Acesso à água e esgotos em ocupação urbana na Região Metropolitana de Belo Horizonte: efeitos na saúde, qualidade de vida e relações de gênero / Access to water and sanitation in urban occupation in the Metropolitan Region of Belo Horizonte: effects on health, quality of life and gender relations

Resumo O artigo visa compreender como ocorre o acesso à água e ao esgotamento sanitário na Ocupação Vitória e a percepção dos moradores acerca da associação entre esse acesso e as condições de saúde: aparecimento de doenças, qualidade de vida e as relações de gênero na comunidade. Trata-se de estudo qualitativo, fundamentado na imersão no trabalho de campo, empregando observação participante na Ocupação e em entrevistas com seus moradores. Observou-se a precariedade do acesso à água pela população, que ocorre por meio de ligações irregulares às redes formais, e a predominância de fossas rudimentares. A população relaciona a falta de saneamento com o surgimento de doenças infecciosas e parasitárias e impactos sobre a desigualdade de gênero. O acesso inadequado à água e esgoto impacta a qualidade de vida da comunidade ao comprometer a produção de alimentos agroecológicos e as práticas culturais e identitárias. A informalidade do assentamento se traduz em maior vulnerabilidade social e maior exposição da população a efeitos sobre sua saúde, principalmente de mulheres e crianças.

Abstract The article aims to understand how access to water and sanitation occurs in the Vitória Occupation and the residents' perception of the association between this access and health conditions: the emergence of diseases, quality of life and gender relations in the community. This is a qualitative study, based on immersion in fieldwork, employing participant observation in the Occupation and in interviews with residents of the Occupation. It was observed the precariousness of access to water by the population, which occurs through irregular connections to formal networks, and the predominance of rudimentary septic tanks. The population relates the lack of sanitation with the emergence of infectious and parasitic diseases and impacts on gender inequality. Inadequate access to water and sewage impacts the community's quality of life by compromising the production of agroecological food and cultural and identity practices. The informality of the settlement translates into greater social vulnerability and greater exposure of the population to effects on their health, especially on women and children.

Estándares de agua, saneamiento e higiene en los establecimientos de salud, 11 de mayo del 2020 / Water, Sanitation, and Hygiene Standards in Health Care Facilities, 11 May 2020

Esta ficha contiene indicadores y estándares mínimos necesarios para la respuesta a la emergencia en los siguientes temas: cantidad de agua, acceso al agua, calidad del agua, saneamiento, higiene, residuos sólidos, limpieza y desinfección, así como dosificaciones para la preparación de soluciones desinfectantes utilizando hipoclorito de sodio.

This technical note contains indicators and minimum standards necessary for emergency response in the following topics: quantity of water, access to water, quality of water, sanitation, hygiene, solid waste, cleaning and disinfection, as well as dosages for the preparation of solutions disinfectants using sodium hypochlorite.

Relatório de Avaliação Rápida da Situação de Saúde -Moçambique: Implementação piloto do novo quadro da OMS para apoiar o Desenvolvimento de Estratégias de Saúde Pública na Mineração Artesanal e de Pequena Escala de Ouro no Contexto da Convenção de Minamata sobre Mercúrio / Rapid Health Situation Assessment Report -Mozambique: Pilot Implementation of the New WHO Framework to Support the Development of Public Health Strategies in Artisanal and Small-Scale Gold Mining in the Context of the Minamata Convention on Mercury

A Mineração Artesanal e de Pequena Escala de Ouro (MAPEO) é, em termos gerais, a exploração de pequenos depósitos de ouro por indivíduos, pequenos grupos ou pequenas cooperativas (1). A MAPEO é, geralmente, um trabalho intensivo com nenhuma ou limitada mecanização, e pode ter baixos índices de recuperação. O sector é geralmente caracterizado por baixos níveis de capital, produtividade, segurança ocupacional e acesso limitado aos mercados de terra e comércio. A MAPEO é praticada em mais de 70 países em todo o mundo. Estima-se que 10-15 milhões de pessoas estejam envolvidas na MAPEO, incluindo 4-5 milhões de mulheres e 1 milhão de crianças, enquanto outros 80 a 100 milhões de meios de subsistência de pessoas estão afectados pela MAPEO (2, 3). A MAPEO é uma actividade importante em muitos países em desenvolvimento, uma vez que representa uma fonte primária e adicional de renda, particularmente em regiões rurais onde as alternativas económicas à agricultura são limitadas. Estima-se que o sector de MAPEO contribua com cerca de 25% da produção global de ouro (2)

