability, etc.
• Safety gear: availability, suitability, etc.
4 • Focus o r p riorities of government on sanitation workers

• Policy d esign
Governance • Financing
(10 issues) • Organisation
• Systems and p rocesses
• Capacity
40
[Behavioural] Familial legacy seems to influence entry into sanitation work,
with the worksite lacking a formal culture of safety
Family and spousal h istory are the key d rivers o f entry
– Most w orkers enter because parents w ere sanitation w orkers as w ell, and have
Entry
internalised a rite of passage

– Workers are pulled into jobs to supplement partners’ S W incomes
Workers feel invisible, o ften o perate without formal contracts, and are
not aware o f terms o f employment
– Lack of proof of w ork and formal identification
– Workers are unaware of payment structures and terms of contracts
On the j ob
Workers are fragmented and lack a u nified voice for collective b argaining
– Workers usually operate in small groups and have low bargaining power
– They have internalised a high displacement rate and are afraid of raising their
voices
Mental model o f s afety is incomplete and h euristic d riven

– Baseline of ‘normal safety’ is very low because of years of inertia
– Conflicting relationship w ith safety gear; not aware of their operationality
41
[Behavioural] Workers perceive occupational health risks to be personal and
lack progression opportunities
Cost o f workplace related injuries and illnesses is internalized and n ot
On the j ob
perceived to b e the liability of the employer

– Have normalized regular illnesses, perceive illness as personal cost
Sanitation workers are risk averse and value assured wages more than
potentially h igher entrepreneurial incomes o r p ersonal safety
– Workers are w ary of outside opportunities, hope to get permanent roles w ithin
Pathways
these jobs
Most s anitation workers are in d ead-‐end j obs without any p athways for
growth and this d ampens ambition
– Caste ceiling to their progression in the job, w orkers can’t get ahead in their roles
42
[Social] The rigidity of caste biases systematically denies other livelihood
opportunities to sanitation workers
Due to u nder-‐employment, sanitation workers p erceive themselves as
disposable and guard even risky sanitation work from o utsiders
– Generations of naturalization have led w orkers to be protective of their jobs from
outside entry
Sanitation workers h ave limited exposure to o ther types o f work and
have an irrationally h igh risk-‐assessment o f external o pportunities
– Artificially high risk perception of the outside world because they lack reference
points
Caste labels p revent sanitation workers from finding employment in

other informal u rban labour markets
Caste
– Highly regimented labour market in urban areas creates rigid barriers to entry for
these w orkers
Sanitation workers are risk averse and wary o f self-‐employment

opportunities d ue to low self-‐efficacy and access to markets
– Workers are sceptical of customer-‐facing businesses and feel like they w on’t be
accepted in the m ainstream
Sanitation workers h ave a low awareness o f livelihood schemes, and are

systematically d enied access
– Given their position in the sub-‐caste hierarchy, they are denied opportunities to
even the caste-‐based schemes
43
[Social] Women face unsafe work environments due to constant interaction
with the public at odd hours, and lack any mechanism to raise issues
Women’s entry into these j obs is compelled b y the n eed to s upplement o r
replace s pousal income
– Women typically end up w orking in these jobs w hen their husbands drop out of
the w orkforce due to sudden accidents
Gender
Women workers are also exposed to an u nfriendly and u nsafe work
environment
– Women lack facilities and face harassment at w ork
Women workers lack “empathetic” s upervision at the workplace

– Only m ale supervisors exist in all types of w ork, and they don’t understand
women’s issues and frequently harass w orkers
44
[Infra] Current sanitation infra regularly puts workers in hazardous
conditions; equipment and gear don’t fully mitigate unsafe conditions
Poor u se o f s anitation systems b y end-‐u sers and the lack o f p ublic
Sanitation sys.
resources exacerbates the p roblem for s anitation workers

interface
– Poor civic sense and lack of resources leads to regular breakdowns that
necessitate m anual intervention
– No disincentives for poor-‐use
Legacy sanitation systems are u nable to h andle the increasing and
Sanitation
changing n ature o f waste and b reak d own frequently

hardware
– Increasing population in urban areas leading to stress on systems

– Higher frequency of blockages and breakdowns necessitates m anual intervention
Machines are n ot d esigned for the full range o f u se cases and p rocedural
bottlenecks in India n ecessitating h uman intervention
Machinery
– Machines are not designed for all types of w ork, don’t work w ell in Indian
conditions and are outdated
– Workers developing artificial relationships w ith m achines
Safety equipment is p rimitive and an impediment to workers

Safety Gear
– Failure to use gear seen as a behavioural problem but gear not suited to nature of
work
– Lack of formal safety culture
45
[Governance] Government agencies are disinclined to acknowledge and
monitor unsafe sanitation work; funding insufficient to affect big changes
There are large incentives for authorities to n ot acknowledge and address
the p roblem o f u nsafe s anitation work
Focus
– Narrow and inconsistent understanding of m anual scavenging among ULBs

– Perverse incentives to identify w orkers, authorities inclined to hide them
The 2013 MS Act widens the scope o f legal engagement with u nsafe
sanitation work b ut h as several loopholes that get exploited
– The Act leaves room for interpretation and doesn’t have proper enforcement and
Policy Design
monitoring provisions
Rehabilitation o r livelihood schemes are n ot d esigned keeping in mind

the u nique n eeds o f d ifferent kinds o f s anitation workers
– Broad brushes in policy design, similar strategies for all w orkers in all contexts
– Over-‐reliance on loan-‐based schemes that aren’t designed properly
Urban local b odies d on’t h ave adequate b udgets for sanitation worker
Financing
safety o r comprehensive mechanisation

– Insufficient spending on gear and equipment: less than 1% of payroll budgets are
spent on gear
– Lower quality m achines are being used due to lack of funds
Ministries employing s anitation workers are o perating in s ilos; u nclear

Org.
responsibility for s anitation worker s afety in u rban local b odies

– Lack of joint solutioning or standardisation between different bodies
46
[Governance] The contractual model of hiring workers is leading to several
accountability challenges; there is poor monitoring of processes
ULBs are increasing their u se o f sub-‐contractors exacerbating the p roblem
for workers
Org.
– ULBs shifting towards contractual m odes of employment

– Contracting processes are inefficient, opaque and ignore w orker safety
Sanitation s ystems are reactive & complaint-‐b ased rather than p roactive
& maintenance-‐b ased; d ata & monitoring are weak d ue to loopholes and
the lack o f o versight
– No m apping of existing systems to aid preventive m aintenance; reactive
Systems & Processes
maintenance soaks up all existing capacity
Processes to avail schemes are arduous and come at a significant cost to
workers; they are d issuaded to claim their rights
– Burden of proof is on sanitation w orkers and processes are tedious
Many workers relapse into s anitation work after h aving b een p art o f an
upskilling p rogram d ue to lack o f o ngoing support
– Workers have to respond to constant financial outflows and there is no effort to
monitor their progress after they undergo rehabilitation
There is a complete absence o f any safety o r o perations training for

Capacity
sanitation workers and their immediate supervisors

– Workers are not m ade aware of occupational risks; even officials don’t have
formal training
47
Table of contents
Our Approach
Key Insights
Next Steps
48
Stakeholders have used various approaches—regulation, mechanisation,
awareness drives—to address the issue, but the problem persists
Governance Infra Behavioural Social
Better sanitation Safety training and Awareness d rives and

Increased regulation
systems d esign orientation p rograms rehabilitation
• MS Act 2013 widened the • HMWSSB introduced • IIHS w hich supports the • SKA has been active in
definition of manual mini-‐jetting m achines for TCC, has conducted: legal advocacy, awareness
scavengers to include preventive m aintenance o Orientation program drives and surveys;
other workers exposed to in narrow lanes for de-‐sludging approach the issue from a
faecal m atter; attempts to operators on safe “caste” or a human rights
fix accountability • Delhi announced plans to sanitation and best angle
achieve 100% practices in de-‐
• In 2014, the Supreme mechanised sewage sludging • Jan Sahas has ben active
Court mandated that cleaning in the city o Training of in awareness drives and
manual sewer cleaning be government officials rehabilitation of w orkers;
made illegal and that on F SM and adopting impacted ~30k workers
ULBs draft plans for a w orker safety lens
mechanization
Current efforts h ave b een somewhat d isjointed — and h ave therefore n ot h ad the
desired impact
HMWSSB: Hyderabad M etropolitan Water Supply and Sewerage Board; IIHS: I ndian I nstitute of Human Settlements; SKA: S afai Karamchari Andolan; NSKFDC: 49
National Safai Karamchari Finance Development Corporation; ASCI: Administrative College of India
These efforts have typically been designed with the intent of realising
extreme scenarios, none of which are likely to get fully realized
Governance Infra Behavioural Social
Scenario 1: Heavy

Scenario 2: Complete Scenario 3: Responsible Scenario 4: Social
regulation and
mechanisation public b ehaviour restructuring
monitoring
Sanitation work is In urban India, toilet Behaviour change takes Caste stigmas melt and
heavily regulated, best interfaces and place “at scale” and workers from other
practices are adopted sanitation hardware are citizens become more castes take up this
by states and ULBs, and upgraded, and cleaning responsible about their profession which is
sub-‐optimal behaviour is completely waste management well-‐paying and
by employers is heavily mechanised, obviating habits thus greatly mechanised; workers
dis-‐incentivised the need for manual reducing blockages in from existing sub-‐castes
intervention and sewers and septic tanks, move to other
eliminating exposure to and workers’ exposure livelihoods
faecal matter to faecal matter in
toilets, drains, etc.
There is need for a b alanced, systemic approach to achieve a combination o f these
scenarios-‐o ur p roposed n ational strategy attempts to d o the same
50
We believe some overarching design principles are important for developing
the national strategy
Acknowledge the p roblem. This is the starting point. Media, CSOs, worker unions,
1
influential agencies and donors can catalyse change
Adopt a “Systems” approach. Holistic approach including technology, infra,

