O direito humano à água e ao esgotamento sanitário como instrumento para promoção da saúde de populações vulneráveis

Responsiveness of water-sector regulation in Brazil to the Covid-19 pandemic: A view through the human rights lens

This paper provides an overview of the regulatory responses to Covid-19 from the regulatory authorities of Brazilian states. This paper aims to provide new insights into the operationalization of the human rights to water and sanitation in the Brazilian regulatory authorities' actions during a health emergency. We find that communities located in unserved areas were not mentioned in the regulatory responses, nor were people in vulnerable situations. Equity and non-discrimination principles were correlated more with economic measures. This study has also identified the absence of responses related to access to sanitation facilities, with normative contents related to the issue not appearing in the content analysis.

Food Safety Issues Related to Eating In and Eating Out

Because of growing urbanization and lack of time to prepare meals at home, eating out or getting food delivered have become common trends for many people. The consumption of food from unknown sources may impose an increased chance of contamination with microbiological hazards, especially if sanitary conditions are not met. We evaluated data from health surveillance agencies and scientific articles on foodborne diseases (FBD) reported internationally according to the exposure sites. We observed that the data are influenced by cultural, political, and socioeconomic differences. For instance, in New Zealand, Australia, United States, Denmark and India, the occurrence of FBD outbreaks was greater from foods prepared in commercial establishments and street vendors than from households. Conversely, in China, countries of the European Union and Brazil, the results are the opposite. Additionally, the pandemic imposed new eating behavior patterns, increasing delivery services and foods prepared in so-called "Dark Kitchens". The underreporting and heterogeneity of data among countries prevented a precise conclusion to the question of whether homemade foods are inherently safer than foods prepared out. Nevertheless, a lower level of development in a country influences its sanitation conditions, as well as the number of street food vendors, the search for cheaper foods, and insufficient knowledge of the population on good hygiene practices, which can all increase the chances of FBD cases.

Global occurrence of SARS-CoV-2 in environmental aquatic matrices and its implications for sanitation and vulnerabilities in Brazil and developing countries

This paper includes a systematic review of the SARS-CoV-2 occurrence in environmental aquatic matrices and a critical sanitation analysis. We discussed the interconnection of sanitation services (wastewater, water supply, solid waste, and stormwater drainage) functioning as an important network for controlling the spread of SARS-CoV-2 in waters. We collected 98 studies containing data of the SARS-CoV-2 occurrence in aquatic matrices around the world, of which 40% were from developing countries. Alongside a significant number of people infected by the virus, developing countries face socioeconomic deficiencies and insufficient public investment in infrastructure. Therefore, our study focused on highlighting solutions to provide sanitation in developing countries, considering the virus control in waters by disinfection techniques and sanitary measures, including alternatives for the vulnerable communities. The need for multilateral efforts to improve the universal coverage of sanitation services demands urgent attention in a pandemic scenario.

Barriers to Water and Sanitation Safety Plans in Rural Areas of South Africa—A Case Study in the Vhembe District, Limpopo Province

The implementation of water and sanitation safety plans (WSSP) has the potential of greatly improving the challenge of resource-limited drinking-water supplies. However, the most effective tool to make WSSP successful is understanding of the factors that contribute to hindering the implementation of these plans, specifically in rural communities. This study therefore aimed at assessing the status of basic services and determining the factors that contribute to hampering the process of WSSP in rural communities. A survey was conducted between March 2020 and March 2021 in rural communities of the Vhembe District, Limpopo Province, South Africa. The overall results indicate that poverty, unemployment, lack of access to purified water, and inadequate sanitation facilities have resulted in waterborne diseases reported within the communities and have a major impact in hindering WSSP. Other barriers observed are inequality regarding financial power, absent and degrading water and sanitation infrastructures, and lack of protection and maintenance of natural water sources. Therefore, there is a need for community members to be educated on proper behavior and perceptions towards sanitation, including working hand-in-hand with different stakeholders, men and women from communities, and different cultures and religions to overcome these barriers, so that human disease associated with water supply, wastewater reuse, and sanitation in rural communities can be alleviated.

