Nearly half the rural population (595 million) does not use toilets. It is a staggering statistic. The government has set a target to end open defecation by 2019. The emphasis is on building toilets and creating awareness through social messages. Evidence suggests that open defecation leads to child stunting, diarrhea and typhoid, among other health-related risks. Studies show that one in every 10 deaths in India is linked to poor sanitation and low-income households bear the brunt. The absence of toilets affects women and adolescent girls more. They are more vulnerable to harassment if they step outside to relieve themselves. To avoid harassment, women often reduce their intake of food and water, which can lead to digestive problems, malnutrition and dehydration. Due to lack of toilets or their maintenance, girls often skip school. Poor sanitation has serious consequences on their nutritional status. It also has significant, long-lasting repercussions on their overall, reproductive and sexual health. To address these concerns, 12 crore toilets are slated to be built under the Swachh Bharat mission. So far, only 0.95 crores have been completed. However, according to a recent nation-wide survey, not even half the existing toilets built under the mission are being used. Most public toilets are in a terrible state, leaving users to defecate in the open. As the Government progresses in its mission, it faces several hurdles. Surveyors recorded that the construction of toilets has not brought about changes in attitude. In rural areas, it was found that households were using latrines for storing grains or as general storage space. According to a study conducted by the Accountability Initiative (AI) at the Centre for Policy Research, approximately 97 percent of the money spent on the Swachh Bharat Mission between April 2015 and February 2016 was on the construction of individual household latrines. An IndiaSpend analysis of the AI study found that “information, education and communication for sanitation and hygiene accounted for 1 percent of expenditure, a three percentage point drop from 2014-15”. What is required is a total change in attitude. For India, the road ahead is rather rough. Some of the impediments include lack of clarity and motivation at the local level.