Saneamiento / Sanitation

A nivel mundial, 2400 millones de personas carecen de acceso a servicios de saneamiento mejorados. El Grupo Banco Mundial se compromete a responder a los desafíos en materia de saneamiento, tales como eliminar la práctica de la defecación al aire libre y mejorar la prestación de servicios.

Guidelines on sanitation and health / Guías para el saneamiento y la salud / Lignes directrices relatives à l'assainissement et à la santé

Safe sanitation is essential for health, from preventing infection to improving and maintaining mental and social well-being. The lack of safe sanitation contributes to diarrhoea, a major public health concern and a leading cause of disease and death among children under five years in low- and middle- income countries; poor sanitation also contributes to several neglected tropical diseases, as well as broader adverse outcomes such as undernutrition. Lack of access to suitable sanitation facilities is also a major cause of risks and anxiety, especially for women and girls. For all these reasons, sanitation that prevents disease and ensures privacy and dignity has been recognized as a basic human right. Sanitation is defined as access to and use of facilities and services for the safe disposal of human urine and faeces. A safe sanitation system is a system designed and used to separate human excreta from human contact at all steps of the sanitation service chain from toilet capture and containment through emptying, transport, treatment (in-situ or off-site) and final disposal or end use. Safe sanitation systems must meet these requirements in a manner consistent with human rights, while also addressing co-disposal of greywater, associated hygiene practices and essential services required for the functioning of technologies.

El saneamiento seguro es esencial para la salud, desde la prevención de la infección hasta la mejora y el mantenimiento del bienestar mental y social. La carencia de saneamiento seguro contribuye a la diarrea, una de las mayores preocupaciones de salud pública y una de las principales causas de enfermedad y muerte entre los niños menores de cinco años en los países de ingresos bajos y medios; el saneamiento deficiente también contribuye a la aparición de varias enfermedades tropicales desatendidas y al surgimiento de resultados adversos más amplios, como la desnutrición. La falta de acceso a instalaciones de saneamiento adecuadas, también es una de las principales causas de riesgo y ansiedad, especialmente para las mujeres y las niñas. Por todas estas razones, el saneamiento que previene la enfermedad y garantiza la privacidad y la dignidad ha sido reconocido como un derecho humano básico. El saneamiento se define como el acceso y uso de instalaciones y servicios para la eliminación segura de la orina y las heces humanas. Un sistema de saneamiento seguro es un sistema diseñado y utilizado para evitar el contacto de las excretas humanas con las personas, en todas las etapas de la cadena de servicios de saneamiento, desde la contención en el inodoro, hasta el vaciado, transporte, tratamiento, (in situ o fuera del sitio) su recepción en los inodoros y su contención a través del vaciado, transporte, tratamiento (in situ o fuera del sitio), hasta su uso y/o disposición final. Los sistemas de saneamiento seguro deben cumplir estos requisitos de manera consistente con los derechos humanos, al tiempo que abordan la codisposición de las aguas grises, l