2
governance, and behaviour change, as the problem is multi-‐dimensional
Data, d ata, d ata. Collect real-‐time data on sanitation workers, service providers,
3
and sanitation hardware to enable preventive maintenance and effective response
Design
principles for Ensure s ustainability through economically viable business models, incentive
4
success programs, continuous learning, etc.
Leverage n on-‐government stakeholders. While government can take ownership of

5 and drive the initiative, the private, non-‐profit, and media sectors can play an
important role; community leaders should be leveraged
6 Monitor h onestly. I ndependent regulatory body that has powers to enforce; third
party audits; worker reporting (with whistle-‐blower protection)
7 Evaluate and learn continuously. Evaluate and learn iteratively to redesign and
refine programs
51
We have developed the national strategy assuming that the MoSJE will ‘own’
it, with other ministries playing a significant role in its implementation
• In defining the national strategy, we have assumed that the Ministry of Social Justice and Empowerment
(MoSJE) will “own” it
– MoSJE is a cross cutting ministry and is therefore well positioned to coordinate with the various ministries that employ
sanitation workers
– The Ministry has drafted the Manual Scavenging Act – and has a worker-‐centric view
– The MoSJE already has institutions that can implement and monitor (NCSK, NSKFDC, SCSK, etc.)
• Other ministries, including the Ministry of Housing and Urban Affairs, Ministry of Railways, and Ministry
of Human Resource Development will also play a significant role in program implementation and
funding
– …depending on the nature of intervention (sanitation worker safety V/s livelihoods)
– These ministries will be supported by development and private sector partners
• We have suggested programmatic interventions, an institutional structure, and monitoring, evaluation
and learning (MEL) framework at a high level. These will need to be validated and fleshed out
52
We have organized the strategy along a comprehensive change management
model
1 2 3 4 5
Change Committing Designing Implementing Monitoring and Sustaining
management evaluating
Impact
Time
Components M&E
Vision Program mix Institutional Incentives
structure framework
Targets Roadmap Financing Learning
PMU
53
1. Committing to change
1 2 3 4 5
Impact
Time
Components M&E
structure framework
PMU
54
[Vision] We propose that the government set a bold three-‐pronged vision for
safe and socially inclusive sanitation work
“By 2022, eliminate unsafe sanitation work, ensure financial security and
social inclusion for workers, and provide them equal opportunity
for mobility into other sustainable livelihoods.”
55
to life – an illustrative end-‐state for workers is given below
Infographic: End-‐state for a sanitation worker by 2022
Illustrative
ENTRY ON -‐THE-‐JOB PROGRESSION
1 3 5 7 9
Training: Worker on-‐ Access to redressal Improvement Example-‐setting:
Choice-‐based entry v s. boarded and trained on mechanisms: Worker has in financial Dynamic worker
legacy based entry: health and safety risks, use camaraderie w ith co-‐ security and becomes role
Worker sees stability and of gear and equipment, workers, supervisor, and health: model for others
is offered payment that is and rights and redressal operator; doesn’t feel Worker feels in the system
adjusted for risk; chooses mechanisms discriminated against; healthier;
sanitation w ork from knows that has access to feels
among other viable “safe” platforms to raise financially
alternatives concerns secure as
savings
increase
Access to and use
Registry: Worker of gear: Worker
receives w orker-‐ has regular access Family legacy
4 to full safety gear Family involvement: broken:
friendly and easy-‐
2 Family oriented on the 10 Worker f eels
to-‐understand kit and cleaning Access to other
risks of the job, benefits of comfort that
contract + ID card equipment and livelihood
using safety gear, etc. and children are
uses them 6 opportunities:
kept abreast through not forced to
everyday Worker can upskill,
health updates, etc.
8 start own business do sanitation
work
and try for other
jobs; has access to
recruitment
platforms, capital,
etc.
56
[Targets] The broader vision will need to be translated into short-‐mid-‐long
term goals and milestones which stakeholders can work towards
Illustrative
1 year 3 years 5 years

Goals
• Safety gear for all w orkers w ith • 80% sewer/septic tank cleaning not • Workplace injuries and frequent
training and full clarity on safety requiring any m anual intervention illnesses reduced by 70%; worksite
Safer protocols; start of a formal safety deaths down to zero
• Workplace injuries and frequent
work culture illnesses reduced by 30%
• Safe environment for female w orkers
• Fair w ages for all w orkers: 2x – 4x • Greater sense of financial security
Financial current wages through insurance, PF, etc.
security • Regular and stable payment of w ages
to w orkers
• Migration of 20% of workers to • Successful collective employment

Opportun-‐ other jobs ventures, esp. by w omen groups
ities for • Additional 5% (more experienced • Sustained rehabilitation of young
mobility workers) become m icro-‐ workers; limited relapse into
entrepreneurs w ithin sanitation sanitation
• All w orkers w ith IDs – sense of • Children of w orkers on trajectory • Greater integration in society as
Social acknowledgment and security to non-‐sanitation livelihoods; not job becomes professionalised and
bound to enter sanitation given workers get access to other job
inclusion
familial legacy opportunities
57
[PMU] In our view, transformation will need to be driven by the Minister of
Social Justice, and managed by a PMU housed in the MoSJE
Steering Committee
Headed by the Minister of MoSJE
…with senior representation from the MoHUA, MHRD and Ministry of Railways Advisory b oard
Representatives from m ulti-‐
Role: To provide overall strategic direction and track progress on key metrics on a regular lateral institutions,
basis foundations, NGOs, tech
companies, etc.
Role:
Program Management Unit (PMU)
Illustrative
• To provide subject m atter
Potentially led by Principal Secretary, MoSJE expertise as needed
Comprising mid to senior level officials from the MoHUA, MHRD and Ministry of • To facilitate partnerships
Railways, supported by teams for different work streams
Role of PMU:

• Design and validate programmatic interventions Partnerships
• Design the institutional framework needed to implement programs NGOs, tech companies,
• Design the Monitoring, Evaluation, and Learning F ramework equipment m anufacturers,
• Determine roll-‐out plan skilling providers, etc.
• Forge partnerships
• Secure buy-‐in from and communicate/coordinate w ith relevant stakeholders Role:
• Monitor progress on initiatives and flag delays and risks, along w ith corrective • To support design,
measures implementation, and
• Report developments to the S teering Committee monitoring
58
2. Program design
1 2 3 4 5
Impact
Time
Components M&E
structure framework
PMU
59
[Program mix] To realise the vision, we have identified high potential programs
across the worker livelihood pathway as well as some cross-‐cutting programs
Goals Financial Opportunities

Safer work Social inclusion
security for mobility
Worker livelihood p athway
Entry On-‐the-‐j ob Progression
1.
1 Sanitation Worker Safety Systems Improvement 9 • Employment Connect
Acknowledgment 3• Behaviour Change Program 7 • Reimagining
and Registry for Safety Sanitation Hardware 10 • Enabling
2.
2 Effective Contract 4• Sanitation Worker Sandbox Design Entrepreneurship
Design 8 • Smart Sanitation
Symptoms Redressal System

11 • Breaking the Family
•5 She-‐safe Legacy
6• Issue Resolution
Mechanisms
Cross-‐cutting enablers
12 Improving Access to SC Benefits and 13 Regulatory R evisions 14 Safe Sanitation Public Awareness
Schemes Campaign
These p rograms h ave b een explained o n the s ubsequent s lides
60
[Program mix] Entry
1. Sanitation Worker Acknowledgement

2. Effective Contract Design
and Registry
• National d atabase o f sanitation workers • Worker friendly contracts for all workers. Provisions
o Well-‐funded comprehensive third party survey or to include:
a census across I ndia o Fair wages, escalation clause and P.F.
o Single-‐window for state and city governments to o Mandatory sick leaves, health check-‐ups,
declare number of sanitation workers without allowances; health, accident and life insurance*
fear of repercussions o Safety gear & equipment (make existing
provisions implementable)
• Aadhar-‐linked ID for sanitation workers o Worker rights and issue resolution
o Progression pathways
• SMS alerts at time of registration, payment of salary, • Contracts designed to o ptimise u ser experience
reminders about training, program, etc (regional language, visuals, simplified versions, etc.)
Will provide a sense of identity and serve as a Will formalise employer-‐worker relationship and hold
springboard for other interventions employers accountable
* Health allowances and benefits for both physical and mental health 61
Key intervention
Detailed solutions present in the Annex
[Program mix] On-‐the-‐job (1/3)
Safety
3. Behaviour Change Program for Safety 4. Sanitation Worker Sandbox
• Building a safety culture

o Townhall and demo days between ULBs and
sanitation workers
o Formal training program for new workers and • Platform for conceptualising, p rototyping, and
safety orientation for supervisors commercialising innovations for
o Master trainers to train other workers
o Sanitation hardware design
• Sustaining a safety culture
o Cleaning equipment
o Video-‐based refresher trainings, SMS alerts for
o Safety gear
using gear, worksite visuals
o Role models who use safety gear and equipment o Monitoring equipment (sensors, GPS, etc.)
o Incentives for workers who use gear regularly and o Personal health devices
influence others to use gear
o Family counselling to make families aware of
health risks and importance of using gear
Will build and sustain a formal culture of safety Will lead to contextually relevant innovations
62
Key intervention
Symptoms redressal
5. She-‐safe 6. Issue Resolution Mechanisms
• Tech and infra initiatives: panic buttons and whistles • Anonymised h elpline for workers to report on
for women to raise alarms; information and access to contraventions – e.g., missing gear, lack of healthcare
washroom facilities assistance, lack of equipment
• Trainings: self-‐defence classes for women workers; • CSO-‐led initiative where CSOs call workers on a
gender sensitisation trainings for male supervisors periodic basis to check on them
• Processes: work schedules that are conducive for • Traffic police to issue fines to contractors based on
women; appointment of female supervisors; work-‐site worker complaints
safety audits and modifications
Will lead to a s afer workplace and amicable work

environment for women Will ensure s peedy redressal of worker grievances
63
Key intervention
Systems improvement
7. Reimagining Sanitation Hardware Design 8. Smart Sanitation System
• Identification and resolution