A população indígena Xavante em Mato Grosso: características sociodemográficas relacionadas à saúde

RESUMO Objetivo Comparar indicadores sociodemográficos dos Xavante de seis terras indígenas com a população não indígena residente em áreas rurais de quatro microrregiões adjacentes. Método Estudo seccional, do tipo ecológico, com análises comparativas entre indígenas e não indígenas residentes no estado de Mato Grosso, Brasil. Compararam-se os seguintes indicadores: estrutura etária e por sexo, taxa de alfabetização, renda, condições de saneamento dos domicílios e mortalidade. Resultados Foram caracterizadas 14.905 pessoas Xavante e 78.106 pessoas não indígenas (brancas, pretas, amarelas e pardas) residentes em domicílios de área rural. A estrutura etária revelou padrões divergentes, 40,0% dos Xavantes tinham menos de 10 anos de idade, contra 15,0% dos não indígenas na mesma faixa etária. Em relação aos não indígenas, os Xavantes apresentaram maior taxa de analfabetismo (31,3% vs. 9,9%) e 84,1% dos domicílios não possuíam banheiro ou sanitário, 39,6% das pessoas Xavante não declararam renda, contra 6,5% para os não indígenas. Conclusão e implicação para a prática Os dados sobre etnia, coletados pela primeira vez por um censo, são essenciais para análises demográficas de segmentos específicos da população, e, no caso dos Xavante, revelam desigualdades em relação aos não indígenas.

The Xavante indigenous population in Mato Grosso: health-related sociodemographic characteristics

ABSTRACT Objective To compare Xavante sociodemographic indicators from six indigenous lands with the non-indigenous population residing in rural areas of four adjacent microregions. Method This is an ecological cross-sectional study, with comparative analyzes between indigenous and non-indigenous residents in the state of Mato Grosso, Brazil. Age and sex structure, literacy rate, income, household sanitation conditions and mortality were compared. Results A total of 14,905 Xavante people and 78,106 non-indigenous people (white, black, yellow and brown) residing in rural areas were characterized. The age structure revealed divergent patterns, 40.0% of Xavante were under 10 years old, against 15.0% of non-indigenous people in the same age group. Regarding non-indigenous people, the Xavante had a higher illiteracy rate (31.3% vs. 9.9%), and 84.1% of the households did not have a bathroom or toilet, 39.6% of Xavante people did not declare an income against 6.5% for the non-indigenous. Conclusion and implication for practice Data on ethnicity, collected for the first time by a census, are essential for demographic analyzes of specific segments of the population, and in the case of the Xavante, they reveal inequalities in relation to non-indigenous people.

Evaluation of the Efficiency of Basic Sanitation Integrated Management in Brazilian Municipalities

This study aims to evaluate the level of technical efficiency of companies that perform the integrated management of basic sanitation in Brazilian municipalities. A Multiple Data Envelopment Analysis (M-DEA) model was applied to estimate the performance of water supply and sewage services in 1628 municipalities covering more than 56% of the Brazilian population, identifying the factors that most influence the efficiency of the sector in the years 2008 and 2016. The M-DEA methodology is an extension of Data Envelopment Analysis (DEA) with multiple DEA executions considering all combinations of inputs and outputs to calculate efficiency scores. The methodology reduces possible biases in the selection of resources and products of the model, ability to support decision-making in favor of improvements in the sector's efficiency based on national regulatory framework. The analyses show that the companies analyzed can increase their operating results and attendance coverage by more than 60%, given the current levels of infrastructure, human and financial resources in the sector. Based on the simulation of potential efficiency gains in Brazilian basic sanitation companies, the estimates show that the coverage of the population with access to sanitary sewage would go from the current 59.9% to 76.5%. The evidence found provides indications to subsidize sanitation management in the country at the micro-analytical level, enabling a better competitive position in the sector for the integrated management of basic sanitation and its universalization in Brazil.

Sanitation conditions of indigenous and nonindigenous households in Brazil according the 2000 and 2010 national censuses

This study compares the availability of basic sanitation infrastructure in indigenous and nonindigenous household located in urban and rural areas using data from the 2000 and 2010 Brazilian National Censuses. The analyses were based on descriptive statistics and modelling with multiple logistic regression. While there was an increase in the availability of basic sanitation in Brazilian households over the decade, indigenous households continued to have worse conditions in 2010. Sewage was the sanitation service with the lowest coverage in both censuses, and indigenous households had a lower rate of sewage services than nonindigenous households did. Logistic regression results confirmed the findings of the descriptive analyses, attesting to the fact that sanitation conditions are worse in indigenous households. In some areas, such as the urban North and Southeast and rural areas of the Central-West region, the gap in basic sanitation infrastructure between indigenous and nonindigenous households increased from 2000 to 2010. This study not only indicates the less-adequate sanitation conditions in indigenous households in Brazil but also attests to the persistence of major inequalities associated with race or color in the country.