L'assainissement sûr est essentiel à la santé, de la prévention des infections à l'amélioration et au maintien du bien-être mental et social. L'absence d'assainissement sûr contribue à la survenue de maladies diarrhéiques, lesquelles constituent un problème majeur de santé publique et la principale cause de mortalité chez les enfants de moins de cinq ans dans les pays à revenu faible ou intermédiaire ; un mauvais assainissement contribue à plusieurs maladies tropicales négligées et entraîne des effets indésirables plus généraux comme la sous-nutrition. Le manque d'accès à des installations d'assainissement appropriées est également une cause majeure de risque et d'anxiété, en particulier pour les femmes et les filles. Pour toutes ces raisons, l'assainissement qui prévient les maladies et garantit le respect de la vie privée et la dignité a été reconnu comme un droit humain fondamental. L'assainissement est défini comme l'accès et l'utilisation d'installations et de services pour l'évacuation sûre de l'urine et des excréments humains. Un système d'assainissement sûr est un système conçu et utilisé pour éviter empêcher tout contact entre les utilisateurs et les excreta à toutes les étapes de la chaîne d'assainissement à savoir de la collecte à partir des toilettes et du confinement à la vidange, au transport, au traitement (sur site ou hors site), à leur élimination ou utilisation finale. es systèmes d'assainissement sûrs doivent répondre à ces exigences tout en respectant les droits humains, prennant en compte également l'évacuation mixte des eaux usées, les pratiques d'hygiène et les services essentiels nécessaires au fonctionnement des technologies

Indonesia National Sanitation (Sanitasi Total Berbasis Masyarakat) Programme

Indonesia is the largest archipelago in the world. With population of 252 million from 360 ethnic groups, Indonesia is the fourth most populous country in the world. Reportedly, the country managed to meet the water related Millennium Development Goals (MDG) targets, however fell short of achieving ones for sanitation1. To accelerate access to basic sanitation the Government of Indonesia (GoI) launched a national sanitation programme called "Sanitasi Total Berbasis Masyarakat"2 in 2010 (henceforth referred to as the STBM programme). UNICEF Indonesia Country Office (henceforth, 'UNICEF' refers to the Indonesia Country Office unless otherwise indicated) is one of the key and longstanding partners extending support to the Government of Indonesia (GOI) for water, sanitation, and hygiene (WASH)sector. UNICEF, with assistance from Bill and Melinda Gates Foundation (BMGF) has been implementing a two-country programme i.e. Malawi and Indonesia, named 'Scaling-up and Strengthening Community Approaches to Total Sanitation', since 2013. 'UNICEF-BMGF Sanitation Programme in Indonesia' (also referred to as UNICEF support to STBM) is part of this cross-regional partnership. Initially, the programme was planned for three (03) years i.e. 2013-15, however later extended for two more years i.e. November 30, 2017. UNICEF-BMGF Sanitation Programme in Indonesia (2013-17) is object of this 'Endline or End of Programme Evaluation'. The readers may note that it is titled as 'Endline Evaluation Survey' in the evaluation TORs, however this remains an 'End of Programme or Ex-post Evaluation'. The report offers an overview of the 'National STBM Programme', which this UNICEF-BMGF programme set out to strengthen and accelerate delivery.

Social and Financial Incentives for Overcoming Collective Action Problems

We study the effect of social and financial incentives on communities' ability to overcome collective action problems. Our specific context is a sample of 107 villages (approximately 19,000 households) in rural Bangladesh, and the collective action problem we study is investment in hygienic latrines and their subsequent maintenance and use. We randomized (1) whether and what type of incentive was provided ­ a financial reward or a non-financial "social recognition" reward, and (2) whether and what type of verbal commitment the households were encouraged to make ­ a private pledge vs. a public pledge. We measure short-term (3 months) and medium-term (12-15 months) effects, and investigate the mechanisms behind the effects.

Promoting handwashing and sanitation behaviour change in low-and middle-income countries: a mixed-method systematic review

This systematic review shows which promotional approaches are effective in changing handwashing and sanitation behaviour and which implementation factors affect the success or failure of such interventions. The authors find that promotional approaches can be effective in terms of handwashing with soap, latrine use, safe faeces disposal and open defecation. No one specific approach is most effective. However, several promotional elements do induce behaviour change. Different barriers and facilitators that influence implementing promotional approaches should be carefully considered when developing new policy, programming, practice, or research in this area.

Community toilet use in slums: willingness to pay and the role of informational and supply side constraints

The study explores the role that informational constraints and inadequate facilities play in driving the willingness to pay (WTP) for access to community toilets and their use in the context of Indian slums.