• Upstream h ardware innovation that breaks down o Mobile app to report complaints
waste into less risky components o Sensors, laser, infra-‐red or U.V. rays in sewer
networks to detect blockages
• Installation o f inspection o r d iaphragm chambers at o Tagging of septic tanks to monitor frequency
household and institution connections to the sewer of de-‐sludging
network o GPS-‐fitted vehicles, trucks fitted with CCTV
cameras for real-‐time monitoring of cleaning
• Improvement o f sewer and septic tank specifications
(materials, dimensions, gradients, etc.) to reduce • Tracking
blockage o Control room at ULBs to monitor sewer
network
• Innovation in sewer n etwork d esign (such as o Incident reporting system
connecting manholes to households for accountability) o Strong analytics backend to identify hotspots
in a city
Will improve and upgrade sanitation infrastructure Will create a proactive maintenance system and reduce
reducing the need for manual intervention the need for manual intervention
64
Key intervention
[Program mix] Progression (1/2)
9.
Employment
Employment
Connect
Connect 10. Smart
Enabling
Sanitation
Entrepreneurship
System
• Sources o f j ob o pportunities • Within sanitation

o Incentives to companies for training and hiring o First preference given to SWs to become
sanitation workers (e.g., training under CSR) micro-‐entrepreneurs when processes are
o Reservations for jobs in non-‐WASH sectors mechanised and privatised
• Interventions to facilitate access and transition • Outside sanitation – collective employment
o Time-‐bound monthly stipend for sanitation o Collective employment groups (SHGs) backed
workers migrating to lower-‐paying (but safer) with capacity building support from CSOs;
jobs financing and subsidies; guaranteed purchase
agreements by corporates and government1
o Matching aptitude to job opportunities
• Outside sanitation – individual b usinesses
o Integrating SWs into skilling programs for
Scheduled Castes and under NULM; better o Single-‐window, fast-‐track clearance for loans
targeting through SW registry o Make smaller value loans available
o Widen the portfolio of acceptable businesses
o Recruitment helpline for sanitation workers
Will link sanitation workers with job opportunities Will provide workers with the tools and support needed
elsewhere, and give them s kills to thrive in these j obs to realise business opportunities
65
Key intervention
(1): NSKFDC running pilot on SHG-‐based businesses in four states, can be scaled up; Detailed solutions present in the Annex
[Program mix] Progression (2/2)
11. Breaking the Family Legacy
• Sources o f j ob o pportunities
o Incentives to companies for skilling and hiring
children of sanitation workers
o Reservations for jobs in non-‐WASH sectors
for children of sanitation workers
• Interventions to facilitate access and transition

o Integrating children of SWs into skilling
programs for SCs and for youth under NULM
o Recruitment helpline for sanitation workers
• Better design, targeting and delivery of existing

scholarships and educational loans for children o f
sanitation workers (focus on Class 9 to higher ed)
Will provide children of workers with lucrative
livelihood opportunities
66
Key intervention
[Program mix] Cross-‐cutting enablers
Cross-‐cutting enablers
12. Improving Access to 14. Safe Sanitation Public

13. Regulatory Revisions
SC Benefits and Schemes Awareness Campaign
• SC certificate camps to provide • Well p ublicised (national and

• Detailed multi-‐stakeholder
sanitation workers with international), 360-‐d egree
review o f Prohibition o f
certificates within a short-‐period sustained campaign that h elps
Employment as Manual
of time build awareness and a common
Scavengers and their
understanding o f:
• Sanitation worker IDs to suffice Rehabilitation Act, 2013
for availing SC schemes, if the o Types of sanitation work
• Fast-‐track p rocessing o f p ending and working conditions
worker does not have an SC
court cases o Issues faced by workers
certificate
(financial, social and
• User-‐centred d esign o f schemes
• Information d issemination on health)
and p rocesses to avail the
various SC related schemes such o Interventions required to
schemes
as education, livelihoods, etc. address the above
Will spur government action and

Will lead to improved social welfare Will plug gaps in the current MS Act
mobilise public support for
and integration in society and create worker-‐centred s chemes
sanitation workers
67
Key intervention
[Roadmap] Implementing the SW Worker Registry, creating the SW Sandbox,
and carrying out Regulatory Revisions will unlock other opportunities
Sanitation
Worker
Sandbox
Sanitation Sanitation Smart Issue Breaking the

Public Hardware Sanitation Resolution Family
Awareness Re-‐design System Mechanisms Legacy
Safer Financial Opportunities for Social

Vision for 2022:
Work Security Mobility Inclusion
Effective Behaviour Enabling Employ-‐ Improving

Contract Change for She-‐safe Entrepren-‐ ment Access to S C
Design SWs eurship Connect Benefits
SW Acknow-‐
Pre-‐requisite linkages Interventions Regulatory
ledgement
Revisions
and R egistry
Other dependencies Outcomes
Implementing the ID and registry p rogram and regulatory revisions, for instance,
promise to u nlock several o ther p rograms
68
[Roadmap] While effort on many of these programs can start concurrently,
they are likely to realise benefits at different points in time
Short term (<1 year*) Mid term (1-‐3 years*) Long term (3-‐5 years*)
Programs
Sanitation Workers
Entry Acknowledgement and Effective Contract D esign
Registry
Effective Contract D esign
Issue Resolution Behaviour Change Reimagining Sanitation

Mechanisms Program for Safety Hardware D esign
On-‐the-‐j ob
Smart Sanitation
She-‐safe System
Sanitation Worker
Sandbox
Employment Connect Breaking the F amily Legacy
Progression Enabling
Entrepreneurship
Safe Sanitation Public Improving Access to SC

Cross-‐Cutting Awareness Campaign Schemes and Benefits
Regulatory Revisions
69
* Note: The time periods mentioned here indicate time from the date of initiating effort on the respective programs
[Roadmap] Given the different nature of programs, we suggest implementing
some “at scale” rapidly, while taking a measured approach on others
Refinement o f existing initiatives
or p rograms that b uild o n current Programs that are n ew b ut Programs that are n ew and
momentum relatively easy to implement ambitious
Implement at scale Pilot and scale-‐up rapidly Pilot and scale-‐up cautiously
SW Acknowledgment And Registry Effective Contract D esign

Entry
Behaviour Change Program F or Reimagining Sanitation Hardware

She-‐safe
Safety Design
Illustrative
On-‐the-‐j ob
Issue Resolution Mechanisms Smart Sanitation System
Sanitation Worker Sandbox
Enabling Entrepreneurship
Progression
Employment Connect
Breaking the Family Legacy
Regulatory Revisions Improving Access to SC Schemes

cutting
Cross
and Benefits
Safe Sanitation Public Awareness
Campaign
70
3. Implementing the programs
1 2 3 4 5
Impact
Time
Components Institutional M&E
Vision Program mix Incentives
structure framework
PMU
71
[Institutional structure] To effectively implement and enforce programs,
there is need for a “guardian” body that safeguards the interests of workers
NCSK has no statutory powers to enforce any measures, government agencies tasked with identification of sanitation workers are also their
direct or indirect employers and have perverse incentives to not acknowledge sanitation workers; thus an empowered guardian is required
“Guardian”: Worker welfare

“Employer”: Development and maintenance of sanitation systems and processes, and hiring of workers
and livelihoods
Urban sanitation School sanitation Railways sanitation
Ministry of Social Justice

Ministry of H ousing and
and Empowerment Ministry of H RD Ministry of Railways
Urban Affairs
National
National Commission for

Safai K aramcharis (NCSK) Role of the guardian
1. Policy design 2. Awareness & Welfare 3. Monitoring & Evaluation

• Defining safety standards • Initiating awareness • Maintaining a national
State
State Commission for Safai and benchmarks campaigns amongst database of w orkers
Karamcharis (SCSK) • Developing S OPs, workers and their • Monitoring and
guidelines for sanitation families enforcement of policies
work • Designing training and norms
Sanitation Worker Safety • Designing m odel w orker programs • Reporting to relevant
ULB
contracts • Grievance redressal stakeholders

