ABSTRACT
Funds to promote access to water and sanitation in developing countries are scarce and most of the investments come from the national governments and households sources, not international resources. In many of these countries, mainly in middle income countries, households are paying direct taxes to access these services, and understanding what determines their choice and motivation is fundamental to promote access to them. It has been argued that is not enough to supply a wide range of alternatives unless the individuals can recognise their benefits and sustainability. The objective of this paper is to understand the choice of sanitation technology by residents in the city of Salvador, Brazil. We propose a unique hybrid choice model that incorporates a set of latent attitudinal variables and explains how the demographic factors within a household influence choice. The substantial difference of our hybrid choice model from descriptive frameworks is that it integrates choice and latent variables (such as attitudes and preferences) allowing us to model explicitly the cognitive process that influences sanitation adoption, draw conclusions from cognitive variables associated with individuals' socio-economic and demographic characteristics, and establishes a causal pathway among these variables. The results show that the attributes of health protection, accessibility, privacy, and house modernisation were what households cared about when opting for flush toilet and sewerage connection, rather than the high cost and consequent household socio-economic status associated with them. The hybrid model is statistically consistent with these findings, and seems to fill the gap between behavioural theory and discrete choice models applied to sanitation.
Subject(s)
Choice Behavior , Models, Theoretical , Sanitation/methods , Urban Population , Adult , Brazil , Family Characteristics , Female , Humans , Male , Middle Aged , Sewage , Social Class , Surveys and Questionnaires , Young AdultABSTRACT
Amazonia is famous for high biodiversity, and the highlands of the transition zone between the Andes and the lowlands of the Amazon basin show particularly high species diversity. Hypotheses proposed to explain the high levels of diversity in the highlands include repeated parapatric speciation across ecological gradients spanning the transition zone, repeated allopatric speciation across geographic barriers between the highlands and lowlands, divergence across geographic barriers within the transition zone, and simple lineage accumulation over long periods of time. In this study, we investigated patterns of divergence in frogs of the genus Epipedobates (family Dendrobatidae) using phylogenetic and biogeographic analyses of divergence in mitochondrial DNA (1778 aligned positions from genes encoding cyt b, 12S and 16S rRNA for 60 Epipedobates and 11 outgroup specimens) and coloration (measured for 18 specimens representing nine species in Epipedobates). The majority of phenotypic and species diversity in the poison frog genus Epipedobates occurs in the transition zone, although two morphologically conserved members of the genus are distributed across the lowlands of the Amazon basin. Phylogenetic analysis reveals that there is a single highland clade derived from an ancestral colonization event in northern Peru by a population of lowland ancestry. Epipedobates trivittatus, a widespread Amazonian species, is a member of the highland clade that reinvaded the lowlands. Comparative analyses of divergence in coloration and mtDNA reveals that divergence in coloration among populations and species in the highlands has been accelerated relative to the lowlands. This suggests a role for selection in the divergence of coloration among populations and species.
Subject(s)
Anura/genetics , Genetic Variation , Genetics, Population , Phylogeny , Animals , Anura/physiology , Cytochromes b/genetics , Peru , RNA, Ribosomal , RNA, Ribosomal, 16S , Selection, GeneticABSTRACT
OBJETIVO: A tuberculose é uma das maiores causas de mortalidade no mundo, porém seus efeitos econômicos são pouco conhecidos. O objetivo do estudo foi o de estimar os custos do tratamento e prevenção da tuberculose para o sistema de saúde (público e privado) e para as famílias. MÉTODOS: O estudo foi realizado no município de Salvador, BA, em 1999. Os dados para estimação dos custos para o sistema de saúde foram coletados nas secretarias de saúde, centros de saúde e em uma entidade filantrópica. Os custos públicos e privados foram estimados pela metodologia da contabilidade de custos. Os dados de custos para as famílias foram coletados por meio de questionários e incluem despesas com transporte, alimentação e outros, bem como as perdas de renda associadas à doença. RESULTADOS: O custo médio para tratamento de um caso novo de tuberculose foi de aproximadamente R$186,00 (US$103); para o tratamento de um paciente multiresistente o custo foi 27 vezes mais alto. Os custos para o serviço público corresponderam a 65 por cento em internações, 32 por cento em tratamento e apenas 3 por cento em prevenção. As famílias comprometeram cerca de 33 por cento da sua renda com despesas relacionadas a tuberculose. CONCLUSÕES: Apesar do fato das famílias não terem que pagar por medicamentos e tratamento, dado que este serviço é oferecido pelo Estado, os custos familiares ligados a perda de rendimentos devido a doença foram muito elevados. A proporção utilizada em prevenção pelo serviço público é pequena. Um maior investimento em campanhas de prevenção poderia não somente diminuir o número de casos, mas também, levar a um diagnósticos precoce, diminuindo os custos associados à hospitalização. A falta de um sistema integrado de custos não permite a visualização dos custos nos diversos setores.
Subject(s)
Cost of Illness , Health Care Costs , Tuberculosis/economicsABSTRACT
OBJECTIVE: Tuberculosis is one the greatest causes of mortality worldwide, but its economic effects are not well known. This study had the objective of estimating the costs to the public and private healthcare systems and to families of tuberculosis treatment and prevention. METHODS: This study was made in the municipality of Salvador, State of Bahia, Brazil, in 1999. Data for estimating the costs to the healthcare system were collected from the Department of Health, healthcare facilities and a philanthropic institution. The public and private costs were analyzed using cost accounting methodology. Cost data relating to families were collected by means of questionnaires, and included data on transportation, food and other expenses, and also income losses associated with this disease. RESULTS: The average cost of treating one new case of tuberculosis was approximately US$103. The cost of treating one multiresistant patient was 27 higher than this. The cost to the public services consisted of 65% on hospitalization, 32% on treatment, and only 3% on prevention. The families committed around 33% of their income on expenses related to tuberculosis. CONCLUSIONS: Despite the fact that the families did not have to pay for medications and treatment, given that this service is offered by the State, the costs to families related to loss of income due to the disease were very high. The proportion of public service funds utilized for prevention is small. Greater investment in prevention campaigns not only might diminish the numbers of cases but also might lead to earlier diagnosis, thus reducing the costs associated with hospitalization. The lack of an integrated cost accounting system makes it impossible to visualize costs across the various sectors.