We discussed the issue of "open defecation" caused by the shortage of healthcare facilities and lack of hygiene awareness in India, as well as the "Clean India Campaign" launched by the Modi government aimed at enhancing healthcare governance capabilities and alleviating healthcare pressures. Domestic and foreign scholars have conducted research on the content and impact of sports, but there is a lack of systematic research on the advantages, disadvantages, and reasons for poor results of sports. This article aims to sort out the effectiveness of exercise execution and explore the underlying reasons for the poor results.

1、 The advantages of the 'Clean India Movement'

The three major advantages of the 'Clean India Movement' were discussed: high flexibility in policy implementation, reflected in the formulation of health policy plans by national committees, flexible implementation by various regions based on actual situations, consideration of state economic conditions in fund allocation, and access to national and state government subsidies for impoverished families; The new toilet has strong research and development capabilities. Through funding projects and expert committee reviews, it has promoted the development of innovative technologies such as biogas digester toilets, portable tent toilets, and double pit composting toilets to meet the needs of different sanitary environments; Wide participation of the public, including national leaders, officials, various sectors of society, and international organizations, to improve toilet coverage through media publicity and practical actions.

2、 Shortcomings of the Clean India Campaign

The first phase of the Clean India Campaign (2014-2019) made progress in toilet construction, but there were problems such as official corruption, data falsification, insufficient budget funds, imperfect fecal treatment systems, and improper policy implementation methods. Corruption among officials and false data reporting have led to a significantly lower actual number of toilet constructions compared to claims, and a low proportion of budget funds in education investment has resulted in insufficient awareness of cleanliness. The inadequate construction of the fecal treatment system has led to environmental and health issues. The phenomenon of manual cleaning of toilets by Dalits is widespread, with health risks and discrimination issues. Government officials have implemented inappropriate policy measures, such as humiliating and harassing people who defecate outdoors, leading to a loss of public support. Although the government claims that the movement has been successful, the actual results are questionable, with low toilet usage and the continued occurrence of open defecation. Exploring these issues will contribute to the improvement of India's health policy.

3、 Reasons for the poor effectiveness of the Clean India campaign

The reasons for the poor effectiveness of the Clean India campaign are multifaceted, including the uneven distribution of water and spatial resources, insufficient government governance capacity, the influence of Indian religious philosophy, and the lack of supporting sewage treatment systems. Uneven distribution of water resources and monsoon changes make it difficult to clean and maintain toilets, especially in areas with water scarcity where on-site sanitation facilities rely on manual cleaning, making it difficult to effectively clean toilets. Urban slums have limited spatial resources, making it difficult for households to build toilets, and community toilet construction is also difficult to achieve due to spatial limitations. The inadequate governance capacity of the Indian government is manifested in the difficulty of implementing policies from top to bottom, the difficulty of forming a joint force between the central and local governments, and the insufficient budget, which makes it difficult for poor families to afford the cost of toilet construction. In Indian philosophy and religious beliefs, close proximity to natural defecation is considered normal. Under the influence of the caste system, high caste groups are unwilling to handle feces, leading to obstacles in toilet construction and maintenance. Insufficient construction of sewage treatment systems has led to sewage becoming a source of water pollution, affecting public health. These factors work together to make it difficult for the Clean India campaign to achieve the expected results.

4、 Conclusion

The 70 year healthcare reform movement in India has had poor results. After Modi's reforms, the number of toilets meets demand, but the quality, usage rate, and hygiene awareness need to be improved. Toilet cleaning and maintenance, government governance, cultural awareness, and sewage treatment systems are key factors that affect effectiveness. The fundamental issue of hygiene lies in insufficient productivity, and it is necessary to develop the economy and increase investment in toilet construction and hygiene education. The government will increase funding, improve fecal treatment, and ensure the safety of sanitation workers in the second phase of the campaign to address the previous issues. The achievements of sports depend on economic and social development as well as cultural progress, and the results of the second stage need time to be verified. The task of health reform in India is still arduous.