Cell
• Assisting NSKFDC w ith
rehabilitation of w orkers
New body/ roles
To execute the expanded role effectively, NCSK n eeds to b e given statutory status and enhanced
capacity and b udgets (currently, NCSK’s annual budget is INR7 mn)
Note: We have assumed that the NSKFDC will continue the way it is currently structured, with tighter coordination with the NCSK at the national level and 72
Sanitation Worker Safety Cell at the ULB level
[Financing] An early estimate indicates that ~INR 81 bn, or INR 30,000 per
worker, is required annually for implementing the programs “at scale” (1/2)
Preliminary estimates
Annual costs (INR mn) (2017)
Total annual costs ~11,000 ~70,000
% of total
These solutions will
1. SW Acknowledgment and Registry 0.1% ~60 ~20
require opex to ensure
workers get safety
Entry
2. Effective Contract Design 1.9% ~400 ~1,100 gear and training;

ensuring workers get
3. Improved & fair remuneration 65.6% ~5,300
~53,000 minimum wages and
benefits will require an
4. Behaviour Change Program for Safety 4.5% 0.5 ~3,600 additional ~INR 53 bn
annually
5. SW Sandbox 0.06% ~5 ~40
On-‐the-‐j ob
6. She-‐safe 0.5% ~50 ~330

Systems upgradation
0.2 ~15
will not only make
7. Issue Resolution Mechanisms 0.02%
sanitation work safer
but also improve
8. Reimagining Sanitation Hardware Design 7.1% ~5,200 ~500
maintenance of
existing sanitation
9. Smart Sanitation System 5.7% ~4,000 ~600 systems
Indicates high funding requirement Amortised capex Opex

73
Note: Budgets are indicative to show magnitude of funding; Costs based on existing number of workers, infrastructure, does not account for change in
number of workers, economies of scale and change in infrastructure; Source: Dalberg analysis
[Financing] An early estimate indicates that ~INR 81 bn, or INR 30,000 per
worker, is required annually for implementing the programs “at scale” (2/2)
Annual costs (INR mn) (2017)
Total annual costs ~11,000 ~70,000

Alternative livelihoods will
% of total require spends on skilling
and capacity building;
10. Employment Connect 0.7% ~550
limited capex will be
Progression
required since existing infra

11. Enabling Entrepreneurship 1.6% ~1,000 ~300 can be utilised; for
entrepreneurship, major
12. Breaking the Family Legacy 12.1% ~9,800 outlay will be on capital and
interest subsidy for loans
13. Improving Access to SC Schemes 0.19% ~150
Cross-‐cutting
and Benefits
Cross-‐cutting solutions will
14. Regulatory revisions -‐ Minimal
require minimal spend
15. Safe Sanitation Public Awareness 0.05% ~40
Campaign
Indicates high funding requirement
Note: Budgets are indicative to show magnitude of funding; Number of workers moving out is calculated based on change in systems in the next five y ears
74
which may displace workers (please see upfront section for details) and assuming an additional 5% workers might leave v oluntarily; For family legacy it is
assumed scholarships are for students from class 9 till college and skilling for students that do not complete their education; Source: Dalberg analysis
[Financing] Eight high-‐impact programs can be run across the country for
approximately INR 730 mn annually. Three others for another INR 3,360 mn.
Easily accomplished within existing Accomplished with minor b udget Need major b udget increases
budgets amendments
SW acknowledgment Employment Reimagining

~60 ~20 ~550 ~5,200
and registry connect hardware design
~500
She-‐safe ~50 ~330 Enabling Smart sanitation
~1,000 ~300 ~4,000
entrepreneurship system
Issue resolution ~600
mechanisms 0.2 ~15
Effective Breaking the
contract ~410 ~1,100 family legacy 0 ~9,800
Regulatory revisions Minimal (deployment)
Behaviour
Safe sanitation public change 0.5 3,600
0 ~40 program
awareness campaign
Sanitation worker
~5 ~40 Improved & fair ~53,000
sandbox
remuneration
Improving access to

SC benefits 0 ~150
Effective contracts
~10
(design)
(All figures in INR m n)
Total
(Recurring, annual 720 m n 3,360 m n 76,700 m n ~ 81 bn
funding required)
Note: Budgets are indicative to show magnitude of funding; Costs based on existing number of workers, infrastructure, does not account for change in 75
[Roadmap] An outlay of INR 570 mn in the first year would be adquate to
make substantial progress across India through seven programs
Short term (<1 year*) Mid term (1-‐3 years*) Long term (3-‐5 years*)
Programs
Sanitation Workers
Entry Acknowledgement and Effective Contract
Registry (80) Implementation (1510)
Effective Contract D esign

(10)
Issue Resolution Behaviour Change Reimagining Sanitation

Mechanisms (15) Program for Safety (3600) Hardware D esign (5700)
On-‐the-‐j ob
Smart Sanitation
She-‐safe (380) System (4600)
Sanitation Worker
Sandbox (45)
Employment Connect (550) Breaking the F amily Legacy

(9800)
Progression Enabling
Entrepreneurship (1300)
Safe Sanitation Public Improving Access to SC

Cross-‐Cutting Awareness Campaign (40) Schemes and Benefits (150)
76
[Roadmap] Seven of these initiatives could be combined into a “single-‐
window” helpdesk for sanitation workers and delivered in stages
Sanitation Workers
Acknowledgement and Employment Connect
Registry
Effective Contract D esign Enabling

Entrepreneurship
Issue Resolution Improving Access to SC

Mechanisms Schemes and Benefits
Breaking the F amily Legacy
77
[Financing] A majority of funding will need to be publicly funded.
Philanthropic capital can fund innovation and advocacy
Source o f capital Types o f expenditure
• Centre: AMRUT and NSKFDC budgets can be utilised for funding sanitation hardware and
Central and State livelihoods programs, scholarships for students, etc. NSDC budgets can also be leveraged
Governments for skilling
• States could potentially fund capital subsidy on loans via SC schemes, and scholarships for
students
• ULBs, Railway Divisions, and school education d epartments o f states to fund safety gear,
ULBs
trainings
• Foundations could fund public awareness campaigns, and innovation in cleaning

Philanthropic capital
equipment and safety gear (sandbox)
(Foundations, CSR)
• CSR can be leveraged for skilling sanitation workers
• Operators to fund tagging of GPS, and fitting CCTV cameras on desludging vehicles (as
User Fee
part of Smart Sanitation System)
(Households and
• Households to part fund installation of diaphragm chambers (to block unwanted materials
Operators)
from entering sewers)
Note: Budgets are indicative to show magnitude of funding; Costs based on existing number of workers, infrastructure, does not account for change in 78
[Roles] While government will take ownership of programs, the development
and private sector can play a complementary role
Government Development sector Private sector
Policy d esign CSOs Manufacturers and innovators

o Design relevant policies, o Conduct research to gather o Develop and scale relevant
schemes, programs evidence on issues and innovations
interventions and report on their
Implementation and monitoring efficacy Media, communications agencies
o Build capacity, allocate budgets o Support on-‐ground o Provide sustained commitment to
and raise funds to implement implementation of safety and the SW issue
the programs livelihoods programs o Design and execute smart and
o Monitor continuously to o Build government capacity effective communication
enforce and refine
Foundations Other p layers
Ecosystem b uilding o Advocacy o Skilling providers to skill workers
o Incentivise private sector to o Organise convenings to spread on alternative job opportunities
create relevant systems, gear awareness o Technology players to develop
and equipment through large o Facilitate partnerships and integrate I T infra, processes
scale orders, better-‐designed o Capacity building through and systems (database, control
tenders, etc. assistance at the ULB level room, etc.)
79
4. Monitoring and evaluating change
1 2 3 4 5
Impact
Time
Components M&E
structure framework
PMU
80
[M&E framework] The MoSJE should put in place a robust M&E framework
Design principles
Metrics: Design a robust monitoring framework incorporating important outcome,

1 output, process and input metrics, linked to goals and milestones (illustrative metrics
given on next slide)
Validity of d ata: Capture data from multiple sources so as to be able to triangulate and
2 validate; in addition to monitoring by government officials, sources could include third
party audits, user feedback, field observations, feedback from families, citizen reporting,
etc.
Frequency: Ensure balance between providing sufficient time for action and timely course
3
correction; some metrics can be monitored more frequently (e.g., use of safety gear),
Design
some may take more time to be realised (e.g., worker health)
principles
4 Recommendations: Make actionable findings available to the right stakeholders in the
appropriate format; hold people accountable to outcomes
Team: Set up a dedicated team that “owns” monitoring and evaluation, i.e. developing the
5 framework, ensuring timely collection of data, running analyses, and making findings
available to stakeholders (team could potentially be housed in the NCSK, with
representatives and coordinators at the state and city-‐levels)
6 Budgets: Earmark sufficient funding for M&E, say ~INR 300mn annually
x Design related principles
81
[M&E framework] Illustrative metrics and potential sources of data are given
below
Illustrative
Impact Effectiveness Efficiency Sustainability
How h as sanitation Have o perational What is the o perational Are there adequate systems
workers’ lives improved? targets for p rograms and financial efficiency and capacity to ensure
been achieved? of meeting the targets? program sustainability?
-‐ Health (e.g., reduction -‐ % cleaning jobs that -‐ Time to achieve -‐ Adequacy of staffing
Parameters
in frequency of illness, have been program targets vs. -‐ Viability of business
reduction in injuries, mechanized planned models (if applicable) or
deaths) -‐ % workers with -‐ Cost to achieve availability of sustained
-‐ Financial (e.g., increase safety gear program targets vs. funding
in absolute pay, -‐ % workers trained planned -‐ Degree of stakeholder
increase in benefits) -‐ Adherence to SOPs buy-‐in
-‐ Social (e.g., satisfaction -‐ No. of citizen -‐ Institutionalization of
of workers) complaints w.r.t. processes
sewer blockages
• Data from SW