The right to water: Impact on the quality of life of rural workers in a settlement of the Landless Workers Movement, Brazil

Access to water for rural populations is vital not only for personal consumption and hygiene but also for food production, income generation and cultural practices. To deepening the understanding of this issue, this research addressed the access to water in a settlement of the Landless Workers Movement. The perspective of the Human Rights to Water and Sanitation was used as a theoretical framework, assessing how inadequate access to water impacts the quality of rural populations. A qualitative research was used, through participant observation and individual interviews with 12 rural workers, living at the Ulisses Oliveira settlement. The findings reflect that water is not sufficiently available to meet the community’s social, economic and cultural needs and that such conditions can lead to a loss of identity. Therefore, access to water must be understood in the light of its political, social and cultural dimensions and the Human Rights to Water and Sanitation can be used as an instrument to public policies.

A vigilância da qualidade da água e o papel da informação na garantia do acesso

RESUMO Este artigo teve como objetivo destacar a relevância da vigilância da qualidade da água para consumo humano no contexto do acesso à água potável, com destaque à perspectiva informacional e de comunicação como elemento fundamental para sua completude. Para tanto, aborda a questão do acesso em seu componente qualitativo, elemento fundamental à garantia de saúde, e o estabelecimento da regulação de vigilância da qualidade da água para consumo humano no mundo e no Brasil. As ações de vigilância de qualidade da água no Brasil, pautadas desde a década de 1980, são fundamentais para garantir o direito ao acesso à água. Todavia, embora ações de comunicação de resultados estejam previstas no escopo da vigilância, no sentido de dar poder aos usuários, existe uma fragilidade na produção e na comunicação que acaba por comprometer o acesso, até então, visto prioritariamente sobre a perspectiva mais dura de disponibilidade e qualidade.

[Basic sanitation and inequalities in color/race in urban households with under-five children, with a focus on the indigenous population]

This study aimed to analyze the presence of basic sanitation services in households with children under five years of age located in urban areas of Brazil, with a focus on indigenous children. This cross-sectional study was based on data from the 2010 Population Census. We calculated the rates of households with running water (public system), sewage disposal (public system or septic tanks), and garbage collection (directly or via public dumpsters). Multiple logistic regression (MLR) models were used to estimate associations between color/race and presence of sanitation services, based on odds ratios (OR). The study considered Brazil's urban metropolitan areas and stratified the results by major geographic region. Significance was set at 5%. The lowest frequencies were for sewage disposal, and all the rates were lower for indigenous people. MLR analyses included 29 comparisons (48.3%) in which households with indigenous children (compared to other color/race categories) were at a disadvantage, especially in the South of Brazil, where all comparisons were negative for indigenous households. Similar results appeared in metropolitan areas. The results thus suggest inequalities basic sanitation services based on color/race, where indigenous people are generally at a disadvantage, especially in the South of Brazil. Given the relationship between sanitation and health, as already demonstrated in the literature, these results can partly explain the low health levels in indigenous children in Brazil.

Factors associated with perceived quality of life in artisanal fishermen: a cross-sectional study

Objective

To analyze a combination of socioeconomic and demographic characteristics, chronotype, stress perception and level of physical activity with the perception of quality of life in artisanal fishermen.

Results

Several variables were associated with lower scores of quality of life domains: workload (P = 0.047), age (P = 0.01), economic class D–E (P = 0.04) and perceived stress scores (P = 0.01) for scores physical domain; workload (P = 0.03) and perceived stress (P < 0.001) for scores psychological domain; Perceived stress (P < 0.001) and age (P = 0.01) for social domain scores; economic class D–E (P = 0.03) and perceived stress (P = 0.01) for environment domain scores; perceived stress (P = 0.01) and age (P = 0.01) for general quality of life scores and; female sex (P = 0.04) and age (P = 0.02) for the score of satisfaction with quality of life.

[Inequality and discrimination in access to water and sanitation in the Belo Horizonte Metropolitan Region, Minas Gerais State, Brazil]

Access to water and sanitation services by the population of the Belo Horizonte Metropolitan Region, Minas Gerais State, Brazil, has been marked by processes of socio-spatial segregation and social exclusion. Considering the recognition, in 2010, of the human rights to water and sanitation by the United Nations, we seek to assess the adequate access to these services in the Belo Horizonte Metropolitan Region through the principle of equality and non-discrimination. We used microdata from the demographic censuses, years 2000 and 2010, from the Brazilian Institute of Geography and Statistics. We analyzed these data through descriptive and comparative statistical analysis, spatial analysis and multivariate analysis, so as to: determine the extent of the universalization of the adequate access to those services; assess the spatial dependence between municipalities regarding this access; identify and characterize possible access discrimination, by specific population groups. Results show an increase in the proportion of households with adequate access to water and sanitation services in the intercensus period; near lack spatial association, showing inequalities among the 34 municipalities of the Belo Horizonte Metropolitan Region; access inequalities among different population groups - according to household situation, income, race or color, sex and educational level - in a possible non compliance with the principle of non-discrimination.