Objective: The study contextualises the spatial heterogeneity and associated drivers of open defecation (OD) in India.
Design: The present study involved a secondary cross-sectional survey data from the fifth round of the National Family Health Survey conducted during 2019–2021 in India. We mapped the spatial heterogeneity of OD practices using LISA clustering techniques and assessed the critical drivers of OD using multivariate regression models. Fairlie decomposition model was used to identify the factors responsible for developing OD hot spots and cold spots.
Setting and participants: The study was conducted in India and included 636?699 sampled households within 36 states and union territories covering 707 districts of India.
Primary and secondary outcome measures: The outcome measure was the prevalence of OD.