Safety Cells (at • Data from SW
Data sources
• Government d ata
ULB level), Safety Cells (at ULB
• Third-‐p arty research
aggregated b y level), aggregated • Third-‐p arty audit
and safety audits
NCSK by NCSK
• SW feedback
• Third-‐p arty audit • Third-‐p arty audit
• SW feedback
82
5. Sustaining change
1 2 3 4 5
Impact
Time
Components M&E
structure framework
PMU
83
[Incentives] Well-‐designed incentives can motivate stakeholders to act
towards making sanitation safer, sooner
Illustrative
Incentive Description Examples
• Develop "leaderboard" to track city-‐wise status on safe Swacch Sarveskshan ranks
1 cities on ODF status
sanitation. This w ill foster a competitive environment
“Race to safe among ULBs
sanitation” • Incorporate cleaning process or sanitation w orker-‐related
parameters under Swacch Sarvekshan
ISC-‐FICCI awards to recognise
2 stakeholders in sanitation
• Conduct national awards ceremony to recognise ULBs,
Safe s anitation awards officials, and organizations that are doing impactful and On Civil Services Day, PM gives
innovative w ork to m ake sanitation safer awards to officials for
excellence in implementation of
priority programmes
3 • Provide conditional financing -‐ ULBs are disbursed m oney Goldman Sachs invested in a
Outcome-‐b ased under AMRUT only if certain safe sanitation standards are program aimed at reducing the
met ( e.g., adequate gear, m echanised cleaning processes) recidivism rate for adolescent
financing
• Introduce social impact bonds where govt. pays lesser offenders in New York-‐ the
interest to the investor if certain positive outcomes have Department pays only based on
been m et reduced re-‐admission
4 • Recognise ULBs w hich are practising safe sanitation as

“Model City” “model cities” – and encourage them to disseminate their HMWSSB is helping the Delhi
recognition practices and findings, and “mentor” other cities Jal B oard adopt
mechanisation for sewer
cleaning
84
[Learning] Continuous learning will help refine and improve programs
Key principles
Diagnosis o f success d rivers and challenges/ risks

• Analyse data generated through the monitoring and evaluation framework (see M&E section) to
diagnose what is working well and areas for improvement
• Modify and re-‐design policies and programs, as required, basis learning
Knowledge b uilding
• Participate in conferences and seminars on the subject
• Conduct learning tours to other countries and cities, visits to organizations that are doing
innovative and impactful work in the space
• Invite experts from other sectors (e.g., mining, construction) and geographies (e.g., Bangladesh,
Malaysia) to learn about best practices that can be applied in the sanitation worker context
Knowledge capture and d issemination

• Document initiatives that are working well – along with their success enablers and design
principles – to inform policy and program design, going forward
• Disseminate key learnings to other cities, states, and nationally
• Disseminate information to stakeholders – workers, contractors, households – via public reports
• Encourage media coverage of initiatives
85
Table of contents
Our Approach
Key Insights
Next Steps
86
A commitment of ~ INR 80-‐100 mn from
philanthropic sources could kick start
several high-‐impact initiatives
across the country.
87
There are some tangible steps that BMGF can take over the next 6-‐12 months
to catalyse change
1 2 3
(3 months) (6 months) (12 months)
• Organise convenings for • Kickstart city p ilots in Trichy • Ramp-‐u p activities in Trichy
sensitizing and mobilizing and Warangal and Warangal; d ocument
ecosystem players. learnings and scaled to o ther
• Build info d issemination cities
• Plan the city p ilots: develop platform on the issue –
detailed implementation plan website, social media, press • Initiate advocacy with key
for Trichy and Warangal briefings. government stakeholders
(Ministry of Social Justice and
• Advocate for d edicated • Make the first s et o f Empowerment, Ministry of
program and fund to focus on innovation grants focused Housing and Urban Affairs)
this issue. on this
• Create coalition focused on • Scale the coalition in the

sanitation worker safety private sector, civil society,
and public sector
88
Coordination with two Ministries and State Governments will be vital for the
first set of seven programs
MoHUA MoSJE State Governments
SW Registry
She-‐Safe
SW Issue Resolution Mechanisms
Sanitation worker sandbox
Public awareness campaign
Improved access to SW benefits
Dalberg recommends a cross-‐cutting multi-‐d isciplinary group b eing setup

in the very n ear term.
89
Annexure: Personas
90
Reluctant inheritor − forced into the profession due to the death of the
primary income earner in the family
Reluctant Key identifiers

• Gender: Female/Male
inheritor • Age: 25 years and above
“ • Education: Limited ~10%
• Types of work: Railways cleaning, drain cleaning, sewer cleaning
• Employer: Contractor/government
Livelihood p athway
ENTRY ON-‐THE JOB PROGRESSION
Background Work environment Motivations/outlook

• Worker w ho is doing • Camaraderie w ith co-‐ • Needs assured income to
this job due to workers; w orks in provide for the family
primary earner’s large groups, w ith • Risk-‐averse
demise/immobility people from the same Aspirations
community • Not thought about
• Aware of the issues moving to other jobs
“My husband is an alcoholic and is not that come w ith the because values a stable
earning anything. I have been job but conscious of income
supporting the family for many years family responsibilities • Wants to educate
now.” children to higher levels
to break out of the
sanitation trap
91
Complacent part-‐timer − content in current work environment and does not
want to move out of the current job
Complacent Key identifiers

part-timer • Gender: Female and m ale
• Age: 20 – 35 years
• Education: Limited ( up to class 8) ~30%
“
• Types of work: School toilet cleaning, CT cleaning
• Employer: School authorities, community toilet operators
Livelihood p athway

• Young m an/ • Works in relatively less • No compelling
woman, typically hazardous, friendly reason to change
doing the job for environments status quo
5+ years • Not getting paid m uch • Complacent; not
• Job is his/ her but has a sense of ambitious
primary source of belonging w ith co-‐ Aspirations
“I like working here, I feel attached to income workers/supervisors, • Sees
has developed a good himself/herself
the children. Even the teachers are v ery
rapport continuing w ith
friendly towards me” • Interacts w ith the this job for the
larger community-‐not next few years
restricted to sanitation
workers
92
Caged bird − started sanitation work because of “family legacy”, but is
inclined to move out of sanitation
Caged bird Key identifiers

• Gender: Male
• Age: 18-‐21 years
“ • Education: Class 8 and above (might be simultaneously pursuing ~5%
higher education)
• Types of work: Sewer, septic tank, PT cleaning
• Employer: Private business/Contractor
Livelihood p athway
Background Motivations/outlook
Work environment
• Young m ale, • Wants to be respected
• Dissatisfied w ith the
recently entered in the society; believes
current job and
the occupation a w hite-‐collar job w ill
understands that it
through informal help him achieve that
is hazardous – but
networks; • Optimistic about his
compelled to
“I want to do a white-‐collar job. S ome apprentice to future
supplement his
experienced Aspirations
people in my community have moved to family’s income and
workers • Sees himself doing a
other jobs s uch as that of a railways has easy access to
the job because of white collar job ( e.g.,
engineer. I want to do that.”
relatives/family BPO) in 2-‐3 years, but
members w orking unaware of
in sanitation opportunities and
pathway to pursue any
opportunity
93
Trapped traditionalist − has been doing the job for many years and living in
the false hope of the job becoming permanent
Key identifiers
Trapped
• Gender: Female and m ale
traditionalist • Age: 35 years+
“ • Types of work: Sewer cleaning, S TP cleaning, railways cleaning
and drain cleaning
• Employer: Private contractors/operators
Livelihood p athway

• Experienced • Works in extremely • Is not open to other jobs
worker, been hazardous because of the switching
doing this for 10-‐ environments cost ( unlearning the existing
15+ years • Benchmark of safety is job and going to an unknown
• Entered the very low-‐considers environment)
“I do this j ob daily thinking I will become profession missing w ork due to • Lives in false hope that the
permanent one day in this j ob. I only because either fever and body aches job w ill become permanent
want a govt. j ob and/or an increase in got displaced (on a m onthly basis) one day; optimistic that it
my income” from agriculture to be normal will happen
or followed • Incurs significant Aspirations
parents’ medical expenses • Wants children to m ove out
sanitation jobs • Feel helpless as can’t of sanitation and is ensuring
raise issues to anyone they at least complete their
education
94
Transient hustler − looking for the “next best thing”, sanitation work is just
one of the many jobs for him
Key identifiers
Transient
• Gender: Typically m ale
hustler • Age: 21-‐30 years
“ • Education: Limited ( up to class 8) ~10%
• Types of work: CT cleaning (typically)
• Employer: Private operators
Livelihood p athway

• Been doing this • Works in relatively a • Has no particular
job for m aximum less hazardous attachment/sense of
2-‐3 years environment belonging to the job
• Came into • Keeps to himself, does • Always looking out for
sanitation looking not interact w ith the “next best thing”
“I was a mechanic earlier, then I went to
for the best others • Risk-‐taking, ready to
the railways. Now I clean the CT during livelihood option, move out of this job
the day and at night I hold the lights in a given limited skills • Leverages informal
wedding procession. Wherever I can get and education networks to source jobs
a decent earning, I’ll go there” • Sanitation jobs Aspirations
might be one of • Wants to do a job that
the m any jobs he pays w ell-‐indifferent to
is currently the type of w ork
pursuing
95
First among equals − sanitation worker on government payroll, whose job is
coveted by other workers for its higher and assured income
Key identifiers
First among
• Gender: Male and female
equals • Age: 40+ years
“ • Types of work: Sewer w ork, drain cleaning
• Employer: Government
Livelihood p athway

