The lack of toilets translates into a major security concern for women.
While politicians are busy battling for credit for highlighting the importance of toilets this election season, defecating in the open continues to be a reality for a majority on the ground.
Jeetu Dhani, a non-descript village in Betul district of Madhya Pradesh, shows the mirror. Lack of awareness on sanitation and the long-winded process in availing the state government's schemes that fund building of toilets have ensured that less than half of the 250 houses there don't have toilets.
But the lack of toilets also translates into a major security concern for women.
"Girls who study in my class tell me going out to defecate is embarrassing for them and with sexual crimes on the rise in the state, they set out with a fear inside them," says Anuradhara Waghmare, a teacher.
Their concerns are not unfounded. According to a report by the National Crime Records Bureau (NCRB), Madhya Pradesh has the highest number of rape cases. Defecating in the open in isolated areas only compounds the problem as it makes women and children more vulnerable to such crimes.
"Toilets may not be a core issue in the upcoming polls but more toilets will certainly help bring down crimes against woman," says social activist Meera Anthony.
Some allege that the efforts of the BJP-led Shivraj Singh Chouhan government, which prides itself on its development-oriented policies, to ensure basic sanitation facilities have been half-hearted.
"The initiative is insufficient," says Anita Narre, who is the state government's brand ambassador for its Samagra Swachta Abhiyaan which aims at encouraging people to have toilets at home.
Ms Narre has only visited one district in the last month to as part of her campaign. The incentive of Rs 500, she says, is too meagre to cover her travel and other expenses for the trips.