India carries a significant burden of infant and child mortality, and improving sanitation is crucial to improving child survival. This study investigated the impact of the Swachh Bharat Mission (SBM), India's ambitious sanitation program, on infant and under-five mortality rates (IMR and U5MR) from 2011 to 2020.

- The researchers used data from 35 Indian states and 640 districts, analyzing changes in IMR, U5MR, and toilet access over time.

- They employed two-way fixed effects regression models to control for confounding factors and estimate the association between toilet construction and child mortality.

- The study found a strong inverse association between increased toilet access and child mortality in India.

- Districts with over 30% of households receiving toilets under SBM saw a 5.3 lower IMR and a 6.8 lower U5MR.

- The study also used placebo, falsification, and robustness checks to support these findings.

Improved sanitation programs, such as the Swachh Bharat Mission (SBM), can significantly enhance population health, especially in developing countries.

India's decrease in infant and child mortality rates after implementing SBM indicates that widespread access to toilets may have prevented between 60,000 and 70,000 infant deaths each year.

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