• Been doing this • Sense of attachment • Understands the
job for several to the w orkplace, unsafe/undignified
years, perhaps a working w ith aspect of the job but
decade or m ore supervisors and other values the higher and
• Permanent govt. workers for m any assured income
“I have been watching my mother do employee years; part of the
this j ob since I was a child. That’s how I • Parents w ere worker union Aspirations
likely sanitation • Heuristics driven • Does not have aspirations
got into it but my s ons are not going to
workers mental m odel of to exit the job
do this j ob. I am sure of that.” safety • Wants children to break
• Earns ~3x of w hat out of the family’s
temporary w orkers sanitation legacy
earn and has job
security
96
Annexure: Solutions
97
[Entry] Sanitation Worker Acknowledgement and Registry
Will provide a sense of identity and serve as a springboard for other interventions
DESCRIPTION WORKERS IMPACTED (100%)

Acknowledgement 1. Types
Types oof f wwork
ork All
Employer Gender
• Well-‐funded comprehensive 3rd party survey or census to 2. Gender Male and F emale
identify number of w orkers in different states, cities, and
districts 3. Employment nature Contractual and Permanent
4. Personas All personas
• Single-‐window for state/city governments to declare
number of sanitation w orkers w ithout fear of repercussion SIMILAR INITIATIVES1,2
Registry • 3rd party survey: In Nov 2017, MoSJE decided to undertake a
The survey and declaration w ill enable: nationwide survey by a third-‐party to account for w orkers
• Aadhar-‐linked ID for sanitation w orkers cleaning dry latrines, open drains, pits, railway tracks, septic
• National database of sanitation w orkers, containing: tanks and sewers; survey to be completed in six months
o Demographic and contact information
• ID cards: No exact comparable but efforts have been tried w ith
o Type of w ork
Los Angeles’ w aste w orkers w here hiring is done only through
o Employer details
unions and unions mandate registration of all w orkers
o Family information
• SMS alerts to w orkers:
o Registration
SUCCESS ENABLERS
o Payment of salary
o Attendance • Third party involvement to ensure unbiased, swift data collection
o Training programs • Empowered host organisation ( Sanitation w orker unit) that can
o Schemes coordinate across m inistries ( urban devt, railways, schools)
• Sophisticated IT infrastructure across levels ( Centre, S tate, ULB)
Level o f o wnership Timeframe for implementation Funding required
City State National <1 year 1-‐3 years 3-‐5 years Low Medium High
<INR 100M INR 100M – 1B >INR 1B
98
Funding figure is a high level estimate to indicate scale of funding; M oSJE: M inistry of S ocial Justice and Empowerment; Source:(1): Manual scavenging law to
be amended to hike compensation for deaths; Indian Express, 2017 (2)-‐Cleaning Up Waste” LAANE 2015; Dalberg analysis
[Entry] Effective Contract Design
Will formalise employer-‐worker relationship and hold employers accountable
DESCRIPTION WORKERS IMPACTED (~90%)

Worker-‐friendly contracts for all workers, provisions include: 1. Types
Types oof f wwork
ork All types oGender
Employer f w ork except latrine cleaning
• Fair w ages 2. Gender Male and F emale
• Escalation clauses Contractual and Permanent
3. Employment nature
• Provident Fund
• Mandatory sick leaves
• Health, accident and life insurance
SIMILAR INITIATIVES1
• Bi-‐annual health check-‐ups, allowance for m edicines
and m ental health counseling Zero Waste LA S ystem has mandatory contracts with fair terms
• Information on protocols, safety gear and equipment that promote waste workers’ safety and improve quality of life-‐:
o Worker training and safety gear
• Worker rights ( refusal to w ork in case of unsafe
o Provisions regarding living w ages; compliance w ith m inimum
conditions, access to gear and equipment, timely
wages; health benefits ( insurance & check-‐ups)
payment of salaries, etc.)
o Worker retention clauses to protect against indiscriminate firing
• Issue resolution or escalation m echanisms
SUCCESS ENABLERS
Contract designed in a way that it is easy to understand for
workers. Possible features could include: • Investment to create user experience optimised contracts
• Use of regional language • Contextualised contracts ( minimum w ages according to states,
insurance schemes, etc.) to be applicable at the ULB level
• Visuals to account for low-‐education levels of w orkers • “Safety officer” at ULB level to ensure enforcement of provisions
• Condensed version of a m ore lengthy formal contract • Sufficient funding to accommodate provisions
99
Funding figure is a high level estimate to indicate scale of funding; S ource: (1)-‐Cleaning Up Waste” LAANE 2015; Dalberg analysis
[On-‐the-‐job] Behaviour Change Program for Safety
Will build and sustain a formal culture of safety
Building a safety culture
1. Types
Types oof f wwork
ork All types oGender
Employer f w ork except latrine cleaning
• Townhall and demo days held by ULBs for sanitation
workers to demonstrate commitment to safety and secure 2. Gender Male and F emale
worker buy-‐in on use of gear and equipment 3. Employment nature Contractual and Permanent
• Formal training program for new w orkers, including 4. Personas All personas
simulation-‐based training for risky jobs
• Master trainers ( potentially informal leaders from groups)
to train w orkers on safety and use of gear SIMILAR INITIATIVES1,2
• Standardized safety orientation for supervisors and officials • Coal Mining in India: Workers take oaths and safety pledges at
the start of work-‐days; refresher trainings for w orkers/officials;
Sustaining a safety culture simulator trainings for w orkers operating heavy machinery
• Video-‐based refresher trainings, SMS alerts for using gear • Shell has introduced a wireline simulator to train well
engineers in Malaysia
• Worksite visuals for reinforcement ( signs indicating proper
o Replicates conditions in w aters and simulates various safety
protocol for jobs, implications of not using gear, etc.)
challenges that could occur
• Role models w ho use safety gear and equipment
• Incentives for workers who use gear regularly and SUCCESS ENABLERS
influence others to use gear • Well-‐designed training program and visuals, contextualised at
• Family counselling to m ake families aware of health risks state or ULB levels
and importance of using gear • Penalties for not complying w ith safety training
• Identification of influencers in w orker groups and communities
Funding figure is a high level estimate to indicate scale of funding; S ource: (1): Learning to drill deeper and more safely, S hell; (2): Coal India S MP 2014; 100
Dalberg analysis
[On-‐the-‐job] Sanitation Worker Sandbox
Will lead to contextually relevant innovations

Platform for conceptualising, prototyping, and commercialising 1. Types of work All
Types of w ork Employer Gender
innovations for sanitation hardware design, cleaning 2. Gender Male and F emale
equipment, safety gear, monitoring equipment (sensors, G PS,
3. Employment nature Contractual and Permanent
etc.) and personal health devices
• Solution generation
o Innovation prizes and challenges that lead to the SIMILAR INITIATIVES1,2,3
design of relevant solutions, w here even governments
can ask innovators to develop solutions for specific • Swachh Bharat H ackathon organised by MoDWS in S ep 2017 to
problems ( suction m achines for narrow lanes, etc.) crowdsource solutions for sanitation and hygiene challenges
• HAL is developing a signal system to identify open manholes,
o Solution testing and commercialisation geotag them and check for breakages; also developing a
o Start-‐ups, entrepreneurs, academic institutes and sewerage safety suit relevant for Indian context
even international m anufacturers can test their ideas • Some innovations are being developed at small scale and can be
in real-‐word settings and get feedback from w orkers, given an impetus through the sandbox. E.g., G enrobotics,
supervisors, etc. founded by eight engineers, has designed a robot named
Bandicoot for eliminating sewer deaths in Kerala1
o Pitch competitions or exhibitions where ULBs can
place orders, m anufacturers can purchase innovations
SUCCESS ENABLERS
o Innovation fund to support funding for promising
ideas, competitions, and behaviour change programs • Host institution w ith state-‐of-‐the-‐art tech facilities ( E.g., IIT)
for adoption of ideas • Buy-‐in from ULBs to test innovations
• Strategy to crowd-‐in innovators, which are currently limited
Funding figure is a high level estimate to indicate scale of funding; S ource: (1): S wachhathon 1.0 receives massive response from young innovators of the 101
country, 2017; (2): HAL to help Water Board in manhole maintenance,2017; (3): Kerala start-‐up has tech solution to sewer deaths, 2017; Dalberg analysis
[On-‐the-‐job] She-‐safe
Will lead to a safer workplace and amicable work environment for women
DESCRIPTION WORKERS IMPACTED (50%1 )
Tech and infra initiatives 1. Types

Types oof f wwork
ork Drain cleaning,
Employer Gender railways track cleaning
and CTC/PT cleaning
• Panic buttons and whistles for w omen to raise alarms
• Anonymous helpline for w omen to raise complaints, 1. Gender Female
coupled with fast-‐track redressal Contractual and Permanent
2. Employment nature
Trainings All personas ( females)
3. Personas
• Self-‐defence classes for w omen w orkers
• Gender sensitisation trainings for m ale supervisors
SIMILAR INITIATIVES2,3
Processes
• Female R ohingya refugees in B angladesh have been given a rape
• Work schedules that are conducive for w omen ( e.g., avoid
alarm, a small hand-‐held device w hich gives off a high-‐pitched
late nights and early m ornings)
ambulance wail at the press of a button (Nov, 2017)
• Appointment of female supervisors from w ithin the • Meghmani F inechem, adopted a m ultipronged approach:
worker group; number can be determined as a ratio to o Separate bathroom and lockers for w omen
female w orkers o Flexible w ork polices to avoid w omen w orking night shifts
• Work-‐site safety audits and m odifications ( such as lighting
in dimly lit areas, surveillance cameras, etc.)
SUCCESS ENABLERS
• Bi-‐annual third party surveys to get feedback on
workplace safety • Buy-‐in from contractors and supervisors w ho m ight be reluctant
to implement this, as they are m ostly m ale
• Robust m onitoring and feedback systems for gauging
effectiveness of and enforcing initiatives
Funding figure is a h igh level estimate to indicate s cale of funding; Source: ( 1): 5 0% d rain cleaners and 2 0% railways cleaners and CT cleaners h ave been assumed to b e women b ased 102
on our field research findings; ( 2): Employing women catalyzes change at a chemical p lant in India; IFC; (3): ‘Rape alarm’ for Rohingya women, Daily Star, 2 017; D alberg analysis
[On-‐the-‐job] Issue Resolution Mechanisms
Will ensure speedy redressal of worker grievances
Helpline support system 1. Types