The effects of improved sanitation on diarrheal prevalence, incidence, and duration in children under five in the SNNPR State, Ethiopia: study protocol for a randomized controlled trial

Diarrhea is one of the leading causes of death, killing 1.3 million in 2013 across the globe, of whom, 0.59 million were children under 5 years of age. Globally, about 1 billion people practice open defecation, and an estimated 2.4 billion people were living without improved sanitation facilities in 2015. Much of the previous research investigating the effect of improved sanitation has been based on observational studies. Recent studies have executed a cluster-randomized controlled trial to investigate the effect of improved sanitation. However, none of these recent studies achieved a sufficient level of latrine coverage. Without universal or at least a sufficient level of latrine coverage, a determination of the effect of improved latrines on the prevention of diarrheal disease is difficult.

Creating a toilet habit

Public health externalities from unhygienic sanitation remain a significant development challenge, even in areas where hygienic latrines are accessible or affordable. Our partner, Sanergy has created a network of hygienic latrines in Nairobi. However, as with many other technical solutions to a range of development problems, widespread adoption of this "clean toilet" option has been a challenge. Barriers such as distance, cost, long queues, or lack of understanding of health risks may preclude individuals from choosing the sanitation option that may be better from a public health point of view. We also hypothesize that behaviors like open defecation may persist because they represent ingrained habits that are difficult to change. Inspired by findings from psychology and neuroscience, we propose field experiments that are designed to instill a revised habit of community toilet use among the slum population of Nairobi. Habit loops have been successfully created by private sector firms to increase demand for many household products and behaviors such as brushing regularly with Pepsodent toothpaste, or spraying Febreze air freshener. We propose to create such a loop for Sanergy toilets using a combination of economic incentives and a marketing campaign that is attentive to psychological cues and rewards. The experiments are designed to separate habit formation from other closely related models of risk aversion and learning.

Sanitario seco: una alternativa para el saneamiento básico en zonas rurales / Dry toilets: a means of alternative sanitation

Objetivo Evaluar el uso de sanitario seco en una zona rural en Colombia. Método Por conveniencia se seleccionaron quince familias ubicadas en zona rural de un municipio de Cundinamarca. Con su acompañamiento se incorporó un elemento demostrativo en una de las viviendas durante cinco meses y se hizo una evaluación ex-post acerca de los aspectos técnicos y económicos asociados a su utilización. Resultados El sanitario seco posee facilidad constructiva y muestra ventajas ambientales asociadas a menor contaminación de fuentes hídricas y menor uso de fertilizantes químicos. En el municipio estudiado los costos de su construcción y funcionamiento pueden representar un ahorro equivalente a $616973456 (U$308487), frente a los sanitarios convencionales. Se encontraron barreras culturales para su utilización. Discusión En muchos países existe en el sector rural un gran porcentaje de hogares que no cuentan con un sistema de alcantarillado para disponer los residuos humanos, lo cual genera desafíos importantes a nivel de salud ambiental y el cuidado de los ecosistemas. La alternativa propuesta es una solución ambientalmente aceptable desde la perspectiva técnica y económica, sin embargo y para que alcance la cobertura necesaria para generar un impacto relevante, deben trabajarse los factores de tipo social y cultural que generan percepciones y prejuicios sobre el manejo de excretas.(AU)

Objective Evaluating dry toilet use in a rural area of Colombia. Method Fifteen families were selected by convenience sampling from the rural area of a municipality in the Cundinamarca department in Colombia. A dry (composting) toilet was installed in one house and used for demonstration purposes over a five-month period. An ex-post evaluation was made concerning technical and economic matters. Results A dry toilet is easy to construct/install and has environmental benefits associated with less contamination of water sources reduction and a reduced amount of chemical fertilizer. Dry toilets’ construction and operating costs may represent savings of Col$616973456 (US$308487) in the municipality being studied, compared to the costs involved in conventional toilet use. However, cultural barriers were found regarding their use. Discussion A large percentage of households in many countries’ rural sectors do not have a sewerage system for disposing of human waste. This situation creates significant challenges regarding environmental health and ecosystem conservation. Dry toilets represent an environmentally-acceptable solution from a technical and economic perspective; however, work is required concerning social and cultural factors producing cultural perceptions and prejudices about handling excreta to provide the necessary coverage and produce a significant impact on people’s awareness.(AU)