Types oof f wwork
ork All
Employer Gender
Grievance redressal is currently carried out by NCSK on the 2. Gender Male and female
national level through an inefficient and slow process
involving w ritten representations. It can be optimized w ith
the following provisions: 4. Personas All personas
• Anonymised helpline (perhaps hosted under the ULB-‐
level safety officer) for w orkers to report
contraventions such as m issing gear, lack of healthcare SIMILAR INITIATIVES1
assistance, w age theft, unsafe w ork environment etc. • CHILDLINE is India’s first 24 hour, free, emergency phone service
for street and railway children in need of aid and assistance-‐
• MIS to track number, nature and status of redressal of team rushes to child w ithin 60 m ins and provide immediate
complaints, action in case complaint not closed w ithin support and long-‐term rehabilitation; operates in 366 cities and
given a time period (specified for different types of districts
complaints)
• CSO-‐led initiative w here local CSOs can call w orkers

periodically and report back on their status SUCCESS ENABLERS
Fine system • Awareness of helpline number and recall

• Traffic police and other law enforcement officials to • Availability of regional language speaking operators
issue fines immediately to contractors based on • Strong back-‐end system to ensure calls are received and issues
workers’ complaints resolved; regular training of operators
103
Funding figure is a high level estimate to indicate scale of funding; S ource: (1): CHILDLINE website; Dalberg analysis
[On-‐the-‐job] Reimagining Sanitation Hardware Design
Will improve sanitation infrastructure, reducing the need for manual intervention
Design of infrastructure can be improved to reduce instances of 1. Types
Types of workEmployerSewer,
of w ork drain and septic tank
Gender
blockages and need for manual intervention 2. Gender Male and F emale
Illustrative hardware design improvements for sewer networks:
4. Personas All except complacent part-‐timer
• Installation of inspection or diaphragm chambers at household
and institution connections to the sewer network to filter out
unwanted m aterial SIMILAR INITIATIVES1
• Innovation in sewer network design
o Upstream hardware innovation that breaks down w aste, • Malaysia: National research and development centre for
both allowing for easier m ovement sewer network design, m aterials, etc. Innovations in
sewer design is one of the factors that led to a 7% annual
o Connection of m anholes directly to households for increased
reduction in complaints
accountability
o Dimensions and gradients based on expected volume and
speed of w ater to reduce blockage
SUCCESS ENABLERS
Illustrative hardware design improvements for septic tanks:
• Rigorous testing in the Indian context (high density urban
• Septic tank improvements to account for inconsistency of sludge areas) before “scaling up” interventions
due to unwanted w aste m aterials ( e.g., kitchen w aste, etc.) • Building case for households to invest in the infra
104
Funding figure is a high level estimate to indicate scale of funding; (1): I ndah Water Konsortium Reports 2010 and 2016; Dalberg analysis
[On-‐the-‐job] Smart Sanitation System
Will reduce the need for manual intervention in sewers, septic tanks and drains
Identification of issues and blockages in the sanitation system 1. Types

Types of workEmployerSewer,
of w ork drain and septic tank
Gender
• Mobile app for citizens and staff to log complaints about 2. Gender Male and F emale
blockages in sewer systems, drain overflow, etc.
• Use of sensors, lasers, etc. in sewers to detect blockages
4. Personas All except complacent part-‐timer
• Tagging of septic tanks to m onitor frequency of de-‐sludging
Resolution of issues SIMILAR INITIATIVES1,2
• Vehicle tracking via GPS • HMWSSB has introduced multiple such initiatives
• Real-‐time m onitoring of sewer cleaning via CCTVs on vehicles o Citizens can report overflows and blockages using an
app called JAL ( Jaldi Action Le)
• Sewer m onitoring equipment and screens fitted to vehicle o App-‐based navigation and m onitoring of assignments;
Tracking pictures taken before and after each unblocking
• Control room at city-‐level to view the entire sewer network
• Malaysia: 1) CCTVs for sewer inspections; 2) data-‐based
• Robust MIS where all cleaning jobs are assigned IDs; monitoring of desludging based on database of septic
resolution status and time, comments, and next steps logged tanks in households and centralised system for
• Strong analytics backend to identify ‘hotspots’ (i.e. those desludging requests; 3) G PS-‐fitted vehicles
parts of the sewer and drain networks that give the m ost
problem) for proactive upgradation and m aintenance SUCCESS ENABLERS
• Adoption by users, w ho are not necessarily tech savvy
• Strong business case for m aking these investments
Funding figure is a high level estimate to indicate scale of funding; HMWSSB: Hyderabad M etropolitan Water S upply and S ewerage Board; Source: (1): Expert 105
interviews; (2): I ndah Water Konsortium Reports 2010 and 2016; Dalberg analysis
[Progression] Employment Connect
Will provide workers with access to lucrative, safer job opportunities

Sources of job opportunities Types of w ork
1. Types of workEmployerAll Gender
• Incentives to companies for skilling and hiring sanitation
2. Gender Male and F emale
workers; provisions such as tax rebates or qualification of spend
3. Employment nature Contractual (permanent unlikely to
as CSR can be provided as incentives
move out)
• Reservations for jobs for sanitation w orkers in non-‐WASH 4. Personas
Caged bird and transient hustler
sectors ( public sector units, m id-‐day m eal cooks, Anganwadi
helpers, m anufacturing units, etc.)
Interventions to facilitate access and transition
• Accenture, ICICI B ank,, Costa Coffee, JW Marriott train
• Time-‐bound monthly stipend for sanitation w orkers m igrating
and hire people w ith disabilities ( PWDs)
to lower-‐paying (but safer) jobs • CSOs like Enable India give employability training to PWDs
• Integrating S Ws into skilling programs for S cheduled Castes and • Babajobs provides blue-‐collar jobs through telephony and
those under NULM; better targeting through S W registry apps for various m ultilingual job seekers
• Recruitment helpline for sanitation w orkers for information on:
o Available employment opportunities or networks w hich SUCCESS ENABLERS
provide employment opportunities • Identifying target segments w ithin sanitation w orkers
o Livelihood schemes who are better placed for jobs
• Identifying local employment opportunities and being
o Processes for application able to m atch them w ith w orker skills and aptitudes
• Building the case for corporates to hire from the pool
Funding figure is a high level estimate to indicate scale of funding; Source: (1): Inclusivity in corporate culture – hiring persons with disabilities: How to 106
enable the differently-‐abled, Financial Express, 2017; Dalberg analysis
[Progression] Enabling Entrepreneurship
Will provide workers with the tools and support needed to realise business opportunities
DESCRIPTION WORKERS IMPACTED (<25%)

Within sanitation Types of w ork
• First preference given to sanitation w orkers to become
sanitation entrepreneurs w hen m echanising a process
3. Employment nature Contractual (permanent unlikely to
Collective employment outside sanitation move out)
4. Personas
• Collective employment groups ( SHGs) supported w ith: Reluctant inheritor
o Capacity building and m entorship from CSOs
o Financing ( particularly pooled small ticket size loans) and SIMILAR INITIATIVES1
subsidies for raw m aterials, land, etc. • NSKFDC is piloting collective m anufacturing schemes that
o Guaranteed purchase agreements by corporates or govt. give funds and training to sanitation w orkers via local CSOs
Individual businesses outside sanitation • HMWSSB provided manual scavengers w ith the option of
owning m ini-‐jetting m achines; subsidised loans from S BI
• Single-‐window, fast-‐track clearance based on S W id for small • Usha International provided technical training and sewing
ticket-‐sized loans machines to former m anual scavengers in Ujjain, former
• Make m icro loans m ore accessible, decrease transaction costs manual scavengers produced agarbattis for ITC
of availing loans
• Broader list of income-‐generating activities that qualify for SUCCESS ENABLERS
rehabilitation loans; allow activities that are feasible in local • Partnerships w ith financial institutions and corporates
areas such as dairy farming, fisheries, etc. • Availability of CSOs to facilitate and support businesses
• Potential integration w ith existing schemes ( e.g., NULM)
Funding figure is a high level estimate to indicate scale of funding; HMWSSB: Hyderabad M etropolitan Water Supply and Sewerage Boar; S ource: (1) Expert 107
interviews; Dalberg analysis
[Progression] Breaking the Family Legacy
Will provide children of workers with lucrative livelihood opportunities

Sources of non-‐WASH job opportunities 1. Types
Types of workEmployerAll Gender
of w ork
• Incentives to companies for skilling and hiring children of 2. Gender Male and F emale
sanitation workers; provisions such as tax rebates or 3. Employment nature Contractual and Permanent
qualification of spend as CSR can be provided as incentives
4. Personas Reluctant inheritor, Complacent
• Reservations for jobs for sanitation w orkers in non-‐WASH part-‐timer, Trapped traditionalist
sectors ( public sector units, m id-‐day m eal cooks, Anganwadi and F irst-‐among equals
helpers, m anufacturing units, etc.)
Interventions to facilitate access and transition
SIMILAR INITIATIVES1,2
• Integrating children of sanitation workers into skilling
programs for S Cs and for youth under NULM • Magic B us India F oundation has a Childhood to Livelihood
program (8-‐18 years) w ith a structured curriculum and
• Recruitment helpline for children of sanitation w orkers for uses sports and activities to provide soft-‐skills training
information on available opportunities, schemes and processes • All Magic B us children complete school till Class 12 and
• Education educational loans and scholarship programs, 80% of youth in the programme get employment
including funding for:
SUCCESS ENABLERS
o Tuition fee ( secondary school, higher education)
o Materials ( books, uniforms, stationery, etc.) • Building the case for corporates to hire from the pool
• Modify existing schemes for children of sanitation
o Transport
workers, to m ake them m ore favourable
• Post-‐scheme tracking of w orkers’ children
Level of ownership Timeframe for implementation Funding required
Funding figure is a high level estimate to indicate scale of funding; (1): Board this ‘bus’ and equip yourself with soft skills, June 2016; From childhood to 108
livelihood: Magic Bus is taking children in a new direction, one child at a time, October 2017; S ource: Dalberg analysis
[Cross-‐cutting enablers] Improving Access to SC Schemes and Benefits
Will lead to improved social welfare and integration in society
Types of w ork
1. Types of workEmployerAll
o SC certificate camps to provide sanitation w orkers w ith
certificates w ithin a short-‐period of time such as a day or 2. Gender Male and F emale
a w eek 3. Employment nature Contractual and Permanent
o Sanitation worker IDs to suffice for availing SC schemes,
if the w orker does not have an S C certificate SIMILAR INITIATIVES
• No direct comparable but Aadhaar is used for availing

o Information dissemination on various S C related schemes benefits under schemes such as cooking gas subsidy,
for education, livelihoods, financing, etc. scholarships, MNREGA, etc.; similarly, for sanitation
workers, their w orker ID can be the basis for availing S C
benefits and schemes
SUCCESS ENABLERS
• Will need to be m anaged politically sensitively, as others

without S C certificates m ight also m ake such demands
• Increased capacity to service sanitation w orkers
• Efficient process to m inimise delays
109
Funding figure is a high level estimate to indicate scale of funding; Source: Dalberg analysis
[Cross-‐cutting enablers] Regulatory Revisions
To plug gaps in the current MS Act and create worker-‐centered schemes

• Detailed multi-‐stakeholder review of Prohibition of 1. Types
Types oof f wwork
ork All
Employment as Manual S cavengers and their R ehabilitation Employer Gender
Act, 2013 ( details in the following slide) 2. Gender Male and female
o Identify and plug loopholes (e.g., Manual cleaning of 3. Employment nature Contractual and Permanent
sewers illegal except w hen “absolutely necessary, w ith 4. Personas All personas
officials’ approval”)
o Increase scope of manual scavenging to include other SIMILAR INITIATIVES1
forms of “unsafe sanitation work” – street sweepers,
PT/CT cleaners, etc. • UMC created an action plan to conform to the MS Act 2013 for
Ahmedabad Municipal Corporation; developed SOPs for faecal
o Mandate creation of detailed and context-‐specific SOPs sludge m anagement for Ahmedabad
for all kinds of sanitation w ork • Administrative S taff College of India ( ASCI) w ith the HMWSSB
o Articulate accountability of local authorities – mention has specified SOPs for sewer cleaning in accordance to 2013
actions to be taken on implementing authority for non-‐ Act
compliance w ith the Act • Chairman of the NCSK has raised the issue of m aking itself a
statutory or constitutional body (Nov, 2017)
• Fast-‐track processing of pending court cases
• User-‐centred design of schemes and processes to avail the SUCCESS ENABLERS
schemes. Can be facilitated through-‐:
• Developing a common understanding of unsafe sanitation w ork
o Human-‐centred design based playbook for government and w orkers to m ake relevant legal amendments and policies
and CSOs • Benchmarking other emerging m arkets ( with similar contexts)
o Prototyping budget for testing and refining schemes and other industries w hile devising policy
<1 year 1-‐3 years 3-‐5 years Low Medium High

City State National <INR 100M INR 100M – 1B >INR 1B
Funding figure is a high level estimate to indicate scale of funding; S ource: (1): Expert interviews; (2): National Commission for Safai Karamcharis Suggests 110
NITI Ayog to Bring Some of The Welfare S chemes for Safai Karamcharis and Manual S cavengers Under Its Purview, Business Standard, 2017; Dalberg analysis
[Cross-‐cutting enablers] Safe Sanitation Public Awareness Campaign
Will spur government action and mobilise public support for sanitation workers

Well publicised (regional and national) campaign on an ongoing Types of w ork
basis. The campaign could cover, among other things:
• Types of sanitation w ork and w orking conditions
• Issues faced by w orkers ( financial, social and health)
• Interventions required to address the above
• Interventions and pilots being implemented
• Recognition of impactful w ork in the space
• NDTV focused on m anual scavenging in its S wachh
• Safety and livelihoods status of w orkers Cleanathon; brought celebrities to speak about the issue
• U.S. govt. released a 3-‐months “Tips F rom F ormer
o Smokers” anti-‐smoking campaign featuring stark images
360 media coverage:
and emotional pleas from ex-‐smokers led to 200,000
• News ( print and online): Informational reporting on govt. people quitting smoking ( 2012)
initiatives, innovations, w orker deaths • Media has played a key role in catalyzing adoption and
• Television: F ocused campaigns on the topic, featuring usage of toilets as part of the S BM
influencers and personalities ( film stars, cricketers, etc.)
• Film: Mini-‐documentaries SUCCESS ENABLERS
• Social m edia: Amplifying the buzz created by other m ediums • Sustained commitment from m edia houses
• Training of journalists to ensure they understand the issue
correctly, and are able to cover it smartly
Funding figure is a high level estimate to indicate scale of funding; Source: (1) CDC: More than 200,000 Americans quit smoking after graphic ad campaign, 111
Washington Post, 2013; Dalberg analysis

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Sanitation

worker safety and livelihoods in India:

The Sanitation Worker Ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

perspective as w ell as supply-­‐ worker and supply-­‐side problem

• Desk and expert research • Collaborative w orking • Discussions/ feedback sessions

Desk research Stakeholder interviews Field research

Review o f government Interactions with • Interactions with 53 workers across

• Understanding the • Scale of unsafe • Profile/ background; how they

3 Avinash Kumar WaterAid

We evaluated the 26 opportunity areas b ased o n their relative

The Sanitation Worker Ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

The Sanitation Worker Ecosystem

Types of work & scale of problem Cleaning processes

Worker challenges & personas Worker ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

Sewer cleaning • Unblocking and cleaning sewer and wastewater

9 Domestic Work • Cleaning toilets in middle-­‐high income • Urban areas

(SECC, 2011) Fecal sludge handlers

Domestic workers ~417k

Number o f sanitation workers (2017)

Septic tank cleaners ~20% ~80% ~18k

Railway workers NA 100% ~95k

CTC/PT cleaners ~10% ~90% ~178k We h ave

Drain cleaners NA 100% ~417k

Number o f sanitation workers (2017)

Sewer cleaners NA NA 100%

Septic tank cleaners NA NA 100% Women prefer

Drain cleaners coming in contact w ith faecal

400,000 ~214k ~17k

The Sanitation Worker Ecosystem

Types of work & scale of problem Cleaning processes

Worker challenges & personas Worker ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

Step 1 Step 2 Step 3 Step 4 Step 5

Step 1 Step 2 Step 3 Step 4 Step 5

Gravel P latforms (like Warangal) Concrete Apron P latforms (like Trichy)

Step 1 Step 2 Step 3

Public/Community toilet cleaning School toilet cleaning

Step 1 Step 2 Step 3 Step 4 Step 5

The Sanitation Worker Ecosystem

Types of work & scale of problem Cleaning processes

Worker challenges & personas Worker ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

• Daily wages of INR 100 – 600 in cities;

• Life expectancy o f ~50

Reluctant Complacent Caged Trapped Transient First among

Relatively new Workers, both Permanent

The Sanitation Worker Ecosystem

Types of work & scale of problem Cleaning processes

Worker challenges & personas Worker ecosystem

National Strategy For Sanitation Worker Safety & Livelihoods

Attention Direct Single job

1993 2003 2007 2011 2013 2014 2016 2017

State Government State Education Divisional Railway

(Council o f Municipal Department Board

Urban Local Body Station Health Office

Welfare and rehabilitation support to sanitation workers

National Safai • Develop and implement

• Route financial interventions

• Only 13 states complied and

Government Labour Suppliers PPP/Service Private Operators Households

perspective as w ell as supply-‐ worker and supply-‐side problem

9 Domestic Work • Cleaning toilets in middle-‐high income • Urban areas

CSOs adopting a rights-‐based approach

Sanitation workers are risk averse and wary o f self-‐employment

Leverage n on-‐government stakeholders. While government can take ownership of

Entry On-‐the-‐j ob Progression

Entry On-‐the-‐j ob Progression

Entry On-‐the-‐j ob Progression

Entry On-‐the-‐j ob Progression

5. She-‐safe 6. Issue Resolution Mechanisms

Entry On-‐the-‐j